Use of Exclusive Breast Feeding Defenitions; a Call for Action!

Abstract

Key words: Exclusive breastfeeding, definitions, 24 hour recall method, strict definition) We read the article titled "Influence of exclusive breast feeding on occurrence, severity and recurrence of acute lower respiratory infections in preschool children" published in the Sri Lanka Journal of Child Health 1 with great interest. The observation made on the duration of exclusive breastfeeding and the low rates of six months exclusive breastfeeding was very important in our context. However, we observed that one major definition is not reported in the paper. Being a case-control study, defining the exposure under investigation is of utmost importance. The exposure studied in this paper was Exclusive Breast Feeding (EBF). But, the definition used for enumeration of EBF has not been reported in the article. The study sample included only 16 cases who were within the first six months of life. Majority were more than one year of age. Neither the most widely used WHO criteria 2 , nor the strict definition of breastfeeding according to Labbock criteria 3 seems to have been used in this study. A literature review on Sri Lankan breastfeeding studies also revealed that EBF is inadequately defined in most studies. We would like to present the most widely used definitions for enumeration of EBF in clinical and epidemiological studies.