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Ballesta-Castillejos A, Rodríguez-Almagro J, Gómez-Salgado J, Martínez-Galiano JM, Romero-Blanco C, Hernández-Martínez A. Preparation and validation of a predictive model of breastfeeding initiation in the first hour of life. Midwifery 2024; 134:104019. [PMID: 38718431 DOI: 10.1016/j.midw.2024.104019] [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: 12/30/2023] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 06/17/2024]
Abstract
OBJECTIVE The objective was to develop and validate a predictive model of initiation of breastfeeding in the first hour after delivery. METHODS Retrospective cohort study on women who gave birth between 2013 and 2018 in Spain. For data collection, an ad hoc questionnaire was designed to be filled in by the mothers, which was distributed to the different Spanish breastfeeding associations which, in turn, shared it with their associate partners. The development of the predictive model was made on a cohort of 3218 women (2/3) and was validated on a cohort of 1609 women (1/3). Mothers whose children were admitted to hospital at the time of birth were excluded. A multivariate analysis was performed by means of logistic regression, and predictive ability was determined by areas under the ROC curve (AUC). RESULTS 81.0 % (2608) women started breastfeeding in the first hour in the derivation cohort, and 80.1 % (1289) in the validation cohort. The predictive factors in the final model were: the highest number of children and skin-to-skin contact at birth as flattering factors, while dystocic delivery reduced the likelihood of the onset of breastfeeding. The predictive ability (ROC AUC) in the derivation cohort was 0.89 (CI 95 %: 0.87-0.90), while in the validation cohort it was 0.89 (CI 95 %: 0.87-0.92). CONCLUSIONS This three-variable predictive model has excellent predictive ability in both the derivation cohort and the validation cohort. This model can identify women who are at high risk of non-initiating breastfeeding within the first hour after delivery.
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Affiliation(s)
| | - Julián Rodríguez-Almagro
- Department of Nursing. Ciudad Real School of Nursing. University of Castilla La-Mancha, Ciudad Real, Spain.
| | - Juan Gómez-Salgado
- Deparment of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva 21071, Spain; Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - Juan Miguel Martínez-Galiano
- Department of Nursing, University of Jaén, Spain. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Cristina Romero-Blanco
- Department of Nursing. Ciudad Real School of Nursing. University of Castilla La-Mancha, Ciudad Real, Spain
| | - Antonio Hernández-Martínez
- Department of Nursing. Ciudad Real School of Nursing. University of Castilla La-Mancha, Ciudad Real, Spain
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Terefe B, Belachew TB, Asmamaw DB, Wassie GT, Azene AG, Eshetu HB, Muchie KF, Bantie GM, Bogale KA, Negash WD. Determinants of early initiation of breastfeeding following birth in West Africa: A multilevel analysis using data from multi-country national health surveys. PLoS One 2024; 19:e0302143. [PMID: 38753614 PMCID: PMC11098389 DOI: 10.1371/journal.pone.0302143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/28/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Early initiation of breastfeeding (EIBF), within the first hour of birth, is crucial for promoting exclusive breastfeeding and establishing optimal nursing practices. However, global EIBF rates remain low, with even lower rates observed in Africa. Despite existing research gaps, this study aims to determine the prevalence of EIBF and identify maternal and child-related factors associated with its practice in West Africa. METHODS This study utilized West African Demographic and Health Survey (DHS) data from 13 countries, including 146,964 children's records. To assess model fit, likelihood test and deviance were used. Similarly, intraclass correlation coefficient, median odds ratio, and proportional change in variance were employed for random effect. A multilevel logistic regression model was used to identify individual- and community-level factors influencing EIBF due to the hierarchical nature of the data. Variables with p-values ≤0.2 in the binary model and <0.05 in the final analysis were considered significantly associated with EIBF. RESULTS The pooled prevalence of EIBF in West African nations was 50.60% (95% CI; 50.34-50.85%). The highest prevalence rate was observed in Serra Leone (75.33%) and the lowest prevalence was found in Senegal (33.94%). In the multilevel multiple logistic regression model, maternal education (AOR = 1.10, 95% CI, 1.03,1.16), marital status AOR = 1.07, 95% CI, 1.01,1.13), birth weight (AOR = 0.91, CI 0.86,0.96), birth orders (AOR = 1.09, CI 1.03,1.16), and (AOR = 1.11, CI 1.03,1.19), place of residence (AOR = 1.14, CI 1.07,1.21), and mode of delivery type (AOR = 0.26, CI 0.24,0.29) were significantly correlated with EIBF in West Africa. CONCLUSIONS The incidence of EIBF in West Africa was found to be low. The study emphasizes the need for targeted behavioral change communication programs to address timely breastfeeding initiation, specifically targeting mothers and child characteristics. Factors such as education, delivery mode, marital status, birth weight, birth order, and place of residence were significantly associated with EIBF. Special attention should be given to improving EIBF rates among women undergoing caesarean sections, infants with low birth weight, and primiparous mothers, along with structural improvements in the healthcare sector in West Africa.
