Determinants of early initiation of breastfeeding in rural Tanzania

Predictors of late initiation of breastfeeding practice in Ethiopia: a multilevel mixed-effects analysis of recent evidence from EDHS 2019

OBJECTIVES

To identify the predictors of late initiation of breastfeeding practice in Ethiopia.

DESIGN

Cross-sectional study design.

SETTING

Ethiopia.

PARTICIPANTS

A total of 1982 weighted samples of mothers with children aged under 24 months were included.

OUTCOME MEASURE

Late initiation of breastfeeding practice.

RESULTS

The prevalence of late breastfeeding initiation practice is 26.4% (95 CI 24.4 to 28.3). Being a young mother (15-24 years) (adjusted odds ratio (AOR) =1.66; 95 CI 1.06 to 2.62), no antenatal care (ANC) visit (AOR=1.45; 95 CI 1.04 to 2.02), caesarean section (AOR=4.79; 95 CI 3.19 to 7.21) and home delivery (AOR=1.53; 95 CI 1.14 to 2.06) were found to be the determinants of late initiation of breast feeding.

CONCLUSION

More than one-fourth of newborn children do not start breast feeding within the WHO-recommended time (first hour). Programmes should focus on promoting the health facility birth and increasing the ANC visits. Further emphasis should be placed on young mothers and those who deliver via caesarean section to improve the timely initiation of breast feeding.

Spatial variation and determinants of delayed breastfeeding initiation in Ethiopia: spatial and multilevel analysis of recent evidence from EDHS 2019

BACKGROUND

Despite the World Health Organization's firm recommendation to start breastfeeding during the first hour after delivery, nearly 54% of children in low- and middle-income countries are unable to initiate breastfeeding within the recommended time frame. Understanding the initiation of breastfeeding is essential for optimal child health and maternal well-being.

METHODS

This study was conducted using the recent Ethiopian Demographic and Health Survey (EDHS) data (2019) on a weighted sample of 1982 Ethiopian mothers of children aged under 24 months. The data extraction was conducted between August 1 and 30, 2023. Delayed' initiation of breastfeeding is defined as failure to initiate breastfeeding within one hour after birth. STATA version 17 was used for non-spatial analysis. ArcGIS Pro and Sat Scan version 9.6 were used to map the visual presentation of delayed breastfeeding initiation. Global Moran's I was computed to determine whether delayed breastfeeding initiation is randomly distributed, clustered, or dispersed. Getis-Ord Gi* Spatial Statistics was done to identify significant spatial clusters of cold and hot spot areas. Multilevel mixed-effect logistic regression analysis was computed to identify determinants of delayed breastfeeding initiation.

RESULTS

The prevalence of delayed breastfeeding initiation is 26.4% (95% CI 24.4, 28.3). Significant clustering of delayed initiation of breastfeeding practice was found in the Somali region. Less clustering was identified in Northern Amhara, Addis Ababa and Dire Dawa. Being a young mother (15-24 years) (AOR 1.66; 95% CI 1.06, 2.62), no antenatal care (AOR 1.45; 95% CI 1.04, 2.02), cesarean section (AOR 4.79; 95% CI 3.19, 7.21) and home birth (AOR 1.53; 95% CI 1.14, 2.06) were found to be determinants of delayed initiation of breastfeeding.

CONCLUSIONS

In Ethiopia, delayed breastfeeding initiation is distributed non-randomly. Significant hotspot areas were identified in the eastern part of Ethiopia. Thus, deploying additional resources in high hotspot regions is recommended. Programs should focus on promoting health facility birth and increasing antenatal care visits. Further emphasis should be considered on supporting young mothers and those giving birth via cesarean section to improve timely breastfeeding initiation.

Factors associated with early initiation of breastfeeding in central Saudi Arabia: a hospital-based survey

BACKGROUND

Early initiation of breastfeeding is central to the success of infant feeding. The World Health Organization (WHO) therefore recommends breastfeeding within the first hour of birth and has set a target to increase the rate to 70% globally by 2030. This suggests the necessity of systematic investigations to capture trends in early initiation of breastfeeding to avail health systems of up-to-date information in the interest of appropriate policy making. Hence, this study was designed to investigate the factors associated with early initiation among mothers who delivered babies in public healthcare facilities in the Al-Qassim Region, Saudi Arabia.

METHODS

The research was a hospital-based, cross-sectional study which featured the recruitment of 546 mothers from March 2021 to June 2021 in five public hospitals. A questionnaire was the tool used for data collection and this was administered via face-to-face, structured interviews. Data were analyzed using binary logistic regression including unadjusted (UOR) and adjusted odds ratio (AOR) with a 95% confidence interval (CI).

RESULTS

The prevalence of early initiation of breastfeeding was 23.1% (120 of 519 respondents). Maternal and paternal socio-demographic variables, household characteristics, parity, age of the previous child, breastfeeding the previous child or otherwise and the sex of the newborn were not associated with the early initiation of breastfeeding. Mode of delivery and antenatal education about breastfeeding were significant factors. Postnatal care practices were also significant: the provision of help in positioning babies for breastfeeding (AOR 3.5; 95% CI 1.62, 7.57), 24-hour rooming-in (AOR 6.26; 95% CI 1.31, 29.8) and encouragement to practice early initiation of breastfeeding (AOR 3.05; 95% CI 1.71, 5.43) were good, better and the best factors associated with early initiation of breastfeeding respectively.

CONCLUSION

The prevalence of early initiation of breastfeeding is poor and represents a threat to child survival in the study area. Postnatal care practices are crucial factors strongly predisposing mothers to early initiation of breastfeeding and should therefore be institutionalized in health policy frameworks to promote the same in Saudi Arabia.

Early Initiation of Breastfeeding (EIBF) and Its Associated Factors Among Mothers With Infants Aged 0 to 6 Months in Jashore District, Bangladesh: A Cross-Sectional Study

OBJECTIVE

Early initiation of breastfeeding (EIBF) is one of the most successful interventions for minimizing newborn morbidity and death. According to the database (Bangladesh Demographic Health Survey 2014), only around half of babies begin breastfeeding during the first hour of life in Bangladesh. The goal of this study was to determine the prevalence of EIBF in the Jashore area while also investigating its associated factors among mothers of infants aged 0 to 6 months in order to better understand the variables that impacted breastfeeding initiation.

METHOD

A cross-sectional study was conducted in the maternity wards of the 3 busiest hospitals in the Jashore district of Bangladesh from May to July 2019. Using random sampling, a total of 423 mother-infant pairs were chosen. Pearson chi-square test and bivariable and multivariable logistic regression statistical analysis were used to identify factors linked to EIBF.

RESULTS

The prevalence of EIBF was 46.3% (196/423). Mothers who had skin-to-skin contact after delivery (adjusted odds ratio [AOR], 2.25; 95% confidential interval [CI], 1.40-3.59), who did not deliver prelacteal food (AOR, 3.68; 95% CI, 1.65-8.21), and who provided colostrum (AOR, 5.89; 95% CI, 1.62-21.49) were more likely to begin breastfeeding within 1 hour than were their counterparts.

CONCLUSIONS

EIBF was found to be strongly linked with skin-to-skin contact after delivery, avoidance of prelacteal feeding, and colostrum feeding practice. As a result, we strongly urge public health officials and health care practitioners to encourage these feeding behaviors in order to increase EIBF.

Examining the prevalence and determinants of early initiation of breastfeeding: Evidence from the 2017/2018 Benin demographic and health survey

Early initiation of breastfeeding has been noted as one of the well-known and successful interventions that contributes to the reduction of early childhood mortality and morbidity. The Government of Benin has established multi-sectoral institutions and policies to increase the prevalence of early initiation of breastfeeding. However, there is little information on the prevalence and the determinants of early initiation of breastfeeding in Benin. This study therefore sought to examine the prevalence and determinants of early initiation of breastfeeding among women in Benin. This is a secondary data analysis of the 2017/2018 Benin demographic and health survey. The study included weighted sample of 7,223 women between the ages of 15 and 49. STATA was used for the data analysis. We used a multilevel logistic regression to investigate the factors of early breastfeeding initiation in Benin. To determine the significant relationships, the data were reported as odds ratios (ORs) with 95% confidence intervals (CIs) and p-value 0.05. The prevalence of early initiation of breastfeeding among mothers was 56.0%. Early initiation of breastfeeding was lower among employed women (aOR = 0.80, 95% CI = 0.69-0.94), women who had caesarean section (aOR = 0.21, 95% CI = 0.16-0.28), those exposed to mass media (aOR = 0.85, 95% CI = 0.75-0.96) and women who received assistance at birth from skilled worker (aOR = 0.57, 95% CI = 0.46-0.71). The findings of this study showed that four in ten children miss early initiation of breastfeeding in Benin. The findings, therefore, call for the need for policymakers to shape existing programs and consider new programs and policies to help improve early initiation of breastfeeding practices in Benin. It is, therefore, recommended that information, education and communication programs targeting mothers who are less likely to practice early initiation of breastfeeding be formulated, implemented, and monitored accordingly by the Ministry of Health.

A descriptive analysis of the coverage of newborn care services among women who delivered in health facilities in 17 sub-Saharan African countries

BACKGROUND

Sub-Saharan Africa (SSA) has seen an increase in facility-based births over the years. However, the region has the world's highest newborn mortality rate (42% in 2019). Quality care around the time of birth can avert these deaths. This study examined the newborn care interventions given to women who gave birth in health facilities in 17 countries in SSA.

