1
|
Khanal V. Influence of breastfeeding education and support on predominant breastfeeding: Findings from a community-based prospective cohort study in Western Nepal. Health Sci Rep 2023; 6:e1548. [PMID: 37680209 PMCID: PMC10480414 DOI: 10.1002/hsr2.1548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023] Open
Abstract
Background and Aims Breastfeeding education and support have the potential to improve breastfeeding outcomes. However, there is a lack of research on the impact of breastfeeding education on predominant breastfeeding in Nepal and other South Asian countries. This study aimed to report the rate of predominant breastfeeding at the first, fourth, and sixth months of birth and examine the influence of breastfeeding promotion on predominant breastfeeding. Methods A community-based prospective cohort study was conducted in western Nepal. A total of 735 mother-infant pairs were recruited within 30 days of childbirth and followed up at the fourth and sixth months to collect data on infant feeding practices. Results The rate of predominant breastfeeding at first, fourth, and sixth months were 88.6% (N = 735), 78.2% (N = 715), and 26.3% (N = 711), respectively, showing a significant decline with infant age. Mothers who received support on breastfeeding skills (Adjusted Odds Ratio [AOR]: 2.55; 95% confidence interval [CI]: 1.73-3.75), those who received advice on keeping mother-infant together (AOR: 2.19; 95% CI: 1.14-4.22) and who had initiated breastfeeding within 1 h of childbirth (AOR: 2.55; 95% CI: 1.73-3.75), and who were educated, had higher likelihood of predominant breastfeeding at sixth month. Conclusion This study asserts a need for continuous and focused breastfeeding promotion programs to educate and support lactating mothers.
Collapse
|
2
|
Khanal V, Bista S, Mishra SR, Lee AH. Dissecting antenatal care inequalities in western Nepal: insights from a community-based cohort study. BMC Pregnancy Childbirth 2023; 23:521. [PMID: 37460948 PMCID: PMC10353079 DOI: 10.1186/s12884-023-05841-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/11/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Antenatal care (ANC) ensures continuity of care in maternal and foetal health. Understanding the quality and timing of antenatal care (ANC) is important to further progress maternal health in Nepal. This study aimed to investigate the proportion of and factors associated with, key ANC services in western Nepal. METHODS Data from a community-based cohort study were utilized to evaluate the major ANC service outcomes: (i) three or less ANC visits (underutilization) (ii) late initiation (≥ 4 months) and (iii) suboptimal ANC (< 8 quality indicators). Mothers were recruited and interviewed within 30 days of childbirth. The outcomes and the factors associated with them were reported using frequency distribution and multiple logistic regressions, respectively. RESULTS Only 7.5% of 735 mothers reported not attending any ANC visits. While only a quarter (23.77%) of mothers reported under-utilizing ANC, more than half of the women (55.21%) initiated ANC visits late, and one-third (33.8%) received suboptimal ANC quality. A total of seven factors were associated with the suboptimal ANC. Mothers with lower education attainment, residing in rural areas, and those who received service at home, were more likely to attain three or less ANC visits, late initiation of ANC, and report receiving suboptimal ANC. Furthermore, mothers from poor family backgrounds appeared to initiate ANC late. Mothers from disadvantaged Madhesi communities tended to receive suboptimal ANC. CONCLUSIONS Despite a high ANC attendance, a significant proportion of mothers had initiated ANC late and received suboptimal care. There is a need to tailor ANC services to better support women from Madhesi ethnic community, as well as those with poor and less educated backgrounds to reduce the inequalities in maternal health care.
Collapse
Affiliation(s)
- Vishnu Khanal
- Nepal Development Society, Bharatpur, Chitwan, Nepal.
| | - Sangita Bista
- Independent Public Health Consultant, Kathmandu, Nepal
| | | | - Andy H Lee
- School of Population Health, Curtin University, Perth, Australia
| |
Collapse
|
3
|
Jubayer A, Nowar A, Islam S, Islam MH, Nayan MM. Complementary feeding practices and their determinants among children aged 6-23 months in rural Bangladesh: evidence from Bangladesh Integrated Household Survey (BIHS) 2018-2019 evaluated against WHO/UNICEF guideline -2021. Arch Public Health 2023; 81:114. [PMID: 37344900 DOI: 10.1186/s13690-023-01131-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 06/12/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Appropriate Complementary feeding (CF) practices play a crucial role in determining child nutrition, growth, and development. This study seeks to examine CF practices and their predictors among children aged 6 to 23 months in rural Bangladesh according to the most recently updated WHO/UNICEF guidelines for CF. METHODS A total of 665 children aged 6 to 23 months from the Bangladesh Integrated Household Survey (BIHS) 2018-2019 dataset were analyzed. The WHO/UNICEF guidelines for CF were followed to evaluate each of the nine CF practice indicators. We also examined the effect of the child, maternal, household, and community-level factors on different CF components using multiple logistic regression analyses. RESULTS Approximately two-thirds of the children initiated complementary feeding on time (63.5%) but had zero vegetable or fruit consumption (63.2%). More than half (52.4%) and the majority (86.5%) of children had minimum meal frequency and minimum milk feeding frequency, respectively. On the other hand, the proportion of minimum dietary diversity was quite low (18.3%), as reflected in the alarming prevalence (16.3%) of minimum acceptable diet. Egg and/or flesh food, sweet beverage, and unhealthy food consumption were 23.3%, 2.5%, and 12.2%, respectively. Child age, mothers' education level, antenatal care visit, household food security, monthly household income, and place of residence were found to be associated with CF practices. CONCLUSION When compared to results obtained using the previous guideline, the new one has resulted in a lower prevalence of Introduction of solid, semi-solid, or soft foods (ISSF), Minimum dietary diversity (MDD), Minimum meal frequency (MMF), and Minimum acceptable diet (MAD). It is crucial to convey the new knowledge for better child feeding and nutrition as the country prepares to apply the new guideline.
Collapse
Affiliation(s)
- Ahmed Jubayer
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, 1000, Bangladesh.
