Predictors of exclusive breastfeeding practice among migrant and non-migrant mothers in urban China: results from a cross-sectional survey

Abstract

Objective To explore and compare the predictors for exclusive breast feeding (EBF) among migrant and non-migrant mothers in China. Design A large-scale cross-sectional study. Setting 12 counties/districts were covered in China. Participants A total number of 10 408 mothers were recruited, of whom 3571 mothers of infants aged 0–5 months in urban China were used for analysis. Outcome The practice of EBF was calculated based on the foods and drinks consumed in the last 24 hours, as recommended by WHO. Results Around 30% of Chinese mothers with infants aged 0–5 months practised EBF in urban areas, with no significant difference between migrant and non-migrant mothers (p=0.433). Among the migrant mothers, factors associated with EBF included residence in big cities (adjusted OR, AOR 1.68 (95% CI 1.20 to 2.34)), premature birth (AOR 0.27 (95% CI 0.09 to 0.81)), knowledge about EBF (AOR 2.00 (95% CI 1.51 to 2.65)), low intention of breast feeding in the first month postpartum (AOR 0.59 (95% CI 0.36 to 0.97)) and mothers working in agriculture-related fields or as casual workers (AOR 1.77 (95% CI 1.18 to 2.64)). Among non-migrant mothers, in addition to similar predictors including residence in big cities (AOR 1.40 (95% CI 1.13 to 1.73)), knowledge about EBF (AOR 1.25 (95% CI 1.02 to 1.53)) and low intention of breast feeding in the first month post partum (AOR 0.46 (95% CI 0.31 to 0.70)], early initiation of breast feeding (EIBF) (AOR 1.78 (95% CI 1.35 to 2.33)) and caesarean delivery (AOR 0.74 (95% CI 0.60 to 0.89)) were also factors associated with EBF. Conclusions There was no significant difference in the prevalence of EBF between migrant and non-migrant mothers in urban China. Premature birth and maternal occupation in agriculture-related fields or casual work were distinctive factors associated with EBF for migrants, while EIBF and caesarean delivery were unique predictors for non-migrants. Trial registration number ChiCTR-ROC-17014148; Pre-results.