METHODS

A cross-sectional population-based study was conducted. We used data from the most recent Demographic and Health Surveys (DHS) conducted in 17 sub-Saharan African countries. We analysed a weighted sample of 226,706 women aged 15-49 years who gave birth in the five years preceding the surveys. We described the coverage of nine newborn care services, namely weighing at birth, breastfeeding initiation within 1 h after birth, skin-to-skin contact, temperature measurement, cord examination, counselling on newborn danger signs, counselling on breastfeeding, breastfeeding observation, and child health assessment before discharge.

RESULTS

Overall, 72.0% (95% CI: 71.1, 72.8) of births occurred in health facilities, ranging from 40.0% (95% CI: 38.0, 42.1) in Nigeria to 96.3% (95% CI: 95.4, 97.1) in South Africa. Weighing at birth was the most common intervention (91.4%), followed by health checks before discharge (81%). The other interventions, including those given immediately at birth (breastfeeding and skin-to-skin contact), had suboptimal coverage. For instance, 66% of newborns were breastfed within 1 h after birth, and 56% had immediate skin-to-skin contact. Service coverage varied considerably by country and healthcare provider type.

CONCLUSIONS

The majority of the examined services, namely early breastfeeding, skin-to-skin contact, cord examination, temperature measurement, counselling on newborn danger signs, breastfeeding observation, and counselling on breastfeeding, were found to have suboptimal coverage. Even though many pregnant women in SSA give birth in healthcare facilities, some newborns do not always get the care they need to be healthy and live. This is a missed chance to improve newborn health and survival around the time of birth.

The effect of perceived insufficient milk on transition to supplementary food and factors affecting it during the first six months postpartum in Turkey: A cross-sectional study

The researchers' aims were to determine the effect of perceived insufficient milk supply on the transition to supplementary food and the factors affecting it. This is a cross-sectional design study, we were conducted between April and August 2019 and included 335 mothers and their babies in a baby-friendly hospital in Turkey. It was shown that mothers with perceived insufficient milk switched to supplementary food 6.538 times more frequently (p < 0.05). It was shown that some maternal, lactational, and infant (baby's age) factors affected the perception of insufficient milk (p < 0.05). The perception of insufficient milk is an important factor contributing to the transition to supplementary food.

Mother and newborn skin-to-skin contact and timely initiation of breastfeeding in sub-Saharan Africa

BACKGROUND

Mother and newborn skin-to-skin contact (SSC) plays a key role in breastfeeding practices of mothers. In this study, we examined the association between mother and newborn SSC and timely initiation of breastfeeding in sub-Saharan Africa (SSA).

METHODS

This cross-sectional study utilized nationally representative data from the Demographic and Health Surveys of 17 countries in SSA from 2015 to 2020. Multilevel binary logistic regression analysis was performed to examine the association between mother and newborn SSC and timely initiation of breastfeeding. The results are presented using adjusted odds ratios (aOR), with 95% confidence interval (CI).

RESULTS

The pooled prevalences of mother and newborn SSC and timely initiation of breastfeeding were 45.68% (95% CI = 34.12-57.23) and 62.89% (95% CI = 55.67-70.11), respectively. Mothers who practiced newborn SSC were more likely to practice timely initiation of breastfeeding compared to those who did not practice SSC [aOR = 1.68, 95% CI = 1.58, 1.78] and this persisted after controlling for all the covariates [aOR = 1.38, 95% CI = 1.29, 1.47]. At the country level, mother and newborn SSC increased the odds of timely initiation of breastfeeding in Angola [aOR = 1.99, 95% CI = 1.44, 2.76], Cameroon [aOR = 1.43, 95% CI = 1.02, 1.99], Ethiopia [aOR = 1.62, 95% CI = 1.16, 2.28], Guinea [aOR = 1.69, 95% CI = 1.10, 2.60], Liberia [aOR = 2.03, 95% CI = 1.33, 3.12], Malawi [aOR = 1.47, 95% CI = 1.02, 2.12], Mali [aOR = 1.42, 95% CI = 1.10, 1.84], Sierra Leone [aOR = 1.87, 95% CI = 1.23, 2.83], South Africa [aOR = 2.59, 95% CI = 1.41, 4.76], Tanzania [aOR = 1.60, 95% CI = 1.27, 2.01], Uganda [aOR = 1.43, 95% CI = 1.02, 1.99], Zambia [aOR = 1.86, 95% CI = 1.50, 2.30], and Zimbabwe [aOR = 1.65, 95% CI = 1.24, 2.21].

CONCLUSION

The prevalence of SCC was relatively low but timely initiation of breastfeeding was high. Mother and newborn SSC is a strong predictor of timely initiation of breastfeeding in SSA. To enhance timely initiation of breastfeeding after birth, this study recommends that more child and maternal healthcare interventions focused on improving mother and newborn SSC should be implemented.

Early Initiation of Breastfeeding and Associated Factors Among Women of Reproductive age in Simiyu Region, Tanzania

Background

Breast milk provides infants with complete nutrition for immune development and protection against childhood diseases and associated mortality. Early initiation of breastfeeding (EIBF) aids in providing colostrum to newborns, providing protection against infection, and improving newborn and infant survival. Although Simiyu reported the lowest prevalence of EIBF in Tanzania, no study has investigated the factors associated with EIBF in this region.

Objective

The study aimed to determine early breastfeeding initiation prevalence and associated factors among women of reproductive age in the Simiyu region.

Methodology

We used data from a cross-sectional study conducted by AMREF Health Africa among 669 women of reproductive age (15-49 years) in the Simiyu region, Tanzania. An interviewer-administered questionnaire collected data on breastfeeding practices (including breastfeeding initiation) among others. A multilevel logistic regression analysis estimated the adjusted odds ratio (OR) and 95% confidence intervals (CI) for factors associated with EIBF.

Results

The mean age of 669 women analyzed was 28.3 years (SD ± 6.8). The prevalence of EIBF was 62.2%, ranging from 52.7% in Bariadi district to 73.3% in Maswa district. Lower odds of EIBF were among women who had a caesarian section (OR = 0.41; 95% CI = 0.17-0.98) and those who gave birth to male children (OR =  0.57; 95%CI = 0.39-0.82) while higher odds of EIBF were among mothers who reported skin-to-skin contact (OR =  2.40; 95%CI = 1.53-3.83) and from Maswa district (OR = 2.73; 95%CI = 1.09-6.89).

Conclusion

The prevalence of EIBF in the Simiyu region remains low (62%) relative to the global target of 70% by 2030 and varies by district. To promote EIBF in the region, good engagement and communication practices between mothers and healthcare providers should be emphasised in educating women about the importance of EIBF. Moreover, the practice of skin-to-skin contact between mother and child should be encouraged immediately after delivery.

Factors associated with early initiation of breastfeeding among children less than 24 months old: the 2019 Ethiopian mini demographic and health survey

Background

The world Health Organization recommended that all mothers be supported to initiate breastfeeding as soon as possible after birth, within the first hour. This study examined the determinants of early initiation of breastfeeding in Ethiopia by using data from the 2019 Ethiopia Mini Demographic and Health Survey.

Methods

The data for this study was extracted from the 2019 Ethiopia Mini Demographic and Health Survey. A total of 1948 children aged less than 24 months at the time of the survey were included for analysis from the nine regional states and two city administrations. The analysis was carried out in STATA Version 14.2 software using survey commands to account for the complex sample design and apply sampling weights. A manual backward stepwise elimination approach was applied.

Result

The prevalence of early initiation of breastfeeding in Ethiopia was noted to be 75.2% [95% CI (71.9, 78.5%)]. In the multivariable analysis, mothers who had vaginal deliveries [AOR = 3.02 (95% CI: 1.55, 5.88)] had 3 times higher odds practicing early initiation of breastfeeding compared to mothers who had a cesarian section. Mothers aged between 35 and 49 years [AOR = 2.40, 95% CI: 1.20, 4.49] had 2.4 times higher odds of practicing early initiation of breastfeeding compared to mothers aged below 20 years. In addition, early initiation of breastfeeding was also associated with the region where mothers resided, in particular mothers in Amhara and Somali region, had lower odds of practicing early initiation of breastfeeding as compared with mothers residing in Tigray region.

Conclusion

Early initiation of breastfeeding in Ethiopia was found to be significantly associated with mode of delivery, mother’s age, and region. As a result, raising awareness about early initiation of breastfeeding is especially important for mothers who have had a cesarean section, which could be accomplished with the help of the health extension workforce.

Timely Initiation of Breastfeeding and Its Associated Factors at the Public Health Facilities of Dire Dawa City, Eastern Ethiopia, 2021

Introduction

Timely initiation of breastfeeding is defined as putting the newborn baby to the breast within one hour of birth. Despite the World Health Organization and national recommendations on timely initiation of breastfeeding, delayed initiation of breastfeeding is still a common problem.

Objective

The aim of this study was to assess the timely initiation of breastfeeding and its associated factors at the public health facilities of Dire Dawa city, Eastern Ethiopia, 2021.

Methods

A health facility-based cross-sectional study was employed from February 1, 2021, to March 2, 2021, at the public health facilities of Dire Dawa city among 302 mother-child pairs. The data were collected by systematic random sampling technique, entered into Epi data 4.2, and analyzed using Statistical Package of Social Science 25.0 version. Bivariate and multivariable logistic regression analyses were employed to estimate the crude and adjusted odds ratio with a confidence interval of 95%, and a P value of < 0.05 was considered statistically significant. Frequency tables, figures, and descriptive summaries were used to describe the study variables.

