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National Health And Morbidity Survey 2016 : Maternal And Child Health (MCH) Volume II : Findings

5.3. INFANT AND YOUNG CHILD FEEDING

5.3.1. Introduction

Appropriate infant feeding practices are crucial for children’s survival as well as growth and
development. An important part of infant feeding practices is breastfeeding, which plays a major role
as the first protection to prevent infant from infections, besides being an ideal source of nutrients,
economic and safe. The global practice of early initiation of breastfeeding recommends that infants
should be put to the breast immediately after birth within one hour without any disruption. This practice
determined the successful establishment and durations of breastfeeding. Thus, the Malaysian
National Breastfeeding Policy 1,2 was formulated in 1993 and revised in 2006 which states that all
mothers are encouraged to breastfeed their babies exclusively with breast milk from birth until six
months of age and thereafter to continue until the child is two years old. Complementary foods should
be introduced only when the baby is six months old, and should be safe, solid, semi-solid or soft
foods (age-appropriate feeding). Meal feeding frequency and dietary diversity should fulfil minimum
acceptable diet and adequacy for both breastfeeding and non-breastfeeding children in ensuring the
children nutrition needs. 3

Therefore, in line with the UNICEF’s Multiple Indicator Cluster Survey (MICS) conducted in various
countries, this survey was also conducted in Malaysia since there are currently very limited national
population data on infant and young child feeding practices. The most recent reported population
data on infant feeding was in the National Health and Morbidity Survey (NHMS 2006) which factors
contribute to duration of mothers breastfed their infants exclusively, information on the dietary diversity
and adequacy of diet were not captured or addressed.

5.3.2. Findings

5.3.2.1. Breastfeeding

Prevalence of early initiation of breastfeeding among infants below 6 months old by
sociodemographic characteristics

The overall prevalence of early initiation of breastfeeding within one hour of birth was 65.3%
(95% CI: 61.42-68.88), initiation of breastfeeding within one day of birth was 24.3% (95% CI:
20.84-28.02), initiation of breastfeeding after one day was 6.9% (95% CI: 5.19-9.18) and
having never put the baby to the breast was 3.6% (95% CI: 2.55-5.01). The prevalence of
early initiation of breastfeeding was significantly higher among mothers from rural areas
[59.8% (95% CI: 70.79-80.42)] as compared to mothers from urban areas [75.9% (95% CI:
54.71-64.67)]. In terms of ethnicity, the highest prevalence of early initiation of breastfeeding
was among Other Bumiputeras [88.1% (95% CI: 80.62-92.93)], followed by Malays [65.4%
(95% CI: 60.69-69.84)] and the lowest among the Chinese [49.0% (95% CI: 36.42-61.67)].

In addition, the percentage of mothers who initiated early breastfeeding within one hour of
birth was among those aged 45-49 years and the lowest was among mothers aged 40-44
years old [27.1% (95% CI: 13.37-47.29)]. Comparing methods of delivery, mothers who had
vaginal delivery (assisted vaginal breech delivery) [99.5% (95% CI: 94.52-99.96)] had the
highest prevalence of early initiation of breastfeeding as compared to mothers who delivered
via Caesarean section [49.0% (95% CI: 41.03-56.93)], or other assisted methods of delivery
such as vacuum [35.2% (95% CI: 15.09-62.41)] and forceps [18.5% (95% CI: 2.23-69.41)].

1. MOH (Ministry of Health Malaysia) (2008b). Guidelines for the Feeding of Infants and Young Children, Ministry of Health Malaysia, Putrajaya
2. Indicators for Assessing Breastfeeding Practice, Report of an Informal Meeting, World Health Organisation, Geneva, 1991
3. Indicators for assessing infant and young child feeding practices, Washington D.C., USA, 2007