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Public Health Nutr. 2010 Dec;13(12):2097-104. doi: 10.1017/S1368980010001667. Epub 2010 Jun 25.

Breast-feeding in a complex emergency: four linked cross-sectional studies during the Bosnian conflict.

Author information

1
Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Mexico.

Abstract

OBJECTIVE:

To examine changes in breast-feeding and impacts on child health during the Bosnian conflict.

DESIGN:

Four linked representative cross-sectional household surveys, 1994 to 1997.

SETTING:

The countries of former Yugoslavia largely missed the international wave of enthusiasm for breast-feeding of the 1980s and early 1990s. The concern is that breast-feeding deteriorates during humanitarian emergencies, when children need it most.

SUBJECTS:

The four surveys visited a random sample of clusters from population registers in the Federation of Bosnia and Herzegovina (BiH) and the Republica Srpska (RS). Interviewers asked about breast-feeding and other factors related to child health, and measured mid upper-arm circumference in 1123 infants aged 1-12 months.

RESULTS:

One-fifth of infants were not breast-fed at all (220/1087). Muslim and displaced children were less likely to breast-feed; 59 % of Muslim displaced children never breast-fed. Among infants in sites visited by all four surveys, there was no change in the proportion ever breast-fed and a significant increase in duration of breast-feeding and exclusive breast-feeding between 1994 and 1997. Children were breast-fed for shorter durations in male absent households, in frontline communities, the RS, and households that did not receive remittances from abroad. Non-breast-fed children and those who breast-fed for less than 4 months were more likely to be malnourished, as were those with complementary foods added either before or after their sixth month of life.

CONCLUSIONS:

If relief agencies had promoted and supported breast-feeding, this might have avoided some of the increased malnutrition that occurred during the conflict.

PMID:
20576196
DOI:
10.1017/S1368980010001667
[Indexed for MEDLINE]

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