• Asma Yaqub
  • Sidra Gul


Background: Human milk is the natural food for full term infants and is the most appropriate milk for the human infants. The objective of the study was to determine the frequency of common reasons of failure of exclusive breastfeeding in children less than six months of age. Methods: It was a cross-sectional study conducted at Rawal institute of health sciences (RIHS) from March to October 2013. Three hundred and ten infant-mother pairs not receiving exclusive breastfeeding were included. Results: The mean infants’ age was 99.2±57.9 days and 185 (59.7%) were male infants. The average number of children in the family was 2.74±1.86, the mean monthly income was 16542±12761 rupees; 169 (54.5%) infants belonged to urban areas, 122 (39.3%) babies were low birth weight; 241 (77.7%) infants were born in the hospital; majority, i.e., 135 (43.5%) mothers were illiterate majority, i.e., 282 (91%) mothers were housewives. In only 2 (0.6%) babies the breast feeding was started within <1 hour after birth. Among the study group 246 (79.4%) were partially breastfed and 64 (20.6%) were completely bottle-fed, 90 (29%) were already started on complementary feeding and the mean age of starting complementary feeding was 4.54±0.783 months. The commonest reason of failure of exclusive breastfeeding was insufficient milk production in 289 (93.2%), working mother in 13 (4.2%) mothers, illness of baby in 2 (0.65%), illness of mother in 6 (1.9%) cases. Conclusion: The commonest reason of failure of exclusive breastfeeding was insufficient milk production in over 90% cases and was followed by working mother, illness of baby and illness of mother in the remaining.Keywords: breast feeding; exclusive breastfeeding; determinant


World Health Organization. Indicators for assessing infant and young child feeding practices. 2007. publications/2008/9789241596664_eng.pdf

Heird WC. The feeding of infants and children. In: Behrman RE, Kliegman RM, Jenson HB (Eds) Nelson Textbook of Pediatrics. 18th ed. Philadelphia: Saunders; 2008.p. 214–25

Senarath U, Dibley MJ, Agho KE. Breastfeeding practices and associated factors among children under 24 months of age in Timor-leste. Eur J Clin Nutr 2007;60:387–97.

National Institute of Population Studies (NIPS) Pakistan and Macro International Inc. Pakistan demographic and health survey 2012–2013, Islamabad, Pakistan. National Institute of Population studies and Macro international Inc. 2009. Available at:

Ibrahim S, Ansari NS. Factors associated with failure of exclusive breast feeding. J Surg Pak 2006;11(1):24–6.

Engebrestsen IM, Wamani H, Karamagi C, Seiyaga N, Tumwine J, Tylleskar T. Low adherence to exclusive breast feeding in Eastern Uganda: A community based cross sectional study comparing dietary recall since birth with 24-hour recall. BMC Pediatrics 2007;7:10.

WHO, Acceptable medical reasons for use of breast milk substitutes 2009. Available at: http://whqlibdoc.who. int/hq/2009/WHO_FCH_CAH_09.01_eng.pdf

Rapid advice: Revised WHO principles & recommendations on infant feeding in the context of HIV 2009. Available At:

Huttly SR, Morris SS, Pisani V. Prevention of diarrhea in young children in developing countries. Bull World Health Organ 1997;75:163–74.

World Health Organization. Infant and young child nutrition: global strategy on infant and young child feeding. Geneva; 2002 (Fifty fifth World Health Assembly).

Knechi GK, Channar MS, Woraich E, Baiwa SN. Patterns of Breast Feeding in Children Under two Years of Age in Bahawalpur. Pak J Med Sci 2001;17(2):94–8.

Afzal MF, Saleemi MA, Asghar MF, Manzoor M, Fatima M, Fazal M. A Study of Knowledge, Attitude and Practice of Mothers about Breast Feeding in Children

Ann King Edward Med Uni 2002;8:28–9.

Kulsoom U, Saeed A. Breast feeding practices and beliefs about weaning among mothers of infants aged 0-12 months. J Pak Med Assoc 1997;47:54–60.

Ibrahim S, Ansari NS. Factors associated with failure of exclusive breast feeding. J Surg Pak 2006;11:24–6.

Aslam S, Sultan M, FAkram F. Exclusive breast-feeding. Professional Med J 2010;17:286–90.

Agha F, Ali HS. Breast feeding; factors causing early termination. Professional Med J. 2011;18:485–8.

National Family Health Survey 3, Vol. I. Ministry of Health and Family Welfare; India: 2007.

Agampodi SB, Agampodi TC, Piyaseeli UK. Breastfeeding practices in a public health field practice area in Sri Lanka: a survival analysis. Int Breastfeed J 2007;2:13.

Oddy WH, Sly PD, de Klerk NH, Landau LI, Kendall GE, Holt PG, et al. Breastfeeding and respiratory morbidity in infancy; a birth cohort study. Arch Dis Child 2003;88:224–28.

Lucast A, Cole TJ. Breast milk and neonatal necrotizing enterocolitis. Lancet. 1990; 336:1519–23.

Blaymore Bire J, Oliver T, Ferguson A, Vohr BR. Human milk reduces outpatient upper respiratory symptoms in premature infants during their first year of life. J Perinatol 2002;22:354–9.

Duncan B, Ey, J, Holbarg CJ, Wright AL, Martinez FD, Taussig LM. Exclusive breastfeeding for at least four months protects against otitis media. Pediatrics 1993;91:867–72