Sociodemographic, health and pro-breast-feeding policies and programmes associated with breast-feeding duration in Latin American countries

Objective: To describe the duration of breast-feeding between 1990 and 2013 and to estimate the association between breast-feeding duration and sociodemographic, health and pro-breast-feeding policies and programmes in Latin American countries. Design: This is a cross-sectional study with data from Demographic and Health Surveys programme conducted in Bolivia, Brazil, Colombia, Peru and the Dominican Republic between 1990 and 2013. The median duration of breast-feeding was estimated by survival analysis. Information on pro-breast-feeding policies and programmes was extracted from the World on Breastfeeding Trends Initiative (WBTi) tool. The association between the duration of breast-feeding and WBTi tool score was analysed by multilevel survival regression. Setting: Nationally representative cross-sectional survey from Bolivia, Brazil, Colombia, Peru and Dominican Republic. Participants: We included children under 24 months of age, totalling 17 318 children. Results: Breast-feeding duration showed a significant increase in all countries, except the Dominican Republic. Mothers with higher schooling level (HR = 1 center dot 66; 95 % CI 1 center dot 35, 2 center dot 04), higher income (HR = 1 center dot 58; 95 % CI 1 center dot 40, 1 center dot 77) and overweight (HR = 1 center dot 14; 95 % CI 1 center dot 05, 1 center dot 23) breastfed for a shorter time. Breast-feeding in the first hour of life (HR = 0 center dot 79; 95 % CI 0 center dot 74, 0 center dot 83) was associated with increase in the duration of breast-feeding. Regarding WBTi, Peru presented the lowest score and the Dominican Republic presented the highest score. WBTi score was inversely related to the duration of breast-feeding for this set of countries (HR = 1 center dot 07; 95 % CI 1 center dot 02, 1 center dot 12). Conclusions: Mothers with better socio-economic conditions and overweight breastfed for a shorter time. Breast-feeding in the first hour was associated with longer duration of breast-feeding. In this set of countries, higher scores from WBTi tool did not result in longer duration of breast-feeding.