Nadine D CoulibalyHealth Sciences Research Institute, Burkina Faso
Title: Revisiting how exclusive is exclusive breastfeeding as determined by the deuterium oxide dose-to-mother technique in a rural community of Burkina Faso
Exclusive breastfeeding (EBF) for the first 6 months is widely recommended by WHO and UNICEF as feeding practice in early infancy. This implies the choice of robust method to ascertain EBF application by mothers. In this work, we compared different methods of assessment of EBF after using the deuterium oxide dose-to-mother technique in “Vallee du Kou”, a rural community of Burkina Faso.
Forty-six mother-baby pairs were recruited and followed-up to 6 months. EBF assessments were performed through longitudinal assessment by the means of 4 cross-sectional measurements at 0-1, 2-3, 4-5 and 6 months using mother’s report (24h recall) and the deuterium oxide dose-to-mother technique (DMT). We also used the DMT data for simulating the WHO model of assessment of EBF that cumulates different age groups and the different methods were compared using the Mc Nemar Test.
The results showed that maternal report overestimated the EBF rate for 20% (p<0.001) compared to DMT. When the DMT was considered, there were an overestimation using cross-sectional measurement (36.2%, p<0.001) compared to the longitudinal measurement. Based on the WHO model applied to the DMT, we showed the WHO model overestimated the EBF for 26,9% (p<0.001) as compared to the DMT longitudinal measurement.
Taken together, the study showed that the deuterium oxide dose-to mother technique gives a more realistic estimate of EBF practice of mothers according to its definition. And the technique gives the best assessment when it’s applied using longitudinal method.
The DMT can therefore be used as a routine method for the assessment of EBF during the nutritional surveys or intervention programs.
Nadine Coulibaly works as a research engineer in the Department of Biomedical Sciences and Public Health of the Institute for Research in Health Sciences (IRSS). She is responsible for the nutrition laboratory at the Regional Directorate of Bobo-Dioulasso. She has 12 years of experience in the use of the stable isotope technique, more specifically in the evaluation of breastfeeding and the measurement of body composition using the deuterium dilution method. She is finalizing her PhD thesis in nutrition.