Results

In this study, timely initiation of breastfeeding was 70.9% (95% CI: 65.6-75.8%). In a multivariable analysis, maternal age group of 25-40 years (AOR = 2.21, 95% CI = 1.09 − 4.48), multiparty (AOR = 2.58, 95% CI = 1.24 − 5.40), counselling on timely initiation of breastfeeding during antenatal care visits (AOR = 2.38, 95% CI = 1.16 − 4.88), institutional delivery (AOR = 3.29, 95% CI = 1.27 − 8.52), vaginal delivery (AOR = 3.06, 95% CI = 1.20 − 7.81), counselling on breastfeeding immediately after delivery (AOR = 2.89, 95% CI = 1.29 − 6.45), not practicing pre lacteal feeding (AOR = 6.76, 95% CI = 2.35 − 19.44), and having good practice of colostrum feeding (AOR = 4.03, 95% CI = 1.95 − 8.36) were associated with timely initiation of breastfeeding. Conclusion and Recommendation. Mothers who had practiced timely initiation of breastfeeding were low compared to the national recommendation (92%). Age of the mother, multiparity, counseling on timely initiation of breastfeeding, institutional delivery, vaginal delivery, counseling after delivery, not practicing prelacteal feeding, and having a good practice of colostrum feeding were predictors of timely initiation of breastfeeding. It indicates a need to encourage mothers to have antenatal care visits and institutional delivery.

A prospective follow-up study on how long newborns are fasting in Debre Markos Comprehensive Specialized Hospital, Ethiopia, 2020

Background

At birth, continuous flow of nutrients to the fetus in utero interrupted due to cut of the route /umbilical cord/. Instead of the cord, breast-mouth connection will be the next route in the extra uterine life. Nevertheless, limited data in our locality show the duration for how long immediate newborns are fasting.

Objective

This study aimed to assess time to initiation of breastfeeding and its predictors among postnatal mothers within 12 hours of birth in Debre Markos Comprehensive Specialized Hospital, North West Ethiopia, 2020.

Methods

A Facility based prospective follow-up study was conducted among 475 participants who were selected using systematic random sampling techniques. To collect the data, techniques including interview, chart review and observation were used. Data was entered to Epi-data version 3.1 and analyzed by STATA 14 software. A cox proportional hazards regression model was fitted to identify predictors for survival time. Results of the final model were expressed in terms of adjusted hazard ratio (AHR) with 95% confidence interval, statistical significance was declared with P-value is less than 0.05.

Results

Newborns were fasting breast-milk for the median time of 2 hours. In this study, 25% of participants initiated breastfeeding within 1 hour, pre-lacteal while 75% initiated within 3 hours. Gave birth to multiple babies (AHR 0.37, 95% CI (0.19, 0.69)), operative delivery (AHR 0.77, 95% CI (0.62, 0.96)), got advice on timely initiation of breastfeeding immediately after delivery (AHR 0.79, 95% CI (0.63, 0.97)), pre-lacteal feeding initiation (AHR 10.41, 95% CI (2.82, 38.47)) and neonatal sickness (AHR 0.08, 95% CI (0.03–0.19)) were statistically significant predictors for time to initiation of breastfeeding.

Conclusion

Fifty percent of mothers initiated breastfeeding within 2 hours. Most of them didn’t initiate breastfeeding based on world health organization’s recommendation, within one hour after delivery. Multiple birth, operative delivery, getting advice on timely initiation of breastfeeding immediately after delivery, giving pre-lacteal feeding and neonatal sickness were found to be predictors of time to initiation of breastfeeding.

Exclusive breastfeeding practice among HIV infected mothers in the southern highlands of Tanzania; assessing the prevalence and factors associated with the practice, an analytical cross-sectional survey

Background

There is no other better way to safeguard an infant’s health in the first 6 months of life than exclusive breastfeeding (EBF). Breast milk is valuable in all aspects of an infant’s physical and mental growth as well as immune development. The study aimed to assess the prevalence and factors associated with EBF practice among HIV-infected mothers in the Southern Highlands of Tanzania.

Method

A hospital-based analytical cross-sectional study was conducted among lactating HIV-infected mothers. A random sampling procedure was used to obtain 372 HIV-infected mothers of infants from 6 to 12 months of age who were still breastfeeding at the time of data collection. An interviewer-administered structured questionnaire was used for data collection. Bivariate and multivariable logistic regression was used to assess factors associated with EBF practice. Statistical package for social science (SPSS volume 20) software was used for data entry and analysis.

Results

The prevalence of EBF practice was 58.1% at 95% Confidence Interval of 52.9% to 63.1%. More than half of the respondents 199 (53.5%) had adequate knowledge while 173(46.5%) had inadequate knowledge about EBF. After adjusting for confounders, factors associated with EBF practice were knowledge about EBF [Adequate knowledge (AOR = 5.11 at 95% CI 3.2–8.17, p < 0.001)], ANC visits [Adequate (AOR = 1.76 at 95% CI 1.09–2.82, p = 0.002)], Income per day [1 0r more USD (AOR = 1.83 at 95% CI 1.14–2.94, p = 0.013)], positive perception of EBF [ positive perception (AOR = 3.51 at 95% CI 2.25–5.47, p < 0.001) and having ever experienced a breast problem AOR = 3.91 at 95% CI 1.89–8.08, p < 0.001.

Conclusion

More than half of interviewed mothers with HIV practiced EBF. The EBF practice among HIV lactating mothers was significantly influenced by adequate knowledge of EBF, positive perception toward EBF, adequate ANC visits, and having never experienced breast problems. Strengthening adherence to ANC routine visits, counseling on breastfeeding, and improving mothers’ knowledge about exclusive breastfeeding would contribute to the enhancement of EBF practice in this region. An innovative interventional study is recommended to develop more effective strategies to improve EBF knowledge and practice among HIV-infected mothers.

Effect of maternal nutrition education on early initiation and exclusive breast-feeding practices in south Ethiopia: a cluster randomised control trial

Introduction: Optimal breast-feeding practices make a major contribution to the promotion of healthy growth and development through much prevention of diarrheal and respiratory diseases which majorly cause morbidity and mortality in under-five children. However, breast-feeding practices remain suboptimality in Ethiopia. Objective: The study objective was to determine the effect of maternal nutrition education on early initiation and exclusive breast-feeding practice in the Hawela Tulla sub-city. Methods: A cluster randomised, parallel-group, single-blinded trial was used. About 310 pregnant women (155 for the intervention group and 155 for the control group) were included. Result: An early initiation of breast-feeding was significantly higher among women who received breast-feeding education than those who did not receive (104(72·7 %) v. 85(59·9 %), P = 0·022) and exclusive breast-feeding practice was also significantly higher among women who received breast-feeding education than those who did not receive (106(74·1 %) v. 86(60·6 %), P = 0·015). Breast-feeding education [AORs 1·55, 95 % CI (1·02, 2·36)], institutional delivery [AOR 2·29, 95 % CI (1·21, 4·35)], vaginal delivery [AOR 2·85, 95 % CI (1·61, 5·41)] and pre-lacteal feeding [AOR 0·47, 95 % CI (0·25, 0·85)] were predictors of early initiation of breast-feeding. Breast-feeding education [AOR 1·72, 95 % CI (1·12, 2·64)] and institutional delivery [AOR 2·36, 95 % CI (1·28, 4·33)] were also determinants of exclusive breast-feeding practices. Conclusion: Breast-feeding education improved early initiation of breast-feeding and exclusive breast-feeding practices. Providing sustained education to women regarding early initiation and exclusive breast-feeding practice should be strengthened.

Magnitude and determinants of breastfeeding initiation within one hour among reproductive women in Sub-Saharan Africa; evidence from demographic and health survey data: a multilevel study

Background

Early initiation of breastfeeding is one of the most simple and essential intervention for child development and survival in the world. World Health Organization recommended to begin breast milk with one hour after delivery. The objective of this study was to determine the magnitude of early initiation of breastfeeding in Sub-Saharan Africa using DHS data set.

Methods

This study was carried out within 32 Sub-Saharan African countries from 2010–2020, a pooled study of early initiation of breastfeeding was performed. For assessing model fitness and contrast, intra-class correlation coefficient, median odds ratio, proportional change in variance, and deviance were used. In order to identify possible covariates associated with early initiation of breastfeeding in the study area, the multilevel multivariable logistic regression model was adapted. Adjusted Odds Ratio was used with 95% confidence interval to declare major breastfeeding factors.

Result

The pooled prevalence of early initiation of breastfeeding in Sub-Saharan Africa countries was 57% (95% CI; 56%—61%), the highest prevalence rate of early initiation of breastfeeding was found in Malawi while the lowest prevalence was found in Congo Brazzaville (24%). In multilevel multivariable logistic regression model; wealth index (AOR = 1.20; 95% CI 1.16 – 1.26), place of delivery (AOR = 1.97; 95% CI 1.89 – 2.05), skin-to-skin contact (AOR = 1.51; 95% CI 1.47 – 1.57), mode of delivery (AOR = 0.27; 95% CI 0.25 – 0.29), media exposure (AOR = 1.36; 95% CI 1.31 – 1.41) were significantly correlated with early initiation of breastfeeding in Sub-Saharan Africa.

Conclusion

The magnitude of early initiation of breastfeeding rate was low in Sub-Saharan Africa. Covariates significantly associated with early initiation of breastfeeding was wealth index, place of delivery, mode of delivery, women educational status, and media exposure. Structural improvements are required for women with caesarean births to achieve optimal breastfeeding practice in Sub-Saharan Africa.

