Trends and associated factors of bottle-feeding in Turkey: Secondary analysis of TDHS 1993-2018 data

Bottle-feeding (BoF) has many negative effects on child health and breastfeeding. In this study, we aimed to examine the trends and associated factors of bottle-feeding in Turkey. We used 1993, 1998, 2003, 2008, 2013, and 2018 Turkey Demographic Health Surveys data and the study sample consisted of the last singleton-born children under the age of three with knowledge of bottle-feeding and their mothers. 11205 (weighted 10596) mother-child pairs were included in the study. Complex sample analysis was used to analyze trends and associated factors of bottle-feeding. The 1993 and 2018 data were analyzed using the binary logistic regression method as two separate models. Bottle-feeding has been in an increasing trend from 1993 to 2013 and decreased slightly in 2018 (33.0%, 44.9%, 47.2%, 49.6%, 51.5%, and 47.9% respectively). The most significant increasing trends were in the eastern region, among the Kurds, those with a low welfare index, those with low maternal education, those with inadequate antenatal care, and infants over 6 months of age. The decrease of bottle use in educated mothers and 8 or more prenatal care recipients in 2018 is remarkable. As a result of the logistic regression analysis of the 2018 data, it was determined that the current determinants of bottle-feeding are the age of the young mother, low birth weight and the age of the child over 6 months. According to the results of the study, bottle-feeding increased the most in people with low socioeconomic status and in children over 6 months old. Prolonged bottle- feeding for up to three years has become very common. In order to reduce bottle- feeding, new programs for risk groups should be developed and existing programs should be expanded.