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Affiliation(s)
- Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadele Biresaw Belachew
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gizachew Tadesse Wassie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abebaw Gedef Azene
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Habitu Birhan Eshetu
- Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kindie Fentahun Muchie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Kassawmar Angaw Bogale
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Wubshet Debebe Negash
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Kumar N, Al-Nahar M, Harris N, Sampath V. Early and Higher Volumes of Formula Supplementation after Birth Impact Breastfeeding Rates at Discharge in Well-Baby Nursery: A Retrospective Cohort Study. Am J Perinatol 2024; 41:e3293-e3304. [PMID: 38011861 DOI: 10.1055/a-2217-9174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
OBJECTIVE Physiologic breast milk production in the first 24 hours is estimated to be between 2 and 10 mL per feed. Many mothers intending to breastfeed use formula supplementation (FS) early on, which can affect successful breastfeeding. Whether the volume and timing of FS introduced in the first 24 hours of life (24 HOL) impacts the rate of "breastfeeding at discharge" (BFAD) is not well-studied and was investigated herein. STUDY DESIGN Single-center, retrospective, chart review of breastfeeding infants born at ≥35 weeks who received supplementation in the first 24 HOL. Comprehensive demographic data pertaining to maternal and infant characteristics, along with infant feeding data, were collected. Four supplementation characteristics, (timing, rate, volume [mL/kg per feed], and type [expressed breast milk (EBM) or formula]) were correlated with BFAD. RESULTS Among 3,102 supplemented infants in whom mothers intended to breastfeed, 1,031 (33.2%) infants were BFAD. At baseline, African American, Medicaid-insured, and single mothers had lower odds of BFAD. The overall maximum volume of FS per feed was 11.0 mL/kg (interquartile range 8.0-14.4). With each hour of delay in first supplementation, the odds of BFAD increased by 2.8% (95% confidence interval [CI] 0.022, 0.035). With every 1 mL/kg increase in the first formula volume, subsequent supplementation frequency increased by 4.5%. A positive association was observed between BFAD and a lower rate of supplementation (cutoff value ≤35.1%). However, among infants with these lower rates of supplementation, each unit increase in maximum FS, from 2 to 15 mL/kg, decreased the probability of BFAD by 4.2% (3.6-4.7%). Additionally, we observed that infants who were given at least one EBM supplementation (n = 223; 7.2%) had substantially increased rates of BFAD (odds ratio [OR] = 9.8, 95% CI 7.2-13.3). CONCLUSION Early and higher volumes of FS negatively impacted BFAD. Birthweight-based FS of feeding with physiological volumes may increase breastfeeding rates at discharge. KEY POINTS · Higher volumes of first supplementation increases subsequent supplementation frequency.. · For each unit increase in maximum supplementation, BFAD probability decreases by 4.2%.. · Even one EBM supplementation increases rates of BFAD..
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Affiliation(s)
- Navin Kumar
- Department of Pediatrics/Neonatology, Hurley Children's Hospital, Flint, Michigan
| | - Mohammed Al-Nahar
- Department of Pediatrics/Neonatology, Hurley Children's Hospital, Flint, Michigan
| | - Nathalee Harris
- Department of Pediatrics/Neonatology, Hurley Children's Hospital, Flint, Michigan
| | - Venkatesh Sampath
- Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri
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Abebe GF, Tilahun M, Tadesse H, Seid A, Yigremachew T, Birhanu AM, Girma D. Predictors of delayed initiation of breast milk and exclusive breastfeeding in Ethiopia: A multi-level mixed-effect analysis. PLoS One 2024; 19:e0301042. [PMID: 38568996 PMCID: PMC10990229 DOI: 10.1371/journal.pone.0301042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 03/10/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Despite the well-established benefits of early initiation of breastfeeding and exclusive breastfeeding for the first six months to promote optimal neonatal and child health, evidence indicates that in Ethiopia, a significant number of newborns initiate breastfeeding late, do not adhere to exclusive breastfeeding (EBF) for the recommended duration, and instead are fed with bottles. OBJECTIVE To determine the proportion of delayed initiation of breast milk, exclusive breastfeeding, and its individual and community-level predictors among mothers in Ethiopia. METHODS A secondary data analysis was done using the 2019 Ethiopian Mini Demographic Health Survey data. We examined a weighted sample of 2,012 children born within the past 24 months and 623 children aged 0-5 months at the time of the survey. The data analysis was done using STATA version 15. To understand the variation in delayed initiation and exclusive breastfeeding, statistical measures such as the Intraclass correlation coefficient, median odds ratio, and proportional change in variance were calculated. We employed a multilevel mixed-effects logistic regression model to identify predictors for each outcome variable. Statistical significance was determined with a p-value < 0.05. RESULTS The proportion of delayed initiation of breast milk and exclusive breastfeeding were 24.56 and 84.5%, respectively. Women aged 34-49 years old (AOR = 0.33: 95% CI; 0.15-0.72), having a television in the house (AOR = 0.74: 95%CI; 0.33-0.97), delivered by cesarean section (AOR = 3.83: 95% CI; 1.57-9.32), and resided in the Afar regional state (AOR = 1.43: 95%CI; 1.03-12.7) were significantly associated with delayed initiation of breast milk. On the other hand, attended primary education (AOR = 0.67: 95%CI; 0.35-0.99), secondary education (AOR = 0.34: 95%CI; 0.19-0.53), women whose household headed by male (AOR = 0.68; 95% CI; 0.34-0.97), and rural residents (AOR = 1.98: 95%CI; 1.09-3.43) were significantly associated with exclusive breastfeeding practice. CONCLUSION Health promotion efforts that encourage timely initation of breast milk and promote EBF, focused on young mothers, those who gave birth through cesarean section, and those residing in urban and the Afar regional state. Furthermore, government health policymakers and relevant stakeholders should consider these identified predictors when revising existing strategies or formulating new policies.
