Breastfeeding practices among Saharawi women in the Algerian refugee camps

Abstract

Background: Optimal feeding of infants and young children living under difficult conditions are important to secure their development and survival. Refugees are a particularly vulnerable group. A previous study in the refugee camps in the Algerian desert, shows that prevalence of exclusive (11%) and predominant breastfeeding (47 %) was low among children <6 months. At the same time prevalence of stunting (21 %) and wasting (8 %) were high. Objectives: To describe breastfeeding practices using the WHO indicators for assessing infant and young child feeding practices (IYCF) and other WHO recommendations. Further to explore possible differences in breastfeeding practices and prevalence of disease and breastfeeding practices and malnutrition. Methods: Data from a survey conducted in 2010 were analyzed to explore breast feeding practices. Ninety-five lactating women and their 95 children under 6 months were included in analysis. Prevalence of exclusive and predominant breastfeeding was assessed using data collected trough 24-hour recall. Results: Nine percent of the children in the study were wasted and 8 % were stunted. Two thirds of the children had been ill the previous two weeks, whereas 28 % with diarrhea and 36 % of other diseases. Sixty seven percent of the children were put to the breast within one hour of birth. Only 7 % of the children were exclusively breastfed, most of which were 0-1 months old (21 %). None of the children 4-5 months of age were exclusively breastfed. Nineteen percent of the children were predominantly breastfed, with prevalence declining with child’s age. Seventy-four percent of the children were breastfed at least 6 times every day, and 99 % at least once a night. Most of the children (86 %) were breastfed on demand. Some of the children (22 %) were given prelacteal feeds. Three out of four were given water the previous day and 35 % were given infant formula. More of the girls (p=0.04) were breastfed frequently at night; the same were children with mothers that stayed at home (p=0.02). Children born into large households and/or households with many children were given less (p<0.00) prelacteal feeds and more were put to the breast within one hour of birth (p<0.05) than those in smaller households/fewer children. Conclusion: Prevalence of wasting and stunting, although moderate by WHO cut offs, are alarming because of the children’s young age. Poor breastfeeding practices and high prevalence of disease and under nutrition puts the children at risk of suffering lifelong consequences such as impaired mental and physical development or death. The children’s health is likely to benefit by establishing breastfeeding practices that comply with recommendations