- Bangladesh Institute of Social Research (BISR) Trust, Dhaka, 1207, Bangladesh.
| | - Abira Nowar
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Saiful Islam
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Md Hafizul Islam
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Md Moniruzzaman Nayan
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, 1000, Bangladesh
| |
Collapse
|
4
|
Sharma N, Oberoi S, Moses PM. Positive influencers for early initiation of breastfeeding. J Family Med Prim Care 2023; 12:990-995. [PMID: 37448922 PMCID: PMC10336937 DOI: 10.4103/jfmpc.jfmpc_1671_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/27/2023] [Accepted: 02/06/2023] [Indexed: 07/18/2023] Open
Abstract
Background The practice of newborns being put to the breasts soon after birth results in a reduction in neonatal mortality. Factors such as antenatal care attendance, delivery at the Baby Friendly Hospital Initiative (BFHI) facility, mode of delivery, number of children, and various socio-cultural practices are found to have a positive impact on the early initiation of breastfeeding. The present study was performed to determine the socio-demographic, maternal, and neonatal factors affecting the early initiation of breastfeeding. Methodology A hospital-based cross-sectional study was performed at the Immunization Clinic and Nursery situated in a government tertiary care hospital for assessing the pattern of breastfeeding initiation. Children born at the hospital and also those reporting to the clinic from outside were included in the study. Results Breastfeeding initiation within 1 hour after delivery was only 30%, and 9% did not initiate breastfeeding at all. About half of the reasons for not initiating breastfeeding were related to mothers, followed by 30% related to babies. Conclusion Upon regression analysis, it was found that urban residence, higher educational status of the mothers, and those mothers who were not counselled on breastfeeding during antenatal visits had higher odds of not initiating breastfeeding and that was statistically significant.
Collapse
Affiliation(s)
- Nidhi Sharma
- Department of Health and Family Welfare, Punjab Civil Medical Services, Punjab, India
| | - Simmi Oberoi
- Department of Community Medicine, GMC Patiala, Punjab, India
| | - Pidakala Mary Moses
- Department of Community Medicine, Mamata Academy of Medical Sciences, Hyderabad, Telangana, India
| |
Collapse
|
5
|
Adhikari N, Acharya K, Upadhya DP, Pathak S, Pokharel S, Pradhan PMS. Infant and young child feeding practices and its associated factors among mothers of under two years children in a western hilly region of Nepal. PLoS One 2021; 16:e0261301. [PMID: 34914802 PMCID: PMC8675745 DOI: 10.1371/journal.pone.0261301] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 11/30/2021] [Indexed: 11/18/2022] Open
Abstract
Infant and young child feeding is a key area to improve child survival and promote healthy growth and development. Nepal government has developed and implemented different programs to improve infant and young child feeding practice. However, the practice remains poor and is a major cause of malnutrition in Nepal. This study aims to identify infant and young child feeding practices and its associated factors among mothers of children aged less than two years in western hilly region of Nepal. A descriptive cross-sectional study was carried out among 360 mothers of under two years' children in Syangja district. A semi structural questionnaire was used. Data was entered in EpiData and analyzed using IBM SPSS version 21. Descriptive statistics were used to report the feeding practices and other independent variables. Bivariate and multivariate logistic regression model was used to establish the factors associated with infant and young child feeding practices. The prevalence of breastfeeding, timely initiation of breastfeeding, exclusive breastfeeding, timely initiation of complementary feeding, minimum dietary diversity, minimum meal frequency and minimum acceptable diet (MAD) were 95.6%, 69.2%, 47.6%, 53.3%, 61.5%, 67.3% and 49.9% respectively. Normal delivery (AOR 6.1, 95% CI 1.2-31.3) and higher maternal autonomy (AOR 5.2, 95% CI 1.8-14.6) were significantly associated with exclusive breastfeeding. Similarly, crop production and food security (AOR 3.8, 95% CI 1.9-7.7), maternal knowledge on MAD (AOR 2.5, 95% CI 1.0-6.2) and maternal autonomy (AOR 4.2, 95% CI 2.1-8.4) were significantly associated with minimum acceptable diet. Factors such as maternal education, maternal health services utilization, maternal knowledge, and maternal autonomy were associated with infant and young child feeding practices, which warrants further attention to these factors to reduce malnutrition.
Collapse
Affiliation(s)
- Nabin Adhikari
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal
| | | | - Dipak Prasad Upadhya
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal
| | - Sumita Pathak
- Nursing Department, Kathmandu Model Hospital, Kathmandu, Nepal
| | - Sachin Pokharel
- La-Grandee International College, Pokhara University, Kaski, Nepal
| | - Pranil Man Singh Pradhan
- Department of Community Medicine, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal
- Nepalese Society of Community Medicine, Lalitpur, Nepal
| |
Collapse
|
6
|
Teshale AB, Worku MG, Tessema ZT, Tesema GA. Prelacteal feeding practice and its associated factors among mothers having children less than 2 years of age in East Africa: a multilevel analysis of the recent demographic and health surveys. Int Breastfeed J 2021; 16:68. [PMID: 34496922 PMCID: PMC8424961 DOI: 10.1186/s13006-021-00414-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 08/24/2021] [Indexed: 11/17/2022] Open
Abstract
Background Prelacteal feeding is a major public health problem that increases the risk of morbidity and mortality in children. It also result delayed breastfeeding initiation and interferes with exclusive breastfeeding. Although numerous studies have been done on prelacteal feeding in individual East African countries, most of them did not consider community-level factors that could affect the likelihood of prelacteal feeding. This study, thus, aimed to assess the pooled prevalence and associated factors of prelacteal feeding practice in East Africa. Methods We used pooled data from the 12 east Africa countries Demographic and Health Surveys (DHS). A total weighted sample of 33,423 women was included in the final analysis. We employed multilevel logistic regression analysis to assess factors associated with prelacteal feeding practice. Finally, the Adjusted odds ratio (AOR) with 95% Confidence (CI) interval was reported and variables with p value< 0.05, in the multivariable analysis, were declared to be significant predictors of prelacteal feeding practice. Result In this study, the pooled prevalence of prelacteal feeding practice was 11.85% (95%CI: 11.50, 12.20) with great variation between countries, ranging from 3.08% (95%CI: 2.35, 3.81) in Malawi to 39.21% (95%CI: 36.36, 42.06) in Comoros. Both individual and community-level factors were associated with prelacteal feeding practice. Of the individual-level factors, home delivery, multiple birth, cesarean delivery, non-exposure to media, delayed initiation of breastfeeding, and being a small-sized baby were associated with higher odds of prelacteal feeding practice. Among the community-level factors, rural residence and higher community-level of media exposure were associated with lower odds of prelacteal feeding practice. Conclusion In this study, the pooled prevalence of prelacteal feeding is high. Both individual and community level variables were associated with prelacteal feeding practice. Therefore, individual and community-level interventions that encourage mothers to deliver in the health facility and promoting timely initiation of breastfeeding are needed to reduce prelacteal feeding practices in east Africa. Moreover, media campaigns regarding this harmful traditional practice could be strengthened.