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Affiliation(s)
- Gossa Fetene Abebe
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia
| | - Menen Tilahun
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia
| | - Hana Tadesse
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia
| | - Abdu Seid
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia
| | - Tariku Yigremachew
- School of Medicine, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia
| | - Anteneh Messele Birhanu
- School of Medicine, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia
| | - Desalegn Girma
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia
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Jurgelėnė V, Kuzmickienė V, Stonienė D. The Role of Skin-to-Skin Contact and Breastfeeding in the First Hour Post Delivery in Reducing Excessive Weight Loss. CHILDREN (BASEL, SWITZERLAND) 2024; 11:232. [PMID: 38397344 PMCID: PMC10887814 DOI: 10.3390/children11020232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/01/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND AND AIMS An excessive weight loss (EWL) of >10% after birth is associated with serious health outcomes. The aim of this study was to determine factors that can reduce weight loss in full-term, exclusively breastfed infants after birth. METHODS This is a retrospective, observational, single-center study. We included 642 healthy, full-term, exclusively breastfed neonates born in 2019 in a baby-friendly hospital, and their healthy mothers. The exclusion criteria were as follows: supplementation with formula, multiple pregnancies, and neonates or mothers with health issues. RESULTS The mean percentage of neonatal weight loss after 24 h of life was 5.13%, and that after 48 h was 6.34%. Neonates delivered via a caesarean section lost more weight after 24 and 48 h of life than those delivered via vaginal delivery (p < 0.01). There is a noticeable pattern that neonates tend to lose more weight if they do not get skin-to-skin contact (SSC) and breastfeeding within the first hour after birth (p > 0.05). CONCLUSIONS Neonates born via a CS tend to lose more weight after 24 and 48 h of life. Immediate SSC and breastfeeding in the first hour after delivery may decrease the excessive weight loss.
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Affiliation(s)
- Valentina Jurgelėnė
- Department of Neonatology, Faculty of Medicine, Lithuanian University of Health Sciences, LT44307 Kaunas, Lithuania; (V.J.); (V.K.)
- Department of Neonatology, Hospital of Lithuanian University of Health Sciences (LUHS) Kauno Klinikos, LT50161 Kaunas, Lithuania
| | - Vilma Kuzmickienė
- Department of Neonatology, Faculty of Medicine, Lithuanian University of Health Sciences, LT44307 Kaunas, Lithuania; (V.J.); (V.K.)
- Department of Neonatology, Hospital of Lithuanian University of Health Sciences (LUHS) Kauno Klinikos, LT50161 Kaunas, Lithuania
| | - Dalia Stonienė
- Department of Neonatology, Faculty of Medicine, Lithuanian University of Health Sciences, LT44307 Kaunas, Lithuania; (V.J.); (V.K.)
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Geleta D, Abebe G, Workneh N, Ararso M, Tilahun T, Beyene G. Hierarchical Predictors of Mortality in Neonatal Sepsis at Jimma Medical Center, Ethiopia: A Case-Control Study. J Multidiscip Healthc 2024; 17:541-555. [PMID: 38348209 PMCID: PMC10860391 DOI: 10.2147/jmdh.s446303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/26/2024] [Indexed: 02/15/2024] Open
Abstract
Background Neonatal sepsis made the neonatal period the most perilous time for child survival, and it continued to cause preventable mortalities worldwide. These mortalities stem from the interaction of several factors that have not been sufficiently studied and, in some cases, remain overlooked. Thus, the study aims to investigate the predictors of mortality that arise from the interaction of these factors and quantitatively determine their etiologic fraction. Methods A case-control study with hierarchical data input was conducted at Jimma Medical Center (JMC) in Oromia, Ethiopia, spanning from May 2022 to July 2023. It employed logistic regression to calculate adjusted odds ratios (AORs) and their corresponding 95% confidence intervals (CI) at a significance level of p ≤ 0.05. The model adjusted odds ratios (ORs) for variables within each level and farther levels and presented an etiologic fraction (EF), indicating the proportion of neonatal mortality attributable to specific factors. Results The analysis of 67 cases and 268 controls unveiled significant predictors of mortality in sepsis that emerged from distal, intermediate, and proximal levels. In the final model, thus, rural residence [AOR 3.1; 95% CI (1.5, 6.3), p ≤ 0.01], prolonged labor [AOR 4.5; 95% CI (2.2, 9.3), p ≤ 0.01], prematurity [AOR 3.9; 95% CI (1.9, 7.9), P ≤ 0.0], gram-negative bacteremia [AOR 3.8; 95% CI (1.9, 7.6); P ≤ 0.01], convulsion [AOR 3.2; 95% CI (1.6, 6.4); P ≤ 0.03], low birth weight [AOR 2.7; 95% CI (1.3, 5.4); P≤0.01], and delayed breastfeeding [AOR 2.5; 95% CI (1.2, 4.9); P ≤ 0.01] attributed a variable percentage of mortality. Conclusion Factors emerging and interacting at distal (residence), intermediate (prolonged labor), and proximal (prematurity, birth weight, convulsion, bacterial etiology, and feeding) levels influence neonatal mortality in sepsis at JMC. Therefore, concurrently improving rural family characteristics, managing labor duration, strengthening diagnostic stewardship, and promoting essential newborn care can actively prevent and reduce these mortalities.
