Assessing Exclusive Breastfeeding Practice
Condition: Exclusive Breastfeeding; Human Milk; Breast Milk
Study type: Observational

Summary: 
      This study was a longitudinal design. The questionnaire on exclusive breastfeeding was
      administered and was validated against the deuterium oxide dose-to-mother technique to assess
      human milk intake of babies aged 3 and 6 mo.
    

Detailed description: 
      This study is a longitudinal design that aimed to assess exclusive breastfeeding (EBF)
      practices in Asian countries and to compare the agreement in EBF between maternal recall and
      the dose-to-mother technique (DTM) technique. The questionnaire on exclusive breastfeeding
      was administered and was validated against the deuterium oxide dose-to-mother technique to
      assess human milk intake of babies aged 3 and 6 mo. The study planned to recruit 30
      mother-baby pairs from each participated country. The was carried out in 7 countries in Asia,
      namely, Indonesia, Malaysia, Mongolia, Pakistan, Sri Lanka, Thailand, and Vietnam.

      Mothers were approached at child birth, to explain the project objective and obtain written
      informed consent. A screening questionnaire was administered to obtain the interest to
      participate in the study. Only mothers who intend to exclusive breastfeeding till 6 mo will
      be eligible for further information and sample collection. Isotope dosing of mothers and
      saliva sample collection were done when the baby is at 3 mo ± 1wk, when a questionnaire
      (validation questionnaire) was administered. A basal saliva sample was collected prior to
      dosing with deuterium oxide. The isotope dosing of the mother was given and saliva samples
      were collected (post-dose) on day 1,2,3,4 and days 13,14.

      The mother-baby pairs were followed up for another sample collection at 6 mo ± 1 wk and all
      procedures were repeated, including a questionnaire administration, basal sample collection,
      deuterium oxide dose administration, and post-dose sample collection. Body weight and
      height/length of mothers and infants were measured. All saliva samples were analyzed by IRMS
      or FTIR.

      Quantity of breast milk intake, non milk oral intake (NMOI) and maternal body composition
      were determined using standard assumption and formulae developed by the International Atomic
      Energy Agency (IAEA). Children with NMOI ≥ 86.6 g/day were considered as non-EBF using stable
      isotopic DTM technique. The overall agreement of EBF classification between the recall and
      DTM techniques is presented using Kappa statistic with 95% confidence interval.
    

Intervention name(s): Deuterium dose-to-mother method for assessing breastfeeding
Intervention type(s): Other
Intervention description(s): Exclusive breastfedding practice was compared between maternal recall and the deuterium dose-to-mother method.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        The participants were mother-baby pairs who were eligible according to the inclusion and
        exclusion criteria. There were recruited from hospitals, health clinics, or communities.