Collapse
Affiliation(s)
- Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, University of Gondar, College of Medicine and Health Science, School of Medicine, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
7
|
Mose A, Abebe H. Prelacteal feeding practice and its determinant factors among mothers having children less than 6 months of age in Bure district, Northwest Ethiopia: a community-based cross-sectional study. BMJ Open 2021; 11:e046919. [PMID: 34475152 PMCID: PMC8413938 DOI: 10.1136/bmjopen-2020-046919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 08/18/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The main aim of this study was to assess prelacteal feeding practice and its determinant factors among mothers having children less than 6 months of age in Bure district, Northwest Ethiopia. DESIGN Community-based cross-sectional study design. SETTING Northern Ethiopia. PARTICIPANTS The present study was conducted among 621 mothers who had children less than 6 months of age in Bure district, Northwest Ethiopia, from 1 March 2019 to 30 March 2019. PRIMARY OUTCOME Mothers prelacteal feeding practice, modelled using multivariable logistic regression. SECONDARY OUTCOME Determinant factors of prelacteal feeding practice. RESULTS This study found that the prevalence of prelacteal feeding practice was 11.6% ((95% CI 9.0% to 14.2%)). Delayed initiation of breast feeding (adjusted OR, AOR=5.4, 95% CI 2.2 to 13.5), mothers who did not get counselling of breast feeding (AOR=2.9, 95% CI 1.2 to 7.2), home delivery (AOR=6.9, 95% CI 2.2 to 21.5), primiparous mothers (AOR=4.1, 95% CI 1.4 to 12.2), a newborn with history of neonatal illness (AOR=3.3, 95% CI 1.3 to 8.5) and lack of postnatal care visits (AOR=3.9, 95% CI 1.3 to 11.8) were determinant factors of prelacteal feeding practice. CONCLUSIONS Delayed initiation of breast feeding, mothers who did not get counselling of breast feeding, home delivery, primiparous mothers, newborns with a history of neonatal illness and lack of postnatal care visits were determinant factors of prelacteal feeding practice. Therefore, healthcare workers should provide a home to home health education for mothers on the merits of early initiation of breast feeding, promote institutional delivery, enhance maternal health-seeking behaviour and encourage mothers to have postnatal care visits is recommended.
Collapse
Affiliation(s)
- Ayenew Mose
- Midwifery, Wolkite University, Welkite, Ethiopia
| | | |
Collapse
|
8
|
Getnet Kassa B. Early Initiation of Breastfeeding and Its Associated Factors Among Mothers Who Delivered Vaginally in South Gondar Zone Hospitals, Northwest Ethiopia, 2020. Int J Womens Health 2021; 13:9-17. [PMID: 33442301 PMCID: PMC7797326 DOI: 10.2147/ijwh.s279698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/24/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose The early onset of skin-to-skin contact encourages the infant to breastfeed within one hour of birth. The aim of this study was to assess the prevalence of early onset breastfeeding and its associated factors among vaginal delivered mothers in hospitals in the South Gondar Zone of Northwest Ethiopia in 2020. Methods From January 12 to February 03, 2020, an institutional-based cross-sectional study was used in South Gondar Zone hospitals. A total of 356 mothers delivered by vaginal were included. Data was collected using a questionnaire administered by the interviewer and entered into version 3.1 of EpiData, and then exported to SPSS version 23.0.0. To classify factors correlated with the outcome variables, logistic regression statistical analyses were used. Results In the study area, the prevalence of early breastfeeding initiation among vaginally delivered mothers was 88.2%. Mothers who had unintended pregnancy [adjusted OR=6.00, 95% CI=2.8, 12.5], had professional guidance [adjusted OR=2.75, 95% CI=1.2, 5.6] and experience with breastfeeding [adjusted OR=1.79 95% CI=1.19, 2.68] among vaginal delivered mothers were positively correlated with early breastfeeding initiation. Conclusion The type of pregnancy and professional guidance among vaginally delivered mothers were significantly associated with early initiation of breastfeeding. Community-based education and counseling on breastfeeding for pregnant mothers and encouraging all mothers to start early breastfeeding.
Collapse
Affiliation(s)
- Bekalu Getnet Kassa
- Department of Midwifery, College of Health Science, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
| |
Collapse
|
9
|
Getnet B, Degu A, Yenealem F. Prevalence and associated factors of early initiation of breastfeeding among women delivered via Cesarean section in South Gondar zone hospitals Ethiopia, 2020. Matern Health Neonatol Perinatol 2020; 6:6. [PMID: 33298188 PMCID: PMC7724884 DOI: 10.1186/s40748-020-00121-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/25/2020] [Indexed: 12/03/2022] Open
Abstract
Background Early initiation of breastfeeding is putting the newborn to breast within one hour after birth. This study was aimed to assess prevalence of early initiation of breastfeeding and its associated factors among mothers who delivered by cesarean section in South Gondar Zone hospitals Northwest Ethiopia, 2020. Methods An institutional based cross-sectional study was employed in South Gondar Zone hospitals from June 12 to July 03, 2020. A total of 356 cesarean delivered mothers were included. Data were collected using interviewer administered questionnaire and entered in to Epi Data version 4.2 and then exported to SPSS version 23.0. Logistic regression statistical analyses were used to identify factors associated with the outcome variables. Results The prevalence of early initiation of breastfeeding among mothers who delivered by cesarean section was 51.9%. Mothers who had intended pregnancy [AOR = 2.69, 95% CI (1.34–5.38)], had professional guidance [AOR = 2.68, 95% CI (1.18–6.10)], had breastfeeding experience [AOR = 2.25, 95% CI (1.35–3.75)], and had four and above antenatal care visits [AOR = 2.20, 95% CI (1.24–3.91)] were positively associated with early initiation of breastfeeding among mothers who delivered by cesarean section. Conclusion Type of pregnancy, professional guidance, had four or more antenatal care and breastfeeding experience were significantly associated with early initiation of breast feeding among mothers who delivered by cesarean section. Community based breastfeeding education and counseling to pregnant mothers and encouraging all mothers to follow recommended ANC visit is should be recommended.
