Application of the deuterium-oxide dose-to-mother technique to determine the exclusivity of breastfeeding in women in Kanye, Botswana

Abstract

Objective: The objective of the study was to determine breastfeeding exclusivity and impact on the nutritional status of mothers and infants. Design: This was an observational descriptive study. Setting: The setting was government clinics in Kanye, Botswana. Subjects: Women who gave birth to singleton healthy babies participated in the study. Method: Milk intake and breastfeeding exclusivity were determined by the deuterium-oxide dose-to-mother technique. Nutritional status was assessed using anthropometric measures (height and weight) in 56 mother-infant pairs at six weeks, and again at three and six months postpartum. Results: Mothers overestimated exclusive breastfeeding rates at all of the time points. However, according to the deuterium-oxide dose-to mother technique, at three months 61% of the mothers were exclusively breastfeeding, 13% were predominantly breastfeeding, and 27% were partially breastfeeding. At six months, none of the mothers were exclusively breastfeeding. The mean body mass index (BMI) and the percentage of body fat of the mothers in all of the groups were within the healthy range of 23.9 kg/m² and 28.3%, respectively, at six months. Mean infant weight was 6.1 ± 0.95 kg, 7.6 ± 1.28 kg and 8.4 ± 1.22 kg at three, six and nine months, respectively. Infant undernutrition based on weight for age was < − 2 standard deviation. Malnutrition was 5.2% and 1.7% at six weeks and six months, respectively. Conclusion: Contrary to reported high rates of breastfeeding in Botswana, low rates of exclusive breastfeeding were observed with the deuterium oxide dose-to-mother technique. Therefore, this technique can be applied as a reliable method of validating mothers’ reports and their recall of exclusive breastfeeding practices. In future, the application of this method would be helpful to identify challenges in infant feeding practices, policies and programmes, all of which need further prioritisation within the Botswana context.