Sex inequality in early initiation of breastfeeding in 24 sub-Saharan African countries: A multi-country analysis of Demographic and Health Surveys

Background

The Sustainable Development Goal (SDG) 3 aims at reducing neonatal and under-5 mortality to below 12 per 1000 and 25 per 1000 live births, respectively, globally by 2030. Studies have found that initiation of breastfeeding within one hour of birth and continuous breastfeeding for over 12 months can positively impact neonatal and infant health. However, there is evidence that the sex of a child may influence the breastfeeding practices of a mother. Thus, we examined sex inequality in early breastfeeding initiation in sub-Saharan Africa.

Materials and methods

Data from Demographic and Health Surveys conducted in 24 sub-Saharan African countries between January 2010 and December 2019 were pooled and analysed. A total of 137,677 women of reproductive age (15–49 years) were considered in this study. Bivariate and multivariable regression analyses were performed, and the results were presented using crude odds ratio (cOR) and adjusted odds ratio (aOR) with statistical significance at a p-value less than 0.05.

Results

The highest inequality in early initiation of breastfeeding was reported in Togo with a difference of 5.21% between the female and male children, while the lowest inequality was reported in Guinea with 0.48% difference between the female and male children. A higher odds of breastfeeding within 1 hour was observed among female children [cOR = 1.05; 95%(CI = 1.02–1.09)] compared to male children, and this persisted after controlling for the confounders included in this study [aOR = 1.05; 95%(CI = 1.02–1.08)].

Conclusion

We found higher odds for early breastfeeding initiation of female children compared to male children in sub-Saharan Africa. To reduce breastfeeding initiation inequalities, programmes that educate and encourage early initiation of breastfeeding irrespective of the child sex should be promoted among mothers.

Association between Mother's Education and Infant and Young Child Feeding Practices in South Asia

The association between mother’s education and the World Health Organization’s (WHO’s) eight Infant and Young Child Feeding (IYCF) core indicators has yet to be explored in South Asia (SA). This study aimed to explore the association between mother’s education and the WHO’s eight IYCF core indicators in SA. We analyzed data from the most recent nationally representative Demographic and Health Surveys of six South Asian Countries (SACs)—Afghanistan, Bangladesh, India, Maldives, Nepal, and Pakistan. We found significantly higher odds (adjusted odds ratio, AOR, 1.13 to 1.47) among mothers who completed secondary or higher education than among mothers with education levels below secondary for the following seven IYCF indicators: early initiation of breastfeeding (EIBF), exclusive breastfeeding under 6 months (EBF), the introduction of solid, semisolid or soft foods (ISSSF), minimum dietary diversity (MDD), minimum meal frequency (MMF), minimum acceptable diet (MAD), and consumption of iron-rich or iron-fortified foods (CIRF); the exception was for the indicator of continued breastfeeding at one year. Country-specific analyses revealed significantly higher odds in EIBF (AOR 1.14; 95% CI: 1.11, 1.18) and EBF (AOR 1.27; 95% CI: 1.19, 1.34) among mothers with secondary or higher education levels in India. In contrast, the odds were lower for EIBF in Bangladesh and for EBF in Pakistan among mothers with secondary or higher education levels. For country-specific analyses for complementary feeding indicators such as ISSSF, MDD, MMF, MAD, and CIRF, significantly higher odds (AOR, 1.15 to 2.34) were also observed among mothers with secondary or higher education levels. These findings demonstrate a strong positive association between mother’s education and IYCF indicators. Strengthening national policies to educate women at least to the secondary level in SACs might be a cost-effective intervention for improving IYCF practices.

Prevalence and determinants of early initiation of breastfeeding (EIBF) and prelacteal feeding in Northern Ghana: A cross-sectional survey

BACKGROUND

There is suboptimal early initiation of breastfeeding (EIBF) with widespread prelacteal feeding in Ghana. However, studies exploring the determinants of EIBF and prelacteal feeding are limited in Ghana. The study was conducted to assess the prevalence and determinants of EIBF and prelacteal feeding in Northern Ghana.

METHODS

This cross-sectional study was conducted among 508 mothers with infants aged 0-24 months in the Sagnarigu Municipality of Northern Ghana. The quantitative data were collected using a structured questionnaire adapted from Ghana's demographic and health survey. Multivariate logistic regression was used to identify the independent determinants of EIBF and prelacteal feeding.

RESULTS

The prevalence of EIBF and prelacteal feeding was 72% and 21%, respectively. The independent positive determinants of EIBF were partner support to breastfeed [adjusted Odds ratio (AOR): 1.86, 95% Confidence interval (CI): 1.09-3.17] and exposure to breastfeeding information during pregnancy (AOR = 1.63 (95% CI: 1.01-2.64). Lower odds of EIBF were observed among mothers from extended family (AOR = 0.62, 95% CI: 0.41-0.95). Regarding prelacteal feeding, negative determinants were having a normal weight baby (AOR: 0.50, 95% CI: 0.27-0.90), exposure to breastfeeding information during pregnancy (AOR: 0.54, 95% CI: 0.31-0.92), while experiencing delayed onset of lactation was a risk factor for prelacteal feeding practice (AOR: 2.35, 95% CI: 1.41-3.94).

CONCLUSION

In this study, EIBF was slightly higher than the 2030 global target on EIBF with widespread prelacteal feeding practice. Health programs aimed at improving EIBF should focus on the women partners, nutrition counselling, and support to mothers from the extended family. In the same vein, programs aimed at discouraging prelacteal feeding practice should also target women at risk, such as those with low birthweight babies and women experiencing delayed lactation onset.

Time trends and determinants of breastfeeding practices among adolescents and young women in Nigeria, 2003-2018

Introduction

Optimal breastfeeding practices have far-reaching health and economic benefits. Evidence suggests disparities in breastfeeding practices by maternal age-groups, with younger mothers often having lower rates of breastfeeding initiation, continuation and exclusivity compared with older mothers. There is limited knowledge of trends and factors associated with breastfeeding practices, particularly among adolescent and younger mothers in Nigeria. We examine key breastfeeding practices in Nigeria over a 15-year period, comparing adolescent mothers to young women.

Methods

We used four Nigeria Demographic and Health Surveys collected between 2003 and 2018. We constructed six key breastfeeding indicators to cover the time period of breastfeeding from initiation to child age 24 months in women of three maternal age groups at the time of birth: young adolescents (<18 years), older adolescents (18–19.9 years) and young women (20–24.9 years). We used logistic regression to examine the association between maternal age group and select breastfeeding behaviours on the 2018 survey.

Results

Analysis showed an increase in optimal breastfeeding practices across the four surveys and among all maternal age groups examined. Adolescent mothers had consistently lower prevalence for three of the six key breastfeeding indicators: early initiation of breastfeeding, exclusive breastfeeding <6 months and no prelacteal feed. Compared with young women, adolescent mothers had a higher prevalence of continued breastfeeding at 1 and 2 years. In multivariate analysis, we found that maternal age group was not associated with early breastfeeding initiation or with exclusive breastfeeding <6 months. However, several sociodemographic (ethnicity, region of residence) and healthcare-related (mode of delivery, antenatal care, postnatal breastfeeding counselling) factors were strongly associated with these two practices.

Conclusions

In Nigeria, there is need to better support breastfeeding and nutritional practices in adolescents and young women focusing on ethnic groups (Hausa, Fulani, Kanuri/Beriberi) and geographic regions (South East) that are lagging behind.

The Relationship Between Place of Birth and Early Breastfeeding Initiation in Indonesia

BACKGROUND

In many countries, hospital-based births are associated with the early initiation of breastfeeding, within the first hour postpartum, especially where the Baby Friendly Hospital Initiative guidelines have been adopted. While Indonesia has adopted the guidelines, there is a relatively low rate of early breastfeeding initiation in the country.

RESEARCH AIM

To determine the relationship between place of birth and early breastfeeding initiation in Indonesia.

METHOD

This study was a retrospective cross-sectional survey using national data from the 2017 Indonesia Demographic and Health Survey (N = 14,279). The association between place of birth and early breastfeeding initiation was examined using logistic regression models, adjusting for potential confounders.

RESULTS

The overall prevalence of early breastfeeding initiation in Indonesia was 60.9% with a greater proportion of mothers giving birth in health facilities. In the multivariate model, there was a significant interaction between wealth index, insurance status, and place of birth on the timing of breastfeeding initiation. In the subgroup of mothers residing in middle wealth index households, women who gave birth in clinics and hospitals had lower odds of early breastfeeding initiation compared to those who gave birth at home (0.56; 0.34, 0.90; p = .018) and (0.58; 0.40, 0.85; p = .005), respectively.

CONCLUSIONS

Place of birth was significantly associated with early breastfeeding initiation. There is a need to consider health disparities and to strengthen the implementation of the WHO guidelines, Baby Friendly Hospital Initiative, and International Code of Marketing of Breastmilk Substitutes, to increase early breastfeeding initiation in Indonesia.

Timely initiation of breastfeeding and associated factors among mothers having children less than two years of age in sub-Saharan Africa: A multilevel analysis using recent Demographic and Health Surveys data

BACKGROUND

Despite the significant advantages of timely initiation of breastfeeding (TIBF), many countries particularly low- and middle-income countries have failed to initiate breastfeeding on time for their newborns. Optimal breastfeeding is one of the key components of the SDG that may help to achieve reduction of under-five mortality to 25 deaths per 1000 live births.