Collapse
Affiliation(s)
- Bekalu Getnet
- Department of Midwifery, College of Health Sciences, Debre Tabor University, P. Box: 272, Debre Tabor, Ethiopia.
| | - Alemu Degu
- Department of Midwifery, College of Health Sciences, Debre Tabor University, P. Box: 272, Debre Tabor, Ethiopia
| | - Fantahun Yenealem
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| |
Collapse
|
10
|
Asim M, Ahmed ZH, Hayward MD, Widen EM. Prelacteal feeding practices in Pakistan: a mixed-methods study. Int Breastfeed J 2020; 15:53. [PMID: 32513203 PMCID: PMC7278149 DOI: 10.1186/s13006-020-00295-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 05/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prelacteal feeding, the feeding a newborn substances or liquids before breastfeeding, is a common cultural practice in Pakistan, but is associated with neonatal morbidity and mortality because it delays early initiation of breastfeeding. In this study, we sought to examine the social and cultural factors associated with prelacteal feeding in Pakistan. METHODS This mixed-method study used data from the Pakistan Demographic and Health Survey (PDHS) 2012-13. Findings from the survey were complemented by qualitative interviews with mothers and healthcare providers. In a subset of PDHS dyads (n = 1361) with children (0-23 months), descriptive statistics and bivariate and multivariable logistic regression analysis examined factors associated with prelacteal feeding. The qualitative study included in-depth interviews with six mothers and six health care providers, which were analyzed using NVivo software version 10. RESULTS In PDHS, a majority of children (64.7%) received prelacteal feeding. The most common prelacteal food was milk other than breast milk (24.5%), while over a fifth (21.8%) of mothers reported giving honey and sugar water. Factors associated with prelacteal feeding included: birth at public health facilities (AOR 0.46, 95% CI 0.02, 0.95), maternal primary education (AOR 2.28, 95% CI 1.35, 3.85), and delayed breastfeeding initiation (AOR 0.03, 95% CI 0.01, 0.61). In our qualitative study, the major themes found associated with prelacteal feedings included: easy access to prelacteal substances at health facilities, deliveries in private health facilities, prelacteals as a family tradition for socialization, insufficient breast milk, Sunna of Holy Prophet, and myths about colostrum. CONCLUSIONS These data indicate that prelacteal feeding is a well-established practice and social norm in Pakistan. Policies and interventions aimed at promoting breastfeeding need to take these customs into consideration to achieve the desired behavioral changes.
Collapse
Affiliation(s)
- Muhammad Asim
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
- Department of Sociology, University of Sargodha, Sargodha, Pakistan
- Population Research Center, University of Texas at Austin, Austin, USA
| | - Zarak Husain Ahmed
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Mark D. Hayward
- Department of Sociology & Population Research Center, University of Texas at Austin, Austin, USA
| | - Elizabeth M. Widen
- Department of Nutritional Sciences & Population Research Center, University of Texas at Austin, Austin, Texas USA
| |
Collapse
|
11
|
Binns C, Lee MK, Yun Low W, Baker P, Bulgiba A, Dahlui M, Thuy Duong DT, Guldan G, Hairi N, Hokama T, Kagawa M, Karunathilake I, Abdul Majid H, Maycock B, Nanishi K, Qiu L, Raheem RA, Scott J, Tang L. Guidelines for Complementary Feeding of Infants in the Asia Pacific Region: APACPH Public Health Nutrition Group. Asia Pac J Public Health 2020; 32:179-187. [PMID: 32475150 DOI: 10.1177/1010539520931328] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Good nutrition in the first "1000 days," including breastfeeding and appropriate complementary foods, prepares for a healthy childhood and adult life, also contributes to the prevention of the double burden of malnutrition. Exclusive breastfeeding provides all required nutrients until an infant is around 6 months of age when complementary foods are needed. A literature review was undertaken of complementary foods in the Asia Pacific region. The foods being used at present are often of low nutrient density may provide insufficient amounts of some critical nutrients, and generally the variety is limited. Guidelines for complementary feeding are provided to assist in education and in public health planning.
Collapse
Affiliation(s)
- Colin Binns
- Curtin University, Perth, Western Australia, Australia
| | - Mi Kyung Lee
- Murdoch University, Perth, Western Australia, Australia
| | - Wah Yun Low
- University of Malaya, Kuala Lumpur, Malaysia
| | - Philip Baker
- Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | | | - Georgia Guldan
- University of Papua New Guinea, Port Moresby, Papua New Guinea
| | - Noran Hairi
- University of Malaya, Kuala Lumpur, Malaysia
| | | | | | | | | | - Bruce Maycock
- Asia Pacific Academic Consortium of Public Health, Kuala Lumpur, Malaysia
| | | | - Liqian Qiu
- Women's Hospital, Zhejiang University Hangzhou, China
| | | | - Jane Scott
- Curtin University, Perth, Western Australia, Australia
| | - Li Tang
- Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, China
| |
Collapse
|
12
|
Dharel D, Dhungana R, Basnet S, Gautam S, Dhungana A, Dudani R, Bhattarai A. Breastfeeding practices within the first six months of age in mid-western and eastern regions of Nepal: a health facility-based cross-sectional study. BMC Pregnancy Childbirth 2020; 20:59. [PMID: 32000701 PMCID: PMC6990469 DOI: 10.1186/s12884-020-2754-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 01/20/2020] [Indexed: 11/20/2022] Open
Abstract
Background The World Health Organization recommends initiation of breastfeeding within 1 hour of birth and exclusive breastfeeding up to 6 months of age. Infant feeding practices, including suboptimal breastfeeding practices, are associated with stunting. Rate of stunting was highest in the Mid-western region and lowest in the Eastern region of Nepal. This study aimed to assess the breastfeeding practices in these two regions, as well as to identify factors associated with partial breastfeeding. Methods We conducted a health facility-based cross-sectional study in the Mid-western and Eastern regions of Nepal from December 2017 to May 2018. Investigators administered a pre-tested questionnaire among consecutive 574 mother-infant dyads at different levels of health facilities. We dichotomized the breastfeeding pattern to partial breastfeeding and full (exclusive or predominant) breastfeeding. We conducted multivariable logistic regression to identify factors associated with partial breastfeeding within 6 months of age. Results There were 574 infants included in the study, all of which received at least some breastfeeding. Only 23.2% of infants were exclusively breastfed until 6 months, with 28.2% predominantly breastfed and 48.6% partially breastfed. Partial breastfeeding rate was 52.3% in the Mid-western region and 44.4% in the Eastern region. Breastfeeding was initiated within an hour from birth in 67.2% of infants. One-quarter of infants were given pre-lacteal feed, honey being the commonest. Knowledge of the recommended duration of exclusive breastfeeding was inadequate in 16, and 65% of mothers reported breastfeeding problems in the first 6 months. Firstborn and low birth weight infants had a significantly higher rate of partial breastfeeding. Partial breastfeeding was also higher when infants were not breastfed within 1 hour from birth, mothers reported having breastfeeding-related problems or had inadequate knowledge of the duration of exclusive breastfeeding. Conclusion Nearly half of the infants were fully breastfed at 6 months of age in Nepal. The rate of partial breastfeeding was higher with inadequate knowledge on duration of exclusive breastfeeding or late initiation of breastfeeding or perceived breastfeeding problems. Hence, programs should address knowledge and practice gaps in breastfeeding practices, particularly among mothers of low birth weight and firstborn infants.