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Affiliation(s)
- Daniel Geleta
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Jimma University, Jimma, Oromia, Ethiopia
| | - Gemeda Abebe
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Jimma University, Jimma, Oromia, Ethiopia
- Mycobacteriology Research Center, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Netsanet Workneh
- Department of Pediatrics and Child Health, Faculty of Medicine, Jimma University, Jimma, Oromia, Ethiopia
| | - Mekdes Ararso
- Department of Pediatrics and Child Health, Faculty of Medicine, Jimma University, Jimma, Oromia, Ethiopia
| | - Tsion Tilahun
- Department of Pediatrics and Child Health, Faculty of Medicine, Jimma University, Jimma, Oromia, Ethiopia
| | - Getenet Beyene
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Jimma University, Jimma, Oromia, Ethiopia
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Ahmed S, Mahmud N, Farzana N, Parvin MI, Alauddin M. 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. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2023; 42:737-745. [PMID: 36630312 DOI: 10.1080/27697061.2022.2161663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/02/2022] [Accepted: 12/17/2022] [Indexed: 06/17/2023]
Abstract
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.
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Affiliation(s)
- Suzon Ahmed
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Niaz Mahmud
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
- Food and Nutritional Sciences Program, North Carolina Agricultural and Technical State University, Greensboro, North Carolina, USA
| | - Nisat Farzana
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Mst Irin Parvin
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Md Alauddin
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
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Ibrahim KH, Ali AM, Wondimagegne ZT. Cessation of exclusive breastfeeding and predictors among infants aged 0-6 months in Ararso district of the Somali region, Ethiopia. A community-based cross-sectional study. PeerJ 2023; 11:e15963. [PMID: 37780392 PMCID: PMC10538283 DOI: 10.7717/peerj.15963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 08/03/2023] [Indexed: 10/03/2023] Open
Abstract
Background Exclusive breastfeeding (EBF) is the gold standard of child feeding practice in which the infant only receives breast milk without any additional food or drink, not even water and it lasts up to 6 months after delivery. In the study area, there is a lack of data on the prevalence of cessation of EBF. Methods Community-based cross-sectional study design was used among 292 mothers of infants aged 0-6 months. The data was collected using a pretested structured questionnaire. Bivariate and multivariate logistic regression analyses were carried out. An odds ratio with a 95% confidence interval was used to measure the strength of the association. Statistical significance was declared at P-value <0.05. Results The prevalence of cessation of EBF was 57.3% with 95% CI [50.9-62.6]. This study showed being employed (working outside the home) (AOR = 2.44; 95% CI [1.32-4.53]), being rural residence (AOR = 1.87; 95% CI [1.05-3.32]), and inadequate knowledge of EBF (AOR = 2:02; 95% CI [1.19-3.43]) were independent predictors of cessation of EBF. Conclusion and Recommendation Our data identified a higher prevalence of cessation of EBF in the study area compared to most studies in Ethiopia and elsewhere. Efforts on improving knowledge of the importance of EBF particularly in rural areas and support for breastfeeding-employed women are recommended.
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Affiliation(s)
- Kalid Hassen Ibrahim
- College of Dry Land Agriculture Food Science and Nutrition Program, Jigjiga University, Jigjiga, Somale Regional State, Ethiopia
| | - Abdulkarim Mohammed Ali
- College of Dry Land Agriculture Food Science and Nutrition Program, Jigjiga University, Jigjiga, Somale Regional State, Ethiopia
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Kumar N, Oredein I, Al-Nahar M, Harris N, Sampath V. Impact of feeding volumes in the first 24 h of life on neonatal feeding intolerance. Front Pediatr 2023; 11:1245947. [PMID: 37705598 PMCID: PMC10495575 DOI: 10.3389/fped.2023.1245947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/03/2023] [Indexed: 09/15/2023] Open
Abstract
Objective This study investigates whether volumes of intake in the first 24 h of life (24 HOL), in relation to birth weight (BW) and gestational age (GA), impact neonatal feeding intolerance (FI). Methods This study employed a retrospective chart review of 6,650 infants born at ≥35 weeks. The volumes of each formula feed per kg BW in the first 24 HOL were assessed. FI was defined as evidenced by chart documentation of emesis, abdominal distension, abdominal x-ray, and/or switching to a sensitive formula. Results Overall, the maximum volume of formula intake per feed was inversely correlated with GA and was higher in infants with FI (β = -1.39, p < 0.001) compared with infants without FI (β = -1.28, p < 0.001). The odds of emesis in late preterm infants with first feeding of >8 ml/kg [adjusted odds ratio (AOR) = 2.5, 95% confidence interval (CI): 1.4-4.6] and formula switching in the exclusively formula-fed group with volumes >10.5 ml/kg [AOR = 2.2, 95% CI (1.8-2.6)] were high. In the breastfeeding group, the odds of FI increased by 2.8-, 4.6-, and 5.2-fold with 5-10, 10-15, and >15 ml/kg of supplementations, respectively. Conclusion A higher volume of intake in relation to BW often exceeds the physiological stomach capacity of newborns and is associated with early FI. Optimizing early feeding volumes based on infant BW and GA may decrease FI, which may be an issue of volume intolerance.
