Trends and factors associated with breastfeeding in Thailand : a secondary analysis of the multiple indicator cluster survey 2005-2016

Abstract

This cross-sectional study was based on secondary data of Thailand Multiple Indicator Cluster Survey (MICS round 3, 4 and 5) between 2005 and 2016 and aimed to identify trends and factors associated with breastfeeding in Thailand. Subjects were selected from the three MICS surveys and then pooled together to form final weighted samples of 9757 children under 2 years for studying early initiation of breastfeeding and 2568 children under 6 months for exclusive breastfeeding. Univariate and multivariate logistic regression analyses were applied to identify trends and factors. Results indicated that the overall breastfeeding rates were low in spite of an overall slight increase in early initiation of breastfeeding from 27.4% in 2005-2006 to 36.7% in 2015-2016 and a significant rise in exclusive breastfeeding from 6.3% to 27.1% during the decade in Thailand. Factors positively associated with early initiation of breastfeeding (p < 0.05) were north (adjusted OR = 1.530) and south regions (adjusted OR = 1.857), age of child (adjusted OR = 1.008), children ever born (adjusted OR = 1.175), average size of child at birth (adjusted OR = 1.180), and weight of child at birth (adjusted OR = 1.217), while negatively associated factors consisted of age of mother (adjusted OR = 0.973), fourth wealth index quintile (adjusted OR = 0.855), primary (adjusted OR = 0.568), secondary (adjusted OR = 0.706) and higher (adjusted OR = 0.504) education levels of mother, delivered in non-public medical sector (adjusted OR = 0.550), times of received antenatal care (adjusted OR = 0.984), and caesarean section (adjusted OR = 0.448). By contrast, factors found positively related to exclusive breastfeeding (p<0.05) included rural area (adjusted OR = 1.417), north (adjusted OR = 2.948) and northeast regions (adjusted OR = 1.551), age of mother (adjusted OR = 1.023), , female child (adjusted OR = 1.527), Richest wealth index quintile (adjusted OR = 1.675), mothers with secondary educational level (adjusted OR = 3.867), and children ever born (adjusted OR = 1.171), while negatively associated factors included age of child (adjusted OR = 0.637), delivered in non-public medical sector (adjusted OR = 0.621), weight of child at birth (adjusted OR = 0.518), times of received antenatal care (adjusted OR = 0.924), and caesarean section (adjusted OR = 0.551). In addition, the variable of area changed from significance in unadjusted to non-significance in adjusted analysis due to the influence of such variables as region, wealth index quintile, place of delivery, size of child at birth, and children ever born. Accordingly, the researcher recommends increasing exclusive breastfeeding practice in Thailand by considering associated factors.