OBJECTIVE

To assess the pooled prevalence and associated factors of timely initiation of breastfeeding among mothers having children less than two years of age in sub-Saharan Africa.

METHODS

We used pooled data from the 35 sub-Saharan Africa (SSA) Demographic and Health Surveys (DHS). We used a total weighted sample of 101,815 women who ever breastfeed and who had living children under 2 years of age. We conducted the multilevel logistic regression and variables with p<0.05, in the multivariable analysis, were declared significantly associated with TIBF.

RESULTS

The pooled prevalence of TIBF in SSA was 58.3% [95%CI; 58.0-58.6%] with huge variation between countries, ranging from 24% in Chad to 86% in Burundi. Both individual and community level variables were associated with TIBF. Among individual-level factors; being older-aged mothers, having primary education, being from wealthier households, exposure to mass media, being multiparous, intended pregnancy, delivery at a health facility, vaginal delivery, single birth, and average size of the child at birth were associated with higher odds of TIBF. Of community-level factors, rural place of residence, higher community level of ANC utilization, and health facility delivery were associated with higher odds of TIBF.

CONCLUSION

In this study, the prevalence of TIBF in SSA was low. Both individual and community-level factors were associated with TIBF. The authors recommend interventions at both individual and community levels to increase ANC utilization as well as health facility delivery that are crucial for advertising optimal breastfeeding practices such as TIBF.

Association of prenatal counselling and immediate postnatal support with early initiation of breastfeeding in Uttar Pradesh, India

BACKGROUND

Timely initiation of breastfeeding, also known as early initiation of breastfeeding, is a well-recognized life-saving intervention to reduce neonatal mortality. However, only one quarter of newborns in Uttar Pradesh, India were breastfed in the first hour of life. This paper aims to understand the association of community-based prenatal counselling and postnatal support at place of delivery with early initiation of breastfeeding in Uttar Pradesh, India.

METHODS

Data from a cross-sectional survey of 9124 eligible women (who had a live birth in 59 days preceding the survey) conducted in 25 districts of Uttar Pradesh, India, in 2018, were used. Simple random sampling was used to randomly select 40 Community Development Blocks (sub district administrative units) in 25 districts. The Primary Sampling Units (PSUs), health service delivery unit for frontline workers, were selected randomly from a linelisting of PSUs in each selected Community Development Block. Bivariate and multivariate logistic regression analyses were performed to assess the association of prenatal counselling and postnatal support on early initiation of breastfeeding in public, private and home deliveries.

RESULTS

Overall 48.1% of mothers initiated breastfeeding within an hour, with major variation by place of delivery (61.2% public, 23.6% private and 32.6% home). The adjusted odds ratio (aOR) of early initiation of breastfeeding was highest among mothers who received both counselling and support (aOR 2.67; 95% CI 2.30, 3.11), followed by those who received only support (aOR 1.99; 95% CI 1.73, 2.28), and only counselling (aOR 1.40; 95% CI 1.18, 1.67) compared to mothers who received none. The odds of early initiation of breastfeeding was highest among mothers who received both prenatal counselling and postnatal support irrespective of delivery at public health facilities (aOR 2.49; 95% CI 2.07, 3.01), private health facilities (aOR 3.50; 95% CI 2.25, 5.44), or home (aOR 2.84; 95% CI 2.02, 3.98).

CONCLUSIONS

A significant association of prenatal counselling and postnatal support immediately after birth on improving early initiation of breastfeeding, irrespective of place of delivery, indicates the importance of enhancing coverage of both the interventions through community and facility-based programs in Uttar Pradesh.

Factors associated with delayed initiation of breastfeeding in health facilities: secondary analysis of Bangladesh demographic and health survey 2014

Background

Irrespective of the place and mode of delivery, ‘delayed’ initiation of breastfeeding beyond the first hour of birth can negatively influence maternal and newborn health outcomes. In Bangladesh, 49% of newborns initiate breastfeeding after the first hour. The rate is higher among deliveries at a health facility (62%). This study investigates the maternal, health service, infant, and household characteristics associated with delayed initiation of breastfeeding among health facility deliveries in Bangladesh.

Methods

We used data from the 2014 Bangladesh Demographic and Health Survey. We included 1277 last-born children born at a health facility in the 2 years preceding the survey. ‘Delayed’ breastfeeding was defined using WHO recommendations as initiating after 1 h of birth. We performed univariate and multivariable logistic regression to determine factors associated with delayed initiation.

Results

About three-fifth (n = 785, 62%) of the children born at a health facility delayed initiation of breastfeeding beyond 1 h. After adjusting for potential confounders, we found delayed initiation to be common among women, who delivered by caesarean section (adjusted Odds Ratio (aOR): 2.93; 95% CI 2.17, 3.98), and who were exposed to media less than once a week (aOR: 1.53; 95% CI 1.07, 2.19). Women with a higher body mass index had an increased likelihood of delaying initiation (aOR: 1.05; 95% CI 1.01, 1.11). Multiparous women were less likely to delay (aOR: 0.71; 95% CI 0.53, 0.96).

Conclusions

Delayed initiation of breastfeeding following caesarean deliveries continues to be a challenge, but several other health facility and maternal factors also contributed to delayed initiation. Interventions to promote early breastfeeding should include strengthening the capacity of healthcare providers to encourage early initiation, especially for caesarean deliveries.

Women's Empowerment and Determinants of Early Initiation of Breastfeeding: A Scoping Review

INTRODUCTION

Early initiation of breastfeeding (EIBF), the immediate provision of mothers' breast milk to infants within the first hour of life, has been recommended by the WHO. However, EIBF is not widely practiced, thereby increasing infant mortality risk. This review explored the available and published studies that identified interventions that empower mothers to practice EIBF.

METHOD

We conducted a scoping review to answer the aforementioned aims. Empowerment, Women, Breastfeed, and Initiation were used as initial keywords, which were further developed using Medical Subject Headings by the National Center for Biotechnology Information. Five databases, namely: Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature via EBSCO, ProQuest, and MedLine via PubMed, were searched for potential articles. We also searched the references in addition to the main search.

FINDINGS

We included 28 articles in this review. Education was mostly used as women's empowerment indicator in EIBF intervention. Additionally, we identified barriers (C-section and postoperative pain, lactation problems and pregnancy complications, mothers' social and demographic factors, mothers' lack of professional support, babies' condition preventing EIBF) and facilitators (mothers' positive behavior in relation to educational level, completion of antenatal care, poor economic situations of mothers, babies' size at birth) of EIBF.

DISCUSSION

Education is the widely used intervention to promote mothers' participation in improving EIBF rate. Furthermore, mothers' and babies' deferring conditions and traditional practices are barriers for EIBF. This review recommends future research and empowerment efforts that sensitively address the identified barriers.

Prevalence, predictors and reasons for home delivery amongst women of childbearing age in Dodoma Municipality in central Tanzania

Introduction

The objective was to determine the prevalence, predictors and reasons for home delivery amongst women of childbearing age in Dodoma, Tanzania.

Methods

A cross-sectional study was conducted amongst women living in Dodoma Municipality. Data were collected using adapted questionnaires and analysed using SPPS version 23. A multivariable logistic regression model was used to assess the independent predictors of home delivery.

Results

A total of 425 women of childbearing age were enrolled in this study. The mean (± SD) age of the participants was 28.7 (±7.1) years. The prevalence of home delivery was 35.5% (n=150, 95% CI 30.9 – 40.2). Women with secondary school and above had 93% less odds of home delivery than women who had no education (AOR=0.0795% CI: 0.03–0.18). Women who lived in rural areas (AOR=3.49, 95% CI: 2.12–5.75), and women living more than 5km from health facilities (AOR=2.67, 95% CI: 1.65–4.37) had higher odds of home delivery. The main reasons for home delivery were transportation cost, and long distance to the nearest health facilities.

Conclusion

In this population, the prevalence of home delivery remained to be high. To address this more collaborative multisectoral effort like strengthening health education and strengthening maternity waiting homes are needed.

Determinants of early initiation of breastfeeding in Papua New Guinea: a population-based study using the 2016-2018 demographic and health survey data

Background

Initiation of breastfeeding after birth comes with a wide range of benefits to the child. For example, it provides the child with all essential nutrients needed for survival within the first six months of birth. This study sought to determine the prevalence and factors associated with early initiation of breastfeeding (EIB) in Papua New Guinea.

Methods

We utilized the Demographic and Health Survey data of 3198 childbearing women in Papua New Guinea. We employed descriptive and binary logistic regression analyses. We presented the results as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR), with 95% confidence intervals (CI) signifying level of precision. Level of statistical significance was set at p < 0.05.

Results

Women aged 20–29 [AOR = 1.583, CI = 1.147–2.185] and those aged 30+ [AOR = 1.631, CI = 1.140–2.335] had higher odds of EIB, compared to those aged 15–19. Women from the Islands region had lower odds [AOR = 0.690, CI = 0.565–0.842] of EIB, compared to those in Southern region. Women who delivered through caesarean section had lower odds of EIB, compared to those who delivered via vaginal delivery [AOR = 0.286, CI = 0.182–0.451]. Relatedly, women who delivered in hospitals had lower odds of EIB [AOR = 0.752, CI = 0.624–0.905], compared to those who delivered at home. Women who practiced skin-to-skin contact with the baby [AOR = 1.640, CI = 1.385–1.942] had higher odds of EIB, compared to those who did not. Women who read newspaper or magazine at least once a week had lower odds of EIB [AOR = 0.781, CI = 0.619–0.986], compared to those who did not read newspaper at all.