Collapse
Affiliation(s)
- Dinesh Dharel
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, 1403 29th Street NW, Calgary, AB, T2N 2T9, Canada. .,BP Koirala Institute of Health Sciences, Dharan, Nepal.
| | | | - Sushma Basnet
- Lifeline Hospital Institute of Health Sciences, Damak, Jhapa, Nepal
| | - Swotantra Gautam
- BP Koirala Institute of Health Sciences, Dharan, Nepal.,Population Health Research Institute (PHRI), Hamilton, Canada
| | | | - Rajesh Dudani
- John H Stroger Hospital of Cook Country, Chicago, USA
| | - Asmita Bhattarai
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
13
|
Bhandari S, Thorne-Lyman AL, Shrestha B, Neupane S, Nonyane BAS, Manohar S, Klemm RDW, West KP. Determinants of infant breastfeeding practices in Nepal: a national study. Int Breastfeed J 2019; 14:14. [PMID: 30988689 PMCID: PMC6448244 DOI: 10.1186/s13006-019-0208-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 03/21/2019] [Indexed: 01/08/2023] Open
Abstract
Background Optimal breastfeeding practices, reflected by early initiation and feeding of colostrum, avoidance of prelacteal feeds, and continued exclusivity or predominance of breastfeeding, are critical for assuring proper infant nutrition, growth and development. Methods We used data from a nationally representative survey in 21 district sites across the Mountains, Hills and Terai (southern plains) of Nepal in 2013. Determinants of early initiation of breastfeeding, feeding of colostrum, prelacteal feeding and predominant breastfeeding were explored in 1015 infants < 12 months of age. Prelacteal feeds were defined as food/drink other than breast milk given to newborns in first 3 days. Predominant breastfeeding was defined as a child < 6 months of age is mainly breastfed, not fed solid/semi-solid foods, infant formula or non-human milk, in the past 7 days. Adjusted prevalence ratios (APR) and 95% confidence intervals (CI) were estimated, using log Poisson regression models with robust variance for clustering. Results The prevalence of breastfeeding within an hour of birth, colostrum feeding, prelacteal feeding and predominant breastfeeding was 41.8, 83.5, 32.7 and 57.2% respectively. Compared to infants not fed prelacteal feeds, infants given prelacteal feeds were 51% less likely to be breastfed within the first hour of birth (APR 0.49; 95% CI 0.36, 0.66) and 55% less likely to be predominantly breastfed (APR 0.45; 95% CI 0.32, 0.62). Infants reported to have received colostrum were more likely to have begun breastfeeding within an hour of birth (APR 1.26; 95% CI 1.04, 1.54) compared to those who did not receive colostrum. Infants born to mothers ≥ 20 years of age were less likely than adolescent mothers to initiate breastfeeding within 1 hour of birth. Infants in the Terai were 10% less likely to have received colostrum (APR 0.90; 95% CI 0.83, 0.97) and 2.72 times more likely to have received prelacteal feeds (APR 2.72; 95% CI 1.67, 4.45) than those in the Mountains. Conclusions Most infants in Nepal receive colostrum but less than half initiate breastfeeding within an hour of birth and one-third are fed prelacteal feeds, which may negatively affect breastfeeding and health throughout early infancy. Electronic supplementary material The online version of this article (10.1186/s13006-019-0208-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Shiva Bhandari
- PoSHAN Study Team, Lalitpur, Nepal.,2Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Andrew L Thorne-Lyman
- 3Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | | | | | - Bareng Aletta Sanny Nonyane
- 3Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Swetha Manohar
- 3Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Rolf D W Klemm
- 3Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.,4Helen Keller International, New York, NY USA
| | - Keith P West
- 3Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| |
Collapse
|
14
|
Prelacteal feeding and associated factors among mothers having children less than 24 months of age, in Mettu district, Southwest Ethiopia: a community based cross-sectional study. BMC Res Notes 2019; 12:9. [PMID: 30616665 PMCID: PMC6323699 DOI: 10.1186/s13104-019-4044-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 01/02/2019] [Indexed: 01/08/2023] Open
Abstract
Objective Despite prelacteal feeding contravenes with exclusive breastfeeding, it is a prevailing problem in Ethiopia. However, its burden and factors were not investigated in Mettu district. Therefore, the objective of our study was to conduct the burden of prelacteal feeding and its associated factors. Community-based cross-sectional study was conducted among 730 mother–child pairs. Stratified cluster sampling was used. Data were collected by face- to- face interview. Logistic regression model was fitted. Results A total of 719 mother–child pairs with a response rate of 98.5% were participated. The overall proportion of prelacteal feeding among mothers was 14.2% [95% CI (12.0, 17.0)]. No maternal education [AOR: 3.54 (95% CI 1.7, 6.98)], single ANC visits [AOR: 6.87 (95% CI 3.21, 14.73)], didn’t know risks of prelacteal feeding [AOR: 2.73 (95% CI 1.47, 5.05)], colostrums avoidance [AOR: 6.030 (95% CI 3.48, 10.46)], home delivery [AOR: 3.04 (95% Cl 1.60, 5.75] and cesarean delivery [AOR: 4.27 (95% CI 2.28, 7.99)] were significantly associated factors. Prelacteal feeding among mother–child pairs was high. Hence, increasing maternal education and institutional delivery are vital for prompt infant feeding.
