Predictors of exclusive breastfeeding practice among migrant and non-migrant mothers in urban China: results from a cross-sectional survey

OBJECTIVE: To explore and compare the predictors for exclusive breast feeding (EBF) among migrant and non-migrant mothers in China. DESIGN: A large-scale cross-sectional study. SETTING: 12 counties/districts were covered in China. PARTICIPANTS: A total number of 10 408 mothers were recruited, of whom 3571 mothers of infants aged 0–5 months in urban China were used for analysis. OUTCOME: The practice of EBF was calculated based on the foods and drinks consumed in the last 24 hours, as recommended by WHO. RESULTS: Around 30% of Chinese mothers with infants aged 0–5 months practised EBF in urban areas, with no significant difference between migrant and non-migrant mothers (p=0.433). Among the migrant mothers, factors associated with EBF included residence in big cities (adjusted OR, AOR 1.68 (95% CI 1.20 to 2.34)), premature birth (AOR 0.27 (95% CI 0.09 to 0.81)), knowledge about EBF (AOR 2.00 (95% CI 1.51 to 2.65)), low intention of breast feeding in the first month postpartum (AOR 0.59 (95% CI 0.36 to 0.97)) and mothers working in agriculture-related fields or as casual workers (AOR 1.77 (95% CI 1.18 to 2.64)). Among non-migrant mothers, in addition to similar predictors including residence in big cities (AOR 1.40 (95% CI 1.13 to 1.73)), knowledge about EBF (AOR 1.25 (95% CI 1.02 to 1.53)) and low intention of breast feeding in the first month post partum (AOR 0.46 (95% CI 0.31 to 0.70)], early initiation of breast feeding (EIBF) (AOR 1.78 (95% CI 1.35 to 2.33)) and caesarean delivery (AOR 0.74 (95% CI 0.60 to 0.89)) were also factors associated with EBF. CONCLUSIONS: There was no significant difference in the prevalence of EBF between migrant and non-migrant mothers in urban China. Premature birth and maternal occupation in agriculture-related fields or casual work were distinctive factors associated with EBF for migrants, while EIBF and caesarean delivery were unique predictors for non-migrants. TRIAL REGISTRATION NUMBER: ChiCTR-ROC-17014148; Pre-results.