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Affiliation(s)
- Navin Kumar
- Division of Neonatology, Hurley Children’s Hospital, Flint, MI, United States
| | | | - Mohammed Al-Nahar
- Division of Neonatology, Hurley Children’s Hospital, Flint, MI, United States
| | - Nathalee Harris
- Division of Neonatology, Hurley Children’s Hospital, Flint, MI, United States
| | - Venkatesh Sampath
- Division of Neonatology, Children’s Mercy Hospital, Kansas City, MO, United States
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Armah-Ansah EK, Wilson EA, Oteng KF, Bawa B, Dawson JY. Examining the prevalence and determinants of early initiation of breastfeeding: Evidence from the 2017/2018 Benin demographic and health survey. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002278. [PMID: 37585375 PMCID: PMC10431659 DOI: 10.1371/journal.pgph.0002278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/18/2023] [Indexed: 08/18/2023]
Abstract
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.
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Affiliation(s)
- Ebenezer Kwesi Armah-Ansah
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Population Dynamics Sexual and Reproductive Health Unit, African Population and Health Research Center, Nairobi, Kenya
- Department of Population and Development, National Research University–Higher School of Economics, Moscow, Russia
| | - Elvis Ato Wilson
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | - Kenneth Fosu Oteng
- Ashanti Regional Health Directorate, Ghana Health Service, Kumasi, Ghana
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Ahmmed F, Hossain MJ, Sutopa TS, Al-Mamun M, Alam M, Islam MR, Sharma R, Sarker MMR, Azlina MFN. The trend in exclusive breastfeeding practice and its association with maternal employment in Bangladesh: A multilevel analysis. Front Public Health 2022; 10:988016. [PMID: 36504941 PMCID: PMC9732371 DOI: 10.3389/fpubh.2022.988016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/27/2022] [Indexed: 11/27/2022] Open
Abstract
Exclusive breastfeeding (EBF) is essential for infant and child health. This study aimed to explore the trend in the EBF over the last decade in Bangladesh and investigated if there was a significant association with maternal employment by analyzing the data extracted from three consecutive nationally representative surveys: Bangladesh Demographic and Health Surveys (BDHS) of 2011, 2014, and 2017-2018. Prevalence of EBF (95% confidence interval) with the Cochran-Armitage test was reported to see the trend in EBF. A chi-square (χ2) test was applied to find the potential factors associated with EBF. Finally, a three-level logistic regression was utilized to find the significant association between maternal employment and EBF while adjusting other covariates. We observed no increase in the practice of EBF over the last decade (P = 0.632). The prevalence of EBF was 64.9% (95% CI: 61.41, 68.18) in 2011, followed by 60.1% (95% CI: 56.25, 64) in 2014, and 64.9% (95% CI: 61.82, 67.91) in 2017. Regression results showed that employed mothers had 24% (p < 0.05) lower odds of EBF than unemployed mothers. Early initiation of breastfeeding was also found to be significantly associated [Adjusted odds ratio (AOR): 1.22, P < 0.05] with EBF. Government and policymakers must come forward with new interventions to increase the practice of EBF, providing basic education and campaigns on the topic of EBF. Maternity leave should be extended up to 6 months of the child's age to achieve an optimal level of EBF.
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Affiliation(s)
- Foyez Ahmmed
- Department of Statistics, Comilla University, Cumilla, Bangladesh
| | - Md. Jamal Hossain
- Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh,*Correspondence: Md. Jamal Hossain ;
| | | | - Md. Al-Mamun
- Department of Sociology, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
| | - Morshed Alam
- Institute of Education and Research, Jagannath University, Dhaka, Bangladesh
| | - Md. Rabiul Islam
- Department of Pharmacy, University of Asia Pacific, Dhaka, Bangladesh
| | - Rohit Sharma
- Department of Rasashastra and Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | | | - Mohd Fahami Nur Azlina
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,Mohd Fahami Nur Azlina
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Kassie B, Wube T, Jara D, Teshome M, Shiferaw A, Getaneh S, Desta M. A prospective follow-up study on how long newborns are fasting in Debre Markos Comprehensive Specialized Hospital, Ethiopia, 2020. PLoS One 2022; 17:e0268558. [PMID: 35972926 PMCID: PMC9380941 DOI: 10.1371/journal.pone.0268558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 05/03/2022] [Indexed: 11/26/2022] Open
Abstract
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.
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Affiliation(s)
- Bekalu Kassie
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
- * E-mail:
| | - Tejitu Wube
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Dube Jara
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Muluken Teshome
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Aster Shiferaw
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Sefinew Getaneh
- Department of Public Health Specialist in Epidemiology, Debre Markos Comprehensive Specialized Hospital, Debre Markos, Ethiopia
| | - Melaku Desta
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Female Genital Mutilation/Cutting and Breastfeeding Outcomes: The Modifying Effects of Healthcare Access and Women’s Attitudes to FGM/C. WOMEN 2022. [DOI: 10.3390/women2030021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The prevalence of female genital mutilation/cutting (FGM/C) in Nigeria is on the rise, although the practice has no known medical/health benefits. This study aims to assess FGM/C’s effect on breastfeeding outcomes and to identify the role of women’s attitudes and their access to healthcare services on these relationships. Associations between FGM/C and breastfeeding outcomes were measured using multi-logistic regression. About 32% of women underwent FGM/C, and 23% believed FGM/C should continue. Women exposed to FGM/C were less likely to initiate early breastfeeding (OR = 0.56, [95% CI = 0.47–0.66]) or to breastfeed exclusively (0.64, [0.57–0.73]). FGM/C acceptance reduced odds of early initiation of breastfeeding (0.57, [0.45–0.73]) (p for interaction < 0.001) and exclusive breastfeeding (0.65, [0.59–0.78]) (p for interaction < 0.001). Four or more antenatal care visits while pregnant modified the associations between FGM/C and early initiation (1.55, [1.26–1.90) (p for interaction < 0.001) or exclusive breastfeeding (2.01, [1.73–2.330]) (p for interaction < 0.001), respectively. FGM/C is associated with breastfeeding outcomes, but this association may be improved with healthcare access and attitudinal changes towards FGM/C. Targeted public health education interventions raising awareness about FGM/C and breastfeeding and policy changes increasing access to prenatal healthcare services in underserved areas are recommended.