Conclusion

The prevalence of EIB in Papua New Guinea was relatively high (60%). The factors associated with EIB are age of the women, region of residence, mode of delivery, place of delivery, practice of skin-to-skin contact with the baby, and exposure to mass media (newspaper). To increase EIB in Papua New Guinea, these factors ought to be considered in the implementation of policies and measures to strengthen existing policies. Health providers should educate mothers on the importance of EIB.

Prevalence of and factors associated with early initiation of breastfeeding among women with children aged < 24 months in Kilimanjaro region, northern Tanzania: a community-based cross-sectional study

Background

Early initiation of breastfeeding offers nutritional and immunological benefits to the newborn, which is critical for health and survival. Understanding factors associated with timely initiation of breastfeeding is crucial for healthcare providers and policy-makers. This study aimed to assess the prevalence and factors associated with early initiation of breastfeeding among mothers with children < 24 months of age in the Kilimanjaro region, Northern Tanzania.

Methods

This study utilized secondary data from a cross-sectional survey conducted in April 2016 and April 2017 in the Kilimanjaro region. A multistage sampling technique was used to select study participants and interviewed using a questionnaire. A total of 1644 women with children aged < 24 months were analyzed. Modified Poisson regression models were used to determine factors independently associated with early initiation of breastfeeding, within first hour of life.

Results

The prevalence of early initiation of breastfeeding in the Kilimanjaro region was 70%, ranging from 64% in Same to 80% in Siha districts. The prevalence of early initiation of breastfeeding was lower among women who initiated prelacteal feeding compared to their counterparts (prevalence ratio [PR] 0.42; 95% Confidence Interval [CI] 0.34, 0.53). Likewise, women living in Same and Hai district had lower prevalence of early initiation of breastfeeding compared to women in Rombo (PR 0.8; 95% CI 0.76, 0.93) and (PR 0.89, 95% CI 0.80, 0.98) respectively. Higher prevalence of early initiation of breastfeeding was found in women with primary education compared to those with secondary education (PR 1.09; 95% CI 1.003, 1.18), and among women with two children compared to one child (PR 1.14, 95% CI 1.03, 1.26).

Conclusions

Early initiation of breastfeeding practice was suboptimal in this study. To improve early initiation of breastfeeding, healthcare providers at reproductive and child health clinics and labour wards should discourage women from prelacteal feeding, give more support to women with one child and those with secondary level of education and above. Furthermore, a qualitative study is crucial to understand the reasons for low prevalence of early initiation of breastfeeding in Same and Hai districts.

Prevalence and factors associated with timely initiation of breastfeeding in Kilimanjaro region, northern Tanzania: a cross-sectional study

BACKGROUND

The World Health Organization (WHO) recommends early initiation of breastfeeding within 1 h as it confers many benefits to the child and prevents neonatal mortality. This study aimed to determine the prevalence and factors associated with timely initiation of breastfeeding in the Kilimanjaro region, northern Tanzania.

METHODS

We analyzed secondary data for 866 participants from a population-based cross-sectional study conducted in April 2016 among mothers with children aged less than 5 years in three districts; Rombo, Same, and Moshi Municipal council in Kilimanjaro region, northern Tanzania. A multistage sampling selected study participants and interviewed using a questionnaire. The generalized linear model, with Poisson family and log-link function was used to estimate the prevalence ratios (PR) and 95% confidence intervals (CI) for factors associated with timely initiation of breastfeeding.

RESULTS

The prevalence of timely initiation of breastfeeding was 71.1%. The vast majority of mothers (90.7%) gave colostrum, and less than a tenth (6.4%) gave pre-lacteal feed to their children. Adjusted for other factors, not giving children prelacteal feeds remained was significantly associated with a higher prevalence of timely initiation of breastfeeding (PR: 2.22, 95%CI 1.38, 3.56, p = 0.001). There was no significant association between other characteristics and the likelihood of timely initiation of breastfeeding in this study.

CONCLUSION

The prevalence of timely initiation of breastfeeding in the Kilimanjaro region was higher than the national estimate. The practice of not giving infants prelacteal feeds increased the likelihood of timely initiation of breastfeeding. There is a need to encourage mothers on the significance of recommended ANC visits and early initiation of breastfeeding to their infants to improve the practice.

Prevalence and factors associated with early initiation of breastfeeding among women in Moshi municipal, northern Tanzania

Background

Early initiation of breastfeeding (EIBF) is a predetermining factor for exclusive breastfeeding, and thus a foundation for optimal breastfeeding practices. Rates of EIBF are low globally (42%) and in Tanzania (51%), yet few studies have been done on this issue in Tanzania. This study aimed to determine the prevalence and factors associated with early initiation of breastfeeding among women in northern Tanzania.

Methodology

This study extracted information from a cohort of 536 women who were followed from 3rd trimester period October 2013 to December 2015 in Moshi municipal, northern Tanzania. The data for this paper was collected by the use of questionnaires at enrolment, delivery and 7 days after delivery. The analysis is based on data from 413 women for whom complete information was obtained. Log binomial regression analysis was used to determine factors associated with early initiation of breastfeeding.

Results

The prevalence of EIBF was 83%. Overall, women had high knowledge on colostrum (94%), knowledge on exclusive breastfeeding (81%) and time of breastfeeding initiation (71%), but only 54% were counseled on breastfeeding during antenatal care. Knowledge on timely initiation of breastfeeding during pregnancy and vaginal delivery were associated with EIBF.

Conclusion

Early initiation of breastfeeding is high (83%) in Moshi Municipal but still below the universal coverage recommended by WHO and UNICEF. There is missed opportunity by health facilities to counsel and support early initiation of breastfeeding given high antenatal and facility delivery in this setting. There is a need to evaluate health facility bottle necks to optimal support of early initiation of breastfeeding in Tanzania.

Exclusive breastfeeding patterns in Tanzania: Do individual, household, or community factors matter?

BACKGROUND

Although there is a broad knowledge about exclusive breastfeeding among women in Tanzania, exclusive breastfeeding (EBF) remained lower than 50% for about 50 years since her independence in 1961. Previous research has mainly focused on either individual or household determinants of breastfeeding patterns. This study takes a holistic approach and examines the extent to which combined individual, household, and community factors matter in explaining exclusive breastfeeding patterns in Tanzania.

METHODS

A cross-sectional analysis was carried out using a nationally representative sample from the 2015/16 Tanzanian Demographic and Health Survey. The dependent variable was exclusive breastfeeding, defined as the proportion of infants below 6 months of age who were exclusively breastfed in the last 24 h. Univariable and multivariable logistic regression analyses were conducted to determine factors associated with exclusive breastfeeding.

RESULTS

In general, the rate of exclusive breastfeeding was 59%. Delivery in the short rainy season (95% Confidence Interval [CI] Adjusted Odds Ratio [AOR] 1.21, 2.65) was associated with higher odds of practicing exclusive breastfeeding. On the one hand, mothers aged between 15 and 19 years of age (95% CI AOR 0.36, 0.93), the average size of infants at birth (95% CI AOR 0.38, 0.80), whether postnatal check-up was attended by a doctor (95% C AOR 0.06, 0.46), and the infant's age above 2 months (95% CI AOR 0.23, 0.53) were associated with lower odds of practicing exclusive breastfeeding. There was weak evidence (95% CI AOR 0.48, 1.05) that living in an urban area was associated with a reduced practice of exclusive breastfeeding.

CONCLUSION

Breastfeeding rates are lower among young mothers, mothers whose husbands/partners decide on childcare, and mothers whose postnatal check-ups were conducted by doctors. Thus, breastfeeding programs and interventions need to focus more on young mothers, husbands/partners, and on training female nurses and midwives to increase the EBF rates. Women who tend to practice exclusive breastfeeding most often live in rural areas. There is an urgent need to understand why exclusive breastfeeding rates among urban women are lower.

Gender inequality in early initiation of breastfeeding in Bangladesh: a trend analysis

Background

Early initiation of breastfeeding within 1 hour after birth is essential for newborns, because it reduces risk of neonatal mortality and hypothermia to a great extent and also helps in preventing the long-term chronic diseases and in increasing energy and immunity to newborn. In order to reach the ‘very good state’ of timely or early initiation of breastfeeding recommended by WHO, Bangladesh needs to increase the current rate of 51.24 to 100%. An attempt has been made in this study to examine how the early breastfeeding practice changes among male and female children with time controlling the factors associated with this practice.

Methods

Data from last four consecutive Bangladesh Demographic and Health Surveys (BDHS) have been used in the study. The participants were included whose child born within the last 5 years preceding the surveys of 2004, 2007 and 2011, and within the last 3 years preceding the survey of 2014 in the study and the respective selected participants were 5145, 4765, 7099 and 4370. To conduct the trend analysis, the descriptive statistics of selected variables along with prevalence of early initiation of breastfeeding have been computed by different years and a multiple logistic regression model has been fitted to the pooled dataset of 2004–2014 considering survey years as time.

Results

Rate of early initiation of breastfeeding increased as time progressed and it was faster for female child compared to male child. For example, female children were significantly 10 and 6% less likely to be initiated early than their counterparts in 2004 and 2007, respectively; whereas after 2007 both male and female children were equally treated for breastfeeding practice. It was also found that rate of early initiation significantly increased for one unit increased in survey year and this increasing rate was higher for female child compared to male child. For example, for one unit of increased in survey year, the early initiation of breastfeeding increased by 60% for male child and by 67% for female child. Besides, survey time, gender, education of parents, wanted index child, mode of delivery, antenatal care visits, wealth index, exposure to media and division were found to have potential influence on early initiation of breastfeeding.

