Socio-economic status and exclusive breastfeeding among infants in a Ugandan cross-sectional study

Nation-wide population based studies on socio-economic inequality in exclusive breastfeeding among infants is scarce in Uganda. This study examined the socio-economic inequality in exclusive breastfeeding among 1424 infants below 6 months of age in a nation-wide population based cross-sectional study. Self-reported maternal exclusive breastfeeding practice in the first six months of their last born baby`s life was the outcome of interest. Household wealth index and maternal occupation constituted the proxy measures of socio-economic status, the exposure variable of interest. The distribution of exclusive breastfeeding practice by infant-mother dyad characteristics was calculated by conducting bivariate analysis. Multivariate binary logistic regression models were then fitted to calculate the odds ratios and their corresponding 95% confidence intervals for exclusive breastfeeding by maternal occupation and household wealth index. The results showed that half of the infants were boys, close to half of their mothers were farmers, and 23% and 16.9% of the infants lived in the poorest and richest households respectively. Overall 67% of the infants were exclusively breastfed. The odds ratios for exclusive breastfeeding by maternal occupation were 0.62 (0.26-1.50) for infants whose mothers were professionals/technical/managers, 0.97(0.50-1.87) for clerical/sales, 0.78 (0.51-1.21), for Farmers, 0.72 (0.29-1.82) for Household/Domestic/Services, 0.72 (0.39-1.36) for skilled manual workers and 0.72 (0.25-2.02) for unskilled manual workers compared to infants of non-working mothers. The odds ratios for exclusive breastfeeding by household wealth index were 2.38 (1.30-4.33), for the poorest, 2.16 (1.18-3.96) poorer, 1.91 (1.10-3.48) middle, and 1.41 (0.75-2.64), for richer households compared to infants in the richest households. In conclusion, an inverse relationship was found between household socio-economic status and exclusive breastfeeding among infants below six months of age and inadequate evidence to conclude existence of an association between maternal socio-economic status and exclusive breastfeeding. Targeting exclusive breastfeeding interventions to mother-infant dyad living in affluent families might be important in reducing socio-economic inequality in exclusive breastfeeding among infants below six months of age in Uganda.