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Factors Influencing Early Initiation of Breastfeeding in Healthy Term Newborns: A Cross-Sectional Study at a Tertiary Care Center in South India. Neonatal Netw 2022; 41:129-136. [PMID: 35644358 DOI: 10.1891/11-t-738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Despite well-known benefits, rates of exclusive breastfeeding and early initiation of breastfeeding are very low. This study was conducted to identify most important and easily modifiable barriers to Early Initiation of Breast Feeding (EIBF).Methods: This hospital-based cross-sectional study was conducted from January 2018 to December 2018. Data on factors which could impact EIBF was collected by interviewing with mothers using semi-structured questionnaire.Results: Only 306 (33.7 percent) of the total 908 mother-neonate dyads enrolled received breastfeeding within 1 hour of birth. Factors affecting EIBF included: delivery by lower segment cesarean section (LSCS), lack of prenatal advice on breastfeeding, use of prelacteal feeds, and maternal illness.Conclusion: Rates of EIBF were very low in present setting. Counseling during antenatal visits on the importance of EIBF, and having adequate staff to support initiation of BF, may improve the EIBF.
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Dudukcu FT, Aygor H, Karakoc H. Factors Affecting Breastfeeding within the First Hour After Birth. Niger J Clin Pract 2022; 25:62-68. [PMID: 35046197 DOI: 10.4103/njcp.njcp_703_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Every baby should start life with breastfeeding. However, some obstacles prevent babies from enjoying this right. Aim This study aimed to determine the factors affecting breastfeeding within the first hour after birth. Patients and Methods This study employed a comparison design. This was a comparative study of women who breastfeed their babies within 1 h of birth and those who did not. The research population consisted of 368 mothers who had babies aged 6-24 months. A semi-structured questionnaire, which consisted of 32 open- and closed-ended questions, was used to collect data. The number and proportions were used for the descriptive statistics, and Chi-square tests were used to compare data between groups. The level of statistical significance was accepted as P < 0.05. Results Of the 368 participants, 50.8% breastfed their babies within the first hour after birth, 49.2% did not breastfeed within the first hour, 51.6% exclusively breastfed in the first 6 months, 48.4% did not breastfeed exclusively in the first 6 months. Moreover, results revealed that a high-risk pregnancy status, mode of delivery, prelacteal food, and the mother's role in making decisions about baby feeding affects breastfeeding practices within the first hour after birth. Conclusions Initiatives should be increased to start breastfeeding within the first hour after birth in women who have high-risk pregnancy and those giving birth by cesarean section. Breast milk should be the baby's first food, and mothers should be the primary decision-makers in baby's nutrition.
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Affiliation(s)
- F T Dudukcu
- Department of Nursing, College of Health Science, KTO Karatay University, Akabe Neighborhood, Alaaddin Kap Street No: 130, Karatay, Turkey
| | - H Aygor
- Department of Nursing, Faculty of Nursing, Necmettin Erbakan University, Yunus Emre, Beyşehir St. No: 281 D: No: 281, Meram, Turkey
| | - H Karakoc
- Department of Midwifery, KTO Karatay University, Akabe Neighborhood, Alaaddin Kap St. No: 130 Karatay, Konya, Turkey
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Santos MVD, Alves VH, Pereira AV, Vieira BDG, Rodrigues DP, Tavares MR, Calandrini TSDS, Ferreira EDA. O VALOR VITAL DO ALEITAMENTO MATERNO PARA MULHERES CUSTODIADAS. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2021-0455pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: compreender as percepções dos valores do aleitamento materno para lactantes custodiadas pelo sistema penal. Método: pesquisa qualitativa e fenomenológica, baseada nos valores schelerianos, com realização de sete entrevistas fenomenológicas com lactantes privadas de liberdade, na unidade prisional feminina do Rio de Janeiro, Brasil. As entrevistas foram realizadas entre novembro 2020 e maio de 2021. Após transcrições das falas, sucedeu-se à análise de conteúdo para o tratamento dos resultados. Resultados: identificaram-se duas categorias para o valor vital: o valor do vínculo como processo de expansão; a lactante como valor de segurança e proteção para o bebê. Por meio da percepção das lactantes privadas de liberdade, o valor vital identificado atua como proteção ao aleitamento materno dentro do espaço prisional, fortalecendo a saúde da mulher e criança. Conclusão: ao desvelar o valor vital, observa-se que este está relacionado à vida cotidiana da mãe e do bebê dentro do cárcere. Entretanto, a instituição prisional não satisfaz as reais necessidades vitais das lactantes custodiadas, sendo, então, necessário redirecionar a prática da amamentação no espaço prisional, transformando-o em ambiente legítimo, que valorize os sentidos do ato de amamentar.