Conclusion

Demographic and health surveys conducted in Bangladesh since 2011 have shown no evidence of gender discrimination regarding timely initiation of breastfeeding. In order to achieve the target rate of early initiation of breastfeeding recommended by WHO, it requires to take effective intervention regarding maternal and child health education.

Factors Associated with the Early Initiation of Breastfeeding in Economic Community of West African States (ECOWAS)

The early initiation of breastfeeding (EIBF) within one hour after birth enhanced mother–newborn bonding and protection against infectious diseases. This paper aimed to examine factors associated with EIBF in 13 Economic Community of West African States (ECOWAS). A weighted sample of 76,934 children aged 0–23 months from the recent Demographic and Health Survey dataset in the ECOWAS for the period 2010 to 2018 was pooled. Survey logistic regression analyses, adjusting for country-specific cluster and population-level weights, were used to determine the factors associated with EIBF. The overall combined rate of EIBF in ECOWAS was 43%. After adjusting for potential confounding factors, EIBF was significantly lower in Burkina Faso, Cote d’Ivoire, Guinea, Niger, Nigeria, and Senegal. Mothers who perceived their babies to be average and large at birth were significantly more likely to initiate breastfeeding within one hour of birth than those mothers who perceived their babies to be small at birth. Mothers who had a caesarean delivery (AOR = 0.28, 95%CI = 0.22–0.36), who did not attend antenatal visits (ANC) during pregnancy, and delivered by non-health professionals were more likely to delay initiation of breastfeeding beyond one hour after birth. Male children and mothers from poorer households were more likely to delay introduction of breastfeeding. Infant and young child feeding nutrition programs aimed at improving EIBF in ECOWAS need to target mothers who underutilize healthcare services, especially mothers from lower socioeconomic groups.

Early initiation of breastfeeding and associated factors among mothers of aged less than 12 months children in rural eastern zone, Tigray, Ethiopia: cross-sectional study

OBJECTIVES

The objectives of this study were to assess early initiation of breastfeeding and associated factors among mothers of aged less than 12 months children in the rural eastern zone, Tigray, Ethiopia.

RESULTS

Totally 803 mother-child pairs were participated in this study with a response rate of 99.25%. Out of this, 787 mothers had ever breastfed their children. Four hundred eighty-seven (61.9%) mothers initiated breastfeeding within 1 h after they gave birth. Mothers having an educational status of primary education were about 2 times more likely to initiate breastfeeding within 1 h of birth [AOR: 1.99, 95% CI 1.36-2.92] and those mothers having secondary education and above were 3.23 times more likely to start breastfeeding [AOR = 3.23, 95% CI 1.99-5.26]. Mothers who had mistimed pregnancy were 58% less likely to initiate breastfeeding within 1 h of birth [AOR: 0.42, 95% CI 0.27-0.65]. On the other hand, mothers who had delivered their child vaginally were 4.6 times more likely to start early initiation of breast feeding [AOR: 4.59, 95% CI 1.99-10.56].

Predictors of early initiation of breastfeeding among Zimbabwean women: secondary analysis of ZDHS 2015

Background

The World Health Organization recommends initiation of breastfeeding within the first hour of delivery. Early initiation is beneficial for both mother and baby. Previous Zimbabwe Demographic and Health Surveys (ZDHS) have shown reduction in early initiation of breast feeding from 68% (2005/06) to 58% (2015). This study sought to investigate factors associated with early initiation of breast feeding among women aged 15–49 years in Zimbabwe.

Methodology

Secondary analysis of ZDHS 2015 data was done to investigate the association between early initiation of breast feeding and maternal, provider and neonatal factors using multivariate logistic regression (n = 2192).

Results

The majority of the study sample (78%) reported having practised early initiation of breastfeeding during their most recent delivery (preceding 24 months).Children who were put on skin to skin contact (AOR = 1.51, 95% CI 1.13–2.02) and those delivered by skilled attendants (AOR = 4.36, 95% CI 1.07–17.77) had greater odds of early initiation compared to those who were not. Other factors associated with early initiation were multiparity (AOR 1.82 95% CI 1.33–2.49) and rural residence (AOR 2.10 95% 1.12–3.93). However, having an abnormal birth weight, i.e. low birth weight (AOR 0.60 95% CI 0.36–0.99) and macrosomia (AOR = 0.42, CI 0.22–0.79) as well as delivery by caesarean section (AOR 0.1195% CI 0.06–0.19) were associated with reduced odds of early initiation.

Conclusion

Early initiation of breast feeding in Zimbabwe is mainly associated with residing in the rural areas and multiparity. The 78% rate of early initiation of breastfeeding was contrary to the 58% reported in the ZDHS findings. Interventions targeting an improvement in early initiation of breastfeeding must aim at women who deliver by caesarean section, women with babies of abnormal birth weight, primi-parous women and women residing in rural areas.

Timely initiation of breastfeeding and associated factors among mothers of infants age 0-6 months old in Bahir Dar City, Northwest, Ethiopia, 2017: a community based cross-sectional study

Background

Early initiation of breastfeeding, also known as early initiation, is the provision of a mothers own breast milk to her infant within one hour of birth. In Ethiopia, there is a considerable variation in the timely initiation of breastfeeding practices. Therefore, the objective of this study was to assess the level of timely initiation of breastfeeding and associated factors among mothers of infants less than six months old in Bahir Dar, Northwest, Ethiopia.

Methods

A community-based cross-sectional study was conducted in Bahir Dar City from April 15 to May 3, 2017. A total of 472 mothers of infant age less than six months were selected by simple random sampling technique. Data were collected using an interviewer administered questionnaire. Descriptive statistics were done to know the distribution of variables. To identify predictors logistic regression was conducted.

Results

The prevalence of timely initiation of breastfeeding was 356 (75.4%). Mothers who birth by a vaginal delivery (Adjusted Odds Ratio [AOR] 6.99; 95% Confidence Interval [CI] 3.49, 14.00), mothers who gave birth at health institution (AOR 3.36; 95% CI 1.47, 7.67), and who get breastfeeding counseling during antenatal care visits (AOR 5.64; 95% CI 2.70, 11.79) were more likely to initiate breastfeeding within one hour than counterparts.

Conclusions

Practice of timely initiation of breastfeeding in this study was suboptimal. Mothers who delivered at the health institution, gave birth by a vaginal delivery, and who got breastfeeding counseling during antenatal visits were the independent predictors of the timely initiation of breastfeeding practice. Encouraging all mothers to give birth in health facilities, counsel mothers to initiate breastfeeding timely at time of Caesarean sections, reduce the indication of the Caesarean procedure and providing breastfeeding counseling during antenatal care visits were recommended. Additionally, health services must establish practices that enable timely breastfeeding whenever possible, in particular, after Caesarean section and systems need to be set up to enable skin-to-skin and timely breastfeeding.

Factors associated with delayed initiation of breastfeeding: a cross-sectional study in South Sudan

Background

The global breastfeeding recommendation states that all infants should be put to the breast within one hour of birth, which is defined as timely initiation or early initiation of breastfeeding. Early initiation of breastfeeding is associated with reduced risk in infant illness and death. Understanding the determinants of delay in initiation of breastfeeding might spur health staff and policy makers to foster timely breastfeeding. We assessed the prevalence and determinants of delay in initiation of breastfeeding among mothers in Juba Teaching Hospital.

Methods

The present study enrolled 806 mother-infant pairs within 24 hrs of birth in Juba Teaching Hospital in 2017. The mothers were interviewed about the time of initiation of breastfeeding, sociodemographic and birth characteristics. The independent variables associated with delay in initiation of breastfeeding were identified using multivariable logistic regression analysis.

Results

In the current study, 52% (418/806) of the mothers initiated breastfeeding later than one hour after birth. Birth by Caesarean section (Adjusted Odds Ratio [AOR] 41; 95% Confidence Interval [CI] 12.21, 138), discarding of colostrum (AOR 9.89; 95% CI 4.14, 23.62), unmarried mothers (AOR 3.76; 95% CI 1.53, 9.24), exposure to infant formula advertisement (AOR 1.82; 95% CI 1.09, 3.02) and no house ownership (AOR 1.52; 95% CI 1.11, 2.09) were independent factors associated with delay in initiation of breastfeeding.

Conclusion

We found that more than half of the mothers delayed the initiation of breastfeeding. Therefore, we recommend training on best breastfeeding practices and counselling skills for health staff in Juba Teaching Hospital. Policy dialogue, with the relevant ministries and departments on the promotion and protection of early initiation of breastfeeding is crucial.

Trends and factors associated with early initiation of breastfeeding in Namibia: analysis of the Demographic and Health Surveys 2000-2013

BACKGROUND

Early initiation of breastfeeding (EIBF) lowers the risk for all-cause mortality in babies, including those with low birth weight. However, rates of neonatal mortality and delayed initiation of breastfeeding remain high in most low- and middle-income countries. This study aimed to assess the trends and factors associated with EIBF in Namibia from 2000 to 2013.

METHODS

An analysis of EIBF trends was conducted using data from three Namibia Demographic Health Surveys. The present sample included singleton children younger than 2-years from 2000 (n = 1655), 2006-2007 (n = 2152) and 2013 (n = 2062) surveys. Descriptive statistics were used to analyse respondents' demographic, socioeconomic and obstetric characteristics. Factors associated with EIBF were assessed using univariate analysis and further evaluated using multivariable logistic regression analysis.