Collapse
|
15
|
Azzeh FS, Alazzeh AY, Hijazi HH, Wazzan HY, Jawharji MT, Jazar AS, Filimban AM, Alshamrani AS, Labani MS, Hasanain TA, Obeidat AA. Factors Associated with Not Breastfeeding and Delaying the Early Initiation of Breastfeeding in Mecca Region, Saudi Arabia. CHILDREN-BASEL 2018; 5:children5010008. [PMID: 29301353 PMCID: PMC5789290 DOI: 10.3390/children5010008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 12/29/2017] [Accepted: 12/31/2017] [Indexed: 11/16/2022]
Abstract
The objective of the study was to find the determinants related to not breastfeeding (BF) and others related to the delay in the early initiation of BF in the Mecca region, Saudi Arabia. A cross-sectional study in the Maternity and Children Hospital and primary healthcare centers was performed. A questionnaire was filled by dietitians to 814 asymptomatic Saudi mothers. Determinants related to not BF and the delay in the early initiation of BF were determined by binary logistic regression, and the odds ratio (OR) and 95% confidence interval (CI) were determined. Significant factors associated with not BF were not rooming-in infants in the mother’s room (OR: 2.37; 95% CI: 1.66–3.41) and using a pacifier (OR: 1.62; 95% CI: 1.13–2.33). The most significant determinant of the early initiation of BF was the initiation of bottle feeding (OR: 18.16; 95% CI: 10.51–31.4), followed by not rooming-in infants in the mother’s room (OR: 2.2; 95% CI: 1.52–3.18), initiation of partial feeding (OR: 1.89; 95% CI: 1.3–2.74), uninformed mothers regarding the importance of BF (OR: 1.56; 95% CI: 1.04–2.35), and cesarean sections (OR:1.42; 95% CI: 1.02–1.98). Risk factors affecting BF and the early initiation of BF in Mecca City should be highlighted in national campaigns to increase mothers’ awareness and promote BF practice.
Collapse
Affiliation(s)
- Firas S Azzeh
- Department of Clinical Nutrition, Collage of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia.
| | - Awfa Y Alazzeh
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, University of Ha'il, Ha'il 21955, Saudi Arabia.
| | - Haifa H Hijazi
- Department of Clinical Nutrition, Collage of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia.
| | - Haneen Y Wazzan
- Department of Clinical Nutrition, Collage of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia.
| | - Monya T Jawharji
- Department of Clinical Nutrition, Collage of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia.
| | - Abdelelah S Jazar
- Department of Clinical Nutrition, Collage of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia.
| | - Amira M Filimban
- Nutrition General Department, Awareness and Nutrition Education Division, Ministry of Health, Makkah 21955, Saudi Arabia.
| | - Ali S Alshamrani
- Pediatric Department, Maternity and Children Hospital, Makkah 21955, Saudi Arabia.
| | - Mai S Labani
- Medical Nutrition Therapy Department, Maternity and Children Hospital, Makkah 21955, Saudi Arabia.
| | - Taghreed A Hasanain
- Medical Nutrition Therapy Department, Maternity and Children Hospital, Makkah 21955, Saudi Arabia.
| | - Ahmad A Obeidat
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Taibah University, Yanbu 21911, Saudi Arabia.
| |
Collapse
|
16
|
Atyeo NN, Frank TD, Vail EF, Sperduto WAL, Boyd DL. Early Initiation of Breastfeeding Among Maya Mothers in the Western Highlands of Guatemala: Practices and Beliefs. J Hum Lact 2017; 33:781-789. [PMID: 28107098 DOI: 10.1177/0890334416682729] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Guatemala exhibits the sixth highest rate of child stunting worldwide, and stunting disproportionately affects Guatemala indigenous communities. In a country struggling to combat this result of malnutrition, early child nutrition is especially critical. Specifically, early initiation of breastfeeding is important for the development of newborn infants. Understanding beliefs and practices related to early initiation of breastfeeding in Maya Guatemala may provide an avenue to guide nutrition interventions in indigenous communities. Research aim: This study aimed to determine major beliefs and practices associated with early initiation of breastfeeding among Maya mothers in Lake Atitlán, Guatemala. METHODS As part of a larger study to assess child nutrition in the Lake Atitlán region, we created a series of semistructured interview questions to document breastfeeding practices and beliefs among mothers. We conducted and audio-recorded in-person interviews that were translated from Kaqchikel, the local language, to Spanish by a community assistant. RESULTS We conducted 178 interviews with mothers; 76% practiced early initiation. Early initiation was associated with the village and complementary feeding practices. Mothers held a variety of beliefs about the value of colostrum, and these beliefs were associated with the village. Mothers who held negative beliefs toward colostrum were more likely to delay breastfeeding initiation. CONCLUSION Although most Maya mothers practice early initiation, the intervillage disparity in breastfeeding practices demonstrates a need to geographically focus breastfeeding interventions. Our novel insights into the breastfeeding beliefs among Maya mothers will serve as a guide to structure culturally competent breastfeeding education interventions in indigenous communities.
Collapse
Affiliation(s)
- Natalie N Atyeo
- 1 Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Tahvi D Frank
- 1 Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Emma F Vail
- 1 Duke Global Health Institute, Duke University, Durham, NC, USA
| | | | - David L Boyd
- 1 Duke Global Health Institute, Duke University, Durham, NC, USA
| |
Collapse
|
17
|
Majra JP, Silan VK. Barriers to Early Initiation and Continuation of Breastfeeding in a Tertiary care Institute of Haryana: A Qualitative Study in Nursing Care Providers. J Clin Diagn Res 2016; 10:LC16-LC20. [PMID: 27790473 DOI: 10.7860/jcdr/2016/19072.8559] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 04/30/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Ever increasing institutional deliveries in India has shifted the responsibility of timely initiation and continuation of breastfeeding from peripheral health workers and families to the nursing care providers of health facilities where the births take place. While institutional deliveries have increased to 72.6%, only 44.6% of the newborns enjoy early breastfeeding in India. AIM To study the barriers to early initiation of breastfeeding in institutional delivery. MATERIALS AND METHODS A total 34 nursing care providers were selected randomly and five Focus Group Discussions (FGDs) were carried out. This Qualitative Study was conducted through FGDs among the nursing care providers of a tertiary care institute in the Indian State of Haryana, India. STATISTICAL ANALYSIS The analyses continued throughout the group discussions as the newly emerged themes were tested in the subsequent discussion. FGDs transcripts were analysed to enhance the robustness of the emerged domain. RESULTS Major barriers to initiation of breast feeding identified included: lack of awareness regarding proper technique of breastfeeding and benefits of colostrum; breast abnormality like inverted/retracted nipples; obstetric/neonatal complications requiring specialised care; and cultural practices like giving pre-lacteals and gender discrimination. It was further reported that the manpower has not been rationalised with ever increasing number of institutional deliveries. The respondents though willing to promote early initiation and continuation of breastfeeding felt excessive workload as one of the major barriers due to multi-tasking nature of their job. CONCLUSION The new challenges to the early initiation and continuation of breastfeeding are emerging due to change in the place of delivery which needs to be addressed at the policy level.