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Hamed NF, Alamri SA, Hamdi NH. Overview of the Updates in Nutrient Profiles, Types, Indications and Side Effects of Infant Formula. ARCHIVES OF PHARMACY PRACTICE 2022. [DOI: 10.51847/confqadrfw] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Santos MVD, Alves VH, Pereira AV, Vieira BDG, Rodrigues DP, Tavares MR, Calandrini TSDS, Ferreira EDA. THE VITAL VALUE OF BREASTFEEDING FOR IMPRISONED WOMEN. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2021-0455en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to understand the perceptions about the values of breastfeeding for nursing mothers under custody of the penitentiary system. Method: a qualitative and phenomenological research study based on the Schelerian values, with seven phenomenological interviews conducted with nursing mothers deprived of their freedom in a women's prison unit from Rio de Janeiro, Brazil. The interviews took place between November 2020 and May 2021. Content analysis for treatment of the results was performed after transcribing the testimonies. Results: two categories were identified for the vital value: The value of bonding as a breastfeeding expansion process; and The nursing mother as a safety and protection value for the infant. Through the perception of the nursing mothers deprived of their freedom, the vital value identified acts as protection for breastfeeding within the prison setting, strengthening the woman's and child's health. Conclusion: by unveiling the vital value, it is observed that it is related to the mother's and infant's everyday life in prison. However, the prison institution does not meet the real vital needs of imprisoned nursing mothers, with the consequent need to redirect the breastfeeding practice in the prison setting, transforming it into a legitimate environment that values the meaning of breastfeeding.
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Raihana S, Alam A, Chad N, Huda TM, Dibley MJ. Delayed Initiation of Breastfeeding and Role of Mode and Place of Childbirth: Evidence from Health Surveys in 58 Low- and Middle- Income Countries (2012-2017). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115976. [PMID: 34199564 PMCID: PMC8199672 DOI: 10.3390/ijerph18115976] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/29/2021] [Accepted: 05/30/2021] [Indexed: 11/24/2022]
Abstract
Background: Timely initiation of breastfeeding is the first step towards achieving recommended breastfeeding behaviours. Delayed breastfeeding initiation harms neonatal health and survival, including infection associated neonatal mortality. Eighty percent of neonatal deaths occur in the low-and middle-income countries (LMICs), where delayed breastfeeding initiation is the highest. Place and mode of childbirth are important factors determining the time of initiation of breastfeeding. In this study, we report the prevalence of delayed breastfeeding initiation from 58 LMICs and investigate the relationship between place and mode of childbirth and delayed breastfeeding initiation in each country. Methods: We analysed data from the most recent Demographic and Health Survey (DHS) and Multiple Indicator Cluster Survey (MICS) collected between 2012 and 2017 and reported by 2019. The study sample comprised all women who had a live birth in the 24 months preceding the survey. ‘Delayed’ initiation of breastfeeding was defined using WHO recommendations as starting breastfeeding after one hour of birth. We coded the stratifying variable for the place and mode of childbirth as “vaginal birth at a facility (VBF)”, “caesarean section birth (CSB) “, and “vaginal birth at home (VBH)”. We used respondent-level sampling weights to account for individual surveys and de-normalised the standard survey weights to ensure the appropriate contribution of data from each country. We report the prevalence and population attributable fractions with robust standard errors. The population attributable risk identifies the proportion of delayed initiation that we could avert among VBH and CSB if everyone had the same risk of delaying breastfeeding as in VBF. Results: The overall prevalence of delayed initiation of breastfeeding was 53.8% (95% CI 53.3, 54.3), ranging from 15.0% (95% CI 13.8, 16.2) in Burundi to 83.4% (95% CI 80.6, 86.0) in Guinea. The prevalence of delayed initiation of breastfeeding was consistently high among women who experienced caesarean section births; however, there was no direct association with each country’s national caesarean section rates. The prevalence of delayed initiation among women who experienced VBF was high in Sub-Saharan Africa and South Asia, even though the CSB rates were low. In some countries, women who give birth vaginally in health facilities were more likely to delay breastfeeding initiation than women who did not. In many places, women who give birth by caesarean section were less likely to delay breastfeeding initiation. Population attributable risk percent for VBH ranged from −28.5% in Ukraine to 22.9% in Moldova, and for CSB, from 10.3% in Guinea to 54.8% in Burundi. On average, across all 58 countries, 24.4% of delayed initiation could be prevented if all women had the same risk of delaying breastfeeding initiation as in VBF. Discussion: In general, women who give birth in a health facility were less likely to experience delayed initiation of breastfeeding. Programs could avert much of the delayed breastfeeding initiation in LMICs if the prevalence of delayed initiation amongst women who experience CSB were the same as amongst women who experience VBF. Crucial reforms of health facilities are required to ensure early breastfeeding practices and to create pro-breastfeeding supportive environments as recommended in intervention packages like the Baby-friendly hospital initiative and Early essential newborn care. The findings from this study will guide program managers to identify countries at varying levels of preparedness to establish and maintain a breastfeeding-friendly environment at health facilities. Thus, governments should prioritise intervention strategies to improve coverage and settings surrounding early initiation of breastfeeding while considering the complex role of place and mode of childbirth.
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Affiliation(s)
- Shahreen Raihana
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; (A.A.); (N.C.); (T.M.H.); (M.J.D.)