RESULTS

EIBF significantly decreased from 82.5% (confidence interval [CI]: 79.5-85.0) in 2000 to 74.9% (72.5-77.2) in 2013. Factors associated with EIBF in 2000 were urban residence (adjusted odds ratio 0.58, 95% CI: 0.36-0.93), poorer household wealth index (1.82, 1.05-3.17), lack of antenatal care (0.14, 0.03-0.81), small birth size (0.38, 0.24-0.63) and large birth size (0.51, 0.37-0.79). In 2013, factors associated with EIBF were maternal age of 15-19 years (2.28, 1.22-4.24), vaginal delivery (2.74, 1.90-3.93), married mothers (1.57, 1.16-2.14), delivery assistance from health professionals (3.67, 1.23-10.9) and birth order of fourth or above (1.52, 1.03-2.26).

CONCLUSIONS

Namibia has experienced a declining trend in EIBF rates from 2000 to 2013. Factors associated with EIBF differed between 2000 and 2013. The present findings highlight the importance of continued commitment to addressing neonatal health challenges and strengthening implementation of interventions to increase EIBF in Namibia.

Peer counselling improves breastfeeding practices: A cluster randomized controlled trial in urban Bangladesh

This study aimed to evaluate the impact of peer counselling on early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) rates for mother-infant pairs living in urban slums, Dhaka, Bangladesh. This randomized controlled trial enrolled 350 mother-infant pairs from selected slums between September 2014 and July 2016. The women assigned to intervention group received peer counselling from locally recruited, trained community female volunteers starting in third trimester of pregnancy until 6 months after delivery; control group received no intervention. EIBF, any liquids given after birth, and EBF were compared between groups. Follow-up was scheduled at enrolment, following childbirth, and every 2 months up to 6 months after delivery. Multiple logistic regressions were used to assess the effect peer counselling and other associated factors on EIBF and EBF practices. EIBF rate was higher in the intervention group than in the control group (89.1% vs. 77.4%, p = .005). More mothers in intervention group were exclusively breastfeeding at 5 months than mothers in the control group (73% vs. 27%, p < .005). Control mothers were twice as likely to not practice EIBF compared with intervention mothers (adjusted odds risk [aOR]: 2.53, CI [1.29, 4.97], p = .007). Overall, caesarean section was associated with an 8.9-fold higher risk of not achieving EIBF (aOR: 8.90, CI [4.05, 19.55], p < .001). Intervention mothers were 5.10-fold more likely to practice EBF compared with control mothers (aOR: 5.10, CI [2.89, 9.01], p < .001) at 5 months. This study demonstrates peer counselling can positively influence both EIBF and EBF among mothers living in urban area.

Early Initiation of Breastfeeding Among Maya Mothers in the Western Highlands of Guatemala: Practices and Beliefs

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.

Only half of the mothers practiced early initiation of breastfeeding in Northwest Ethiopia, 2015

Background

Early initiation of breastfeeding has been well-recognized in reducing neonatal mortality; however, it remains sub-optimal in Ethiopia. This study therefore assessed the prevalence of early initiation of breastfeeding and associated factors among mothers with children aged 6–24 months in Dabat Health and Demographic Surveillance System (HDSS) site, northwest Ethiopia, where literature on the issue is markedly scarce.

Methods

This community-based cross-sectional survey was carried out from May to June, 2015, at Dabat HDSS site, Dabat District. Eight hundred twenty-two mother–child pairs were included in the study. A multivariable logistic regression model was employed to identify factors associated with early initiation of breastfeeding.

Results

This study demonstrated that the prevalence of early initiation of breastfeeding was 53.3%. Institutional delivery (AOR = 4.9; 95% CI 3.2, 7.4), higher Infant and Young Child Feeding (IYCF) knowledge (AOR = 2.3; 95% CI 1.6, 3.3), higher wealth status (AOR = 4.1, 95% CI 2.8, 6.0) and low fathers’ education (AOR = 0.3, 95% CI 0.2, 0.6) were significantly associated with early initiation of breastfeeding in the multivariate analysis.

Conclusion

In summary, the coverage of early initiation of breastfeeding in Dabat HDSS site was low, considerably below the national target. Therefore, efforts should be intensified to step-up early initiation of breastfeeding by focusing on the identified determinants.

Timely initiation of breastfeeding and its association with birth place in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Timely initiation of breastfeeding is defined as putting the newborn to the breast within 1 h of birth. In Ethiopia, different studies have been conducted to assess the prevalence of timely initiation of breastfeeding and associated factors. The findings of these studies were inconsistent and characterized by great variability. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence of timely initiation of breastfeeding and its association with birth place in Ethiopia using the available studies.

METHODS

Databases, including PubMed, Google scholar, Science direct and Cochrane library were systematically searched. All original studies reporting the prevalence of timely initiation of breastfeeding in Ethiopia were considered. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 11 statistical software was used to analyze the data. The Cochrane Q test statistics and I² test were used to assess the heterogeneity between the studies. A random effect model was computed to estimate the pooled prevalence of timely initiation of breastfeeding. In addition, the associations between timely initiation of breastfeeding and place of birth were determined.

RESULTS

Sixteen studies were finally included in the meta-analysis. The findings of this meta-analysis revealed that, the pooled prevalence of timely initiation of breastfeeding in Ethiopia was 61.4% (CI: 51.4, 71.5%). The study also indicated that rural mothers had lower rate of initiating breastfeeding within the first 1 h after delivery as compared to their urban counterparts. Additionally, mothers who gave birth at health institution were almost 2.11 times more likely to initiate breastfeeding within 1 h as compared to mothers who did not give birth at health institution.

CONCLUSION

In this study, timely initiation of breastfeeding in Ethiopia was significantly low compared to the current global recommendation on breastfeeding. Women from rural area were less likely to initiate breastfeeding within 1 h as compared with women from urban areas. Mothers who give birth at health institution were more likely to initiate breastfeeding timely.

Infant feeding practices in the Saharawi refugee camps Algeria, a cross-sectional study among children from birth to six months of age

BACKGROUND

Appropriate breastfeeding and infant feeding practices are crucial to a child's growth and development. The objective of this paper is to describe breastfeeding and general feeding practices and the nutrition status among children from birth to 6 months of age, in the Saharawi refugee camps located in Algeria.

METHODS

A cross-sectional study was carried out among 111 lactating mothers with infants from birth to 6 months of age. Data regarding breastfeeding practices and a 24 h dietary recall for the infants were collected to assess the World Health Organization's (WHO) indicators for infant and young child feeding. For exclusive and predominant breastfeeding, age disaggregation for each month was applied to the data. Background characteristics from the mothers and infants were collected, together with anthropometrical measures. We explored predictors for breastfeeding and nutrition status in multiple regression models.

RESULTS

In total 13.8%, 8.2% and 16.5% of the infants were stunted, wasted and underweight, respectively. Approximately 65% initiated breastfeeding within 1 h after birth and 11.7 and 21.6% were exclusively or predominantly breastfed less than 6 months. The most commonly given solid foods were dates (27.0%) and bread (10.8%). In multiple regression models, initiation of breastfeeding within 1 h after birth gave increased probability of exclusive or predominant breastfeeding. Giving birth at home as opposed to in a hospital and increasing number of children gave increased probability of initiating breastfeeding early. Exclusive or predominant breastfeeding seemed to protect against underweight and wasting.

CONCLUSIONS

Exclusively or predominant breastfeeding was low among Saharawi refugee infants. Wasting and underweight was common and more likely to occur if the infants were not exclusively or predominantly breastfed. These findings support the current international breastfeeding recommendations, and suggest that there is an urgent need for promoting infant feeding practices in the Sahara refugee camps.

Timely initiation of breastfeeding and associated factors among mothers in Motta town, East Gojjam zone, Amhara regional state, Ethiopia, 2015: a cross-sectional study

BACKGROUND

Timely initiation of breastfeeding within one hour after birth and exclusive breastfeeding is recommended for the first six months of infant life along with continuation of breastfeeding up to two years. Timely initiation of breastfeeding has the potential to prevent 22 % of neonatal deaths. The objective of this study was to assess timely initiation of breastfeeding and associated factors among mothers who have infants less than six months of age in Motta town, East Gojjam, Amhara Regional State, Ethiopia.

METHOD

Community based quantitative cross-sectional study was conducted from April 7, 2015 to May 7, 2015. Simple random sampling technique was applied after taking all registered mothers who have infants less than 6 months old from local health extension workers of each kebele. A total of 423 mothers with infant less than six month old were included in this study. The data was collected from all four Kebeles using interviewer administered questionnaire. Descriptive and inferential statistics were used to present the data. Both bivariate and multivariate logistic regression analyses were used to identify factors associated with timely initiation breastfeeding.

RESULT

Prevalence of timely initiation of breastfeeding was78.8 % [95 % CL: 74.88 %, 82.72 %]. Mothers who gave birth to their infant in a health institution [AOR = 3.486(1.253, 9.700)], birthed vaginally [AOR = 5.722(3.134, 11.246)] and didn't give prelacteal food [AOR = 4.627(2.095, 10.220)] were more likely to initiate breastfeeding early than their counterparts.

CONCLUSION

Prevalence of timely initiation of breastfeeding in the study area was 78.8 %. Place of delivery, mode of delivery and prelactal feeding were the independent predictors of timely initiation of breastfeeding. Recommendations to increase timely initiation of breastfeeding were: encouraging mothers to deliver their child in a health institution, minimizing caesarean delivery as much as possible and educating mothers and community as a whole to avoid traditional prelactal feeding practice.