Collapse
Affiliation(s)
- Jai Pal Majra
- Professor and Head, Department of Community Medicine, BPS Government Medical College for Women , Khanpur Kalan, Sonepat, Haryana, India
| | - Vijay Kumar Silan
- Assistant Professor, Department of Community Medicine, BPS Government Medical College for Women , Khanpur Kalan, Sonepat, Haryana, India
| |
Collapse
|
18
|
Khanal V, Scott JA, Lee AH, Karkee R, Binns CW. The supplemental use of infant formula in the context of universal breastfeeding practices in Western Nepal. BMC Pediatr 2016; 16:68. [PMID: 27206532 PMCID: PMC4875692 DOI: 10.1186/s12887-016-0602-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 05/11/2016] [Indexed: 11/10/2022] Open
Abstract
Background While the initiation of breastfeeding is universal in Nepal, little has been reported on formula feeding practices. This study aimed to report the prevalence of, and factors associated with, the use of infant formula as supplementary feeds in the Western region of Nepal. Methods A community-based cohort study was conducted to collect infant feeding information among 735 postpartum mothers using structured questionnaires. Complete formula feeding data were collected from 711 women in the first, fourth and sixth month postpartum. Factors independently associated with formula feeding were investigated using multiple logistic regression. Results All mothers were breastfeeding their infants at the time of recruitment. The prevalence of formula feeding was 7.5 % in the first month and 17 % in the sixth month. About a quarter of mothers (23.8 %) reported providing infant formula at least once during the first six months of life. Infant formula was used commonly as top-up food. Stepwise logistic regression showed that infants born to families residing in urban areas (adjusted odds ratio (aOR): 2.14; 95 % confidence interval (CI): 1.37 to 3.33), mothers with higher education (aOR: 2.08; 95 % CI: 1.14 to 3.80), and infants born by caesarean section (aOR: 1.96; 95 % CI: 1.21 to 3.18) were at greater risk of formula feeding. Conclusion The current findings indicate that health workers should support mothers to initiate and continue exclusive breastfeeding particularly after caesarean deliveries. Furthermore, urban health programs in Nepal should incorporate breastfeeding programs which discourage the unnecessary use of formula feeding. The marketing of formula milk should be monitored more vigilantly especially in the aftermath of the April 2015 earthquakes or other natural disasters.
Collapse
Affiliation(s)
- Vishnu Khanal
- Nepal Development Society, Bharatpur, Chitwan, Nepal.
| | - Jane A Scott
- School of Public Health, Curtin University, Perth, Australia
| | - Andy H Lee
- School of Public Health, Curtin University, Perth, Australia
| | - Rajendra Karkee
- School of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Colin W Binns
- School of Public Health, Curtin University, Perth, Australia
| |
Collapse
|
19
|
Khanal V, Lee AH, Karkee R, Binns CW. Postpartum Breastfeeding Promotion and Duration of Exclusive Breastfeeding in Western Nepal. Birth 2015; 42:329-36. [PMID: 26306895 DOI: 10.1111/birt.12184] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/30/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Encouragement and skills provided to mothers during the postpartum period have been found to be successful in increasing exclusive breastfeeding rates. However, evidence from developing countries is limited. This study aimed to ascertain whether education and skill support provided by health workers during the postpartum period were associated with increased duration of exclusive breastfeeding in Western Nepal. METHODS A community-based prospective cohort study was conducted between January and October 2014, in the Rupandehi district of Nepal. Information on breastfeeding promotion provided by health workers after birth was collected from 649 mothers. The association between breastfeeding promotion and exclusive breastfeeding was investigated using multivariable Cox regression analysis. RESULTS Of the 649 mothers, 35 percent received all eight types of breastfeeding promotion advice, and 60 percent received six or more such types of advice. Breastfeeding promotion, such as "breastfeeding on demand" (hazard ratio [HR] 0.74 [95% CI 0.59-0.92]) and "not to provide pacifier or teats" (HR 0.82 [95% CI 0.68-0.97]), were significantly associated with a lower risk of exclusive breastfeeding cessation. The dose-response relationship was also significant for the number of advices received (HR 0.94 [95% CI 0.90-0.97]). CONCLUSIONS This study provides evidence that breastfeeding education and support immediately after childbirth could increase the duration of breastfeeding. The results suggest further attention to breastfeeding promotion in all maternity hospitals and birthing centers through skilled birth attendants.
Collapse
Affiliation(s)
- Vishnu Khanal
- School of Public Health, Curtin University, Perth, Australia.,Nepal Development Society, Bharatpur, Nepal
| | - Andy H Lee
- School of Public Health, Curtin University, Perth, Australia
| | - Rajendra Karkee
- School of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Colin W Binns
- School of Public Health, Curtin University, Perth, Australia
| |
Collapse
|
20
|
Acharya P, Khanal V. The effect of mother's educational status on early initiation of breastfeeding: further analysis of three consecutive Nepal Demographic and Health Surveys. BMC Public Health 2015; 15:1069. [PMID: 26482789 PMCID: PMC4610048 DOI: 10.1186/s12889-015-2405-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 10/12/2015] [Indexed: 11/13/2022] Open
Abstract
Background The World Health Organization recommends initiating breastfeeding within the first hour of birth. This study is aimed at assessing the effect of the mother’s education on early initiation of breastfeeding. Methods Data from the Nepal Demographic and Health Surveys (NDHS) 2001, 2006 and 2011 were used which included 12,845 last born children born within 5 years before the surveys. Early initiation of breastfeeding was defined as the initiation of breastfeeding within the first hour after birth. Hierarchical modelling was used to ascertain the association of maternal education and early initiation of breastfeeding, after controlling for other covariates in a multiple logistic regression. Results Maternal education was associated with a higher likelihood of early initiation of breastfeeding in each survey. Pooled data analysis revealed higher odds of early initiation of breastfeeding among the mothers with primary education (adjusted odds ratio (OR) 1.24, 95 % confidence interval (CI): 1.09, 1.42) and secondary or higher education (OR: 1.63 95 % CI: 1.42, 1.88). In the most recent NDHS 2011 survey, odds of early initiation of breastfeeding was higher among mothers with primary education (OR: 1.52; 95 % CI: 1.21, 1.91) and mothers with secondary or higher education (OR: 2.20; 95 % CI: 1.76, 2.76) compared to mothers with no education. Similarly, the odds of early initiation of breastfeeding was higher among mothers with secondary and higher education in the 2006 data (OR: 1.66; 95 % CI: 1.30, 2.12) and in 2001 (OR = 1.30; 95 % CI: 1.00, 1.67). Conclusions As the association between a mother’s educational status and her likelihood of early initiation of breastfeeding increases, long-term approaches to prioritising education for women and girls should be explored. In the short term, uneducated mothers should be targeted with breastfeeding promotion strategies such as counselling and peer education. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2405-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
| | - Vishnu Khanal
- Nepal Development Society, Bharatpur, Nepal. .,School of Public Health, Curtin University, Perth, Australia.
| |
Collapse
|
21
|
Factors associated with Early Initiation of Breastfeeding in Western Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:9562-74. [PMID: 26287223 PMCID: PMC4555298 DOI: 10.3390/ijerph120809562] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 08/05/2015] [Indexed: 11/25/2022]
Abstract
The initiation of breastfeeding within one hour of birth has numerous nutritional and immunological benefits and has been found to reduce neonatal mortality. This community-based prospective cohort study aimed to report the rate of, and factors associated with, early initiation of breastfeeding in Western Nepal. The rate of early initiation of breastfeeding was reported, and associations between early initiation and independent variables were tested by Chi-square test, followed by multiple logistic regression. Of the 735 mother-infant pairs, a total of 310 (42.2%) reported early initiation. Mothers who were assisted by traditional attendants during childbirth, delivered by caesarean section, from ethnically disadvantaged families and had delivered low birth weight infants, were less likely to initiate breastfeeding early whereas the mothers who were from the poorest families and did not introduce prelacteal feeds to their infants were more likely to initiate breastfeeding within the first hour. Skills-training to support breastfeeding as part of the training of skilled birth attendants and other health workers is likely to promote recommended infant feeding practices.
Collapse
|
22
|
Khanal V, Lee AH, Karkee R, Binns CW. Prevalence and factors associated with prelacteal feeding in Western Nepal. Women Birth 2015; 29:12-7. [PMID: 26252964 DOI: 10.1016/j.wombi.2015.07.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Revised: 06/05/2015] [Accepted: 07/12/2015] [Indexed: 01/16/2023]
Abstract
BACKGROUND Newborn infants are often given prelacteal feeds in Nepal despite government policies encouraging exclusive breastfeeding for the first six months of life. AIM This study investigated the prevalence, reasons, types and factors associated with prelacteal feeding in the south-western region of Nepal. METHODS Information on prelacteal feeding was obtained from 735 recently delivered women who were recruited for a prospective community-based cohort study conducted during 2014 in the Rupandehi district of Nepal. Factors associated with prelacteal feeding were assessed using logistic regression analysis. FINDINGS A total of 225 (30.6%) mothers reported giving prelacteal feeds to their infants. The most popular prelacteal food was formula milk (41.7%), followed by cow or buffalo milk (26.6%), and sugar/glucose water (12.4%). Caesarean delivery (17.3%), cultural preference (16.4%) and being tired after childbirth (10.6%) were the most commonly cited reasons. Almost half (48%) of the mothers were advised by their mother/mother-in-law on prelacteal feeding method. Higher parity (adjusted odds ratio (OR) 2.05; 95% confidence interval (CI) 1.18-3.54), low birthweight (OR 1.97; 95% CI 1.23-3.16), caesarean delivery (OR 3.70; 95% CI 2.37-5.80) and wealthy status (OR 2.49; 95% CI 1.52-4.06) were associated with prelacteal feeding. CONCLUSION Nearly one-third of the infants in this study were given prelacteal feeds. Future breastfeeding promotion programmes should focus on the mothers with low birthweight infants, of high parity, from a wealthy family and those who had caesarean delivery.
Collapse
Affiliation(s)
- Vishnu Khanal
- School of Public Health, Curtin University, Perth, Australia.
| | - Andy H Lee
- School of Public Health, Curtin University, Perth, Australia
| | - Rajendra Karkee
- School of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Colin W Binns
- School of Public Health, Curtin University, Perth, Australia
| |
Collapse
|
23
|
Boccolini CS, Pérez-Escamilla R, Giugliani ERJ, Boccolini PDMM. Inequities in milk-based prelacteal feedings in Latin America and the Caribbean: the role of cesarean section delivery. J Hum Lact 2015; 31:89-98. [PMID: 25421875 DOI: 10.1177/0890334414559074] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Prelacteal feeds (ie, foods other than breast milk offered before the milk comes in) have been identified as a risk factor for shorter breastfeeding duration and neonatal mortality. OBJECTIVE This study aimed to test for socioeconomic inequities on the risk of milk-based prelacteal feeding associated with cesarean section delivery. METHODS We conducted secondary cross-sectional data analyses of 7 Demographic and Health Surveys conducted in Latin American and Caribbean countries between 2005 and 2010 (N = 49 253 women with children younger than 3 years of age). Multivariate logistic regression was used to test the association between cesarean section delivery and the risk of milk-based prelacteal feeding in the total samples as well as within the lowest and highest wealth quintile subsamples by country and in the pooled sample. RESULTS Almost one-third of newborns received milk-based (22.9%) prelacteal feeds. Prelacteal feeding prevalence varied from 17.6% in Guiana to 55% in Dominican Republic. Cesarean section delivery was associated with significantly higher odds of introduction of milk-based prelacteals in all countries (adjusted odds ratio [AOR] range, 2.34 in Bolivia to 4.50 in Peru). The association between cesarean section delivery and risk of milk-based prelacteal feeds was stronger among the poorest than wealthiest women (AOR [95% confidence interval], 2.94 [2.58-3.67] vs 2.17 [1.85-2.54]). CONCLUSION Women of lower socioeconomic status may need additional breastfeeding support after cesarean section delivery to prevent the introduction of milk-based prelacteals. Reducing the rates of cesarean section deliveries is likely to reduce the prevalence of prelacteal feeding.
Collapse
|