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
- Correspondence: or ; Tel.: +61-406-890-170
| | - Ashraful Alam
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; (A.A.); (N.C.); (T.M.H.); (M.J.D.)
| | - Nina Chad
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; (A.A.); (N.C.); (T.M.H.); (M.J.D.)
| | - Tanvir M. Huda
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; (A.A.); (N.C.); (T.M.H.); (M.J.D.)
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Michael J. Dibley
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; (A.A.); (N.C.); (T.M.H.); (M.J.D.)
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Birhan TY, Seretew WS, Alene M. Trends and determinants of breastfeeding within one hour in Ethiopia, further analysis of Ethiopian Demographic and Health Survey: multivariate decomposition analysis. Ital J Pediatr 2021; 47:77. [PMID: 33771215 PMCID: PMC8004466 DOI: 10.1186/s13052-021-01032-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/19/2021] [Indexed: 11/24/2022] Open
Abstract
Background Despite the substantial efforts to improve timely/early initiation of breastfeeding, avoidance of colostrum, and delayed initiation of breastfeeding remains a big challenge in developing countries. Therefore, this study aimed to analyze the trends of early breastfeeding rate over time based on the Ethiopian Demographic and Health Survey (EDHS). Methods Secondary data analysis was conducted based on the Ethiopian Demographic Health Surveys (EDHSs) conducted in 2005, 2011, and 2016. A total weighted sample of 9, 111, 10,106, and 8564 in 2005, 2011, and 2016 respectively were included for analysis. Trend and Logistic based decomposition analysis technique was used for analyzing the trends of early breastfeeding initiation over time and factors contributing to the change in early breastfeeding initiation rate. STATA 15 was employed for data management and analyses. All analyses presented in this paper were weighted for the sampling probabilities and non-response. Result Among children age less than 5 years the rate of early breastfeeding initiation rate overtime was increased from 70.5% in 2005 to 72.7% in 2016. The highest rate of improvement was seen in the second phase of the study (2011–2016) while it shows a decline in the first phase (2005–2011) from 70.5 to 55.1%. The decomposition analysis indicated that about half of the overall change in early breastfeeding initiation rate was due to the difference in women’s composition. Particularly, an increase in health facility delivery and vaginal delivery was a significant predictor of the increasing rate of early breastfeeding initiation over the surveys. Conclusion Early initiation of breastfeeding slightly increasing over the last 10 years in Ethiopia. Half of the overall increase in the early initiation of breastfeeding was due to the change in compositional characteristics of women over 10 years in Ethiopia. Change in the composition of women according to health facility delivery and vaginal delivery were the major source of the increase in early breastfeeding initiation over time. Public interventions including promoting health facility delivery of women for further improvements of early breastfeeding initiation should be needed.
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Affiliation(s)
- Tilahun Yemanu Birhan
- Department of Epidemiology and Biostatistics, Institute of public health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Wullo Sisay Seretew
- Department of Epidemiology and Biostatistics, Institute of public health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Muluneh Alene
- Department of Public Health, College of Health Science, DebreMarkos University, Debre Markos, Ethiopia
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Teshale AB, Tesema GA. 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. PLoS One 2021; 16:e0248976. [PMID: 33755702 PMCID: PMC7987153 DOI: 10.1371/journal.pone.0248976] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 03/08/2021] [Indexed: 11/18/2022] Open
Abstract
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.
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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
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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22
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Variation and determinants of early initiation of breastfeeding in high and low neonatal mortality settings in India. J Biosoc Sci 2021; 54:199-216. [PMID: 33678208 DOI: 10.1017/s0021932021000092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Early initiation of breastfeeding (EIBF) is considered one of the most cost-effective interventions for infant survival and well-being. This study aimed to examine the variations in, and determinants of, early initiation of breastfeeding among women in high and low neonatal mortality rate (NMR) settings in India using data from the fourth round of the National Family Health Survey conducted in 2015-16. At 35%, EIBF was found to be disproportionately low in the high NMR group of states compared with 52% in the low NMR group, with the national average being 44%. The chance of EIBF significantly increased if childbirth was vaginal, delivery took place in a health institution, the mother received breastfeeding advice and the birth was a planned one in both high and low NMR settings. In the high NMR group of states, the probability of initiating breastfeeding immediately after birth improved to a great extent if childbirth was assisted by a trained person and if the mother was exposed to any type of mass media. There is an urgent need to increase the access of mothers to breastfeeding advice during pregnancy and to increase their exposure to mass media, particularly in high NMR states. In addition, achieving universal access to institutional deliveries and deliveries assisted by a skilled birth attendant, especially in high NMR settings, and promoting early breastfeeding, especially in the case of Caesarean deliveries, would further improve the level of EIBF in the country as a whole. These interventions can potentially increase the prevalence of early initiation of breastfeeding and help India attain the neonatal mortality rate target of Sustainable Development Goal 3.
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Effect of cesarean section on initiation of breast feeding: Findings from 2016 Ethiopian Demographic and Health Survey. PLoS One 2020; 15:e0244229. [PMID: 33338080 PMCID: PMC7748140 DOI: 10.1371/journal.pone.0244229] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/05/2020] [Indexed: 11/19/2022] Open
Abstract
Background Early initiation of breast feeding has great importance for both mothers and newborns. Despite, recommendations for exclusive and early initiation of breast feeding within one hour of birth, Ethiopia reports that 58% of infants under six months of age are exclusively breastfed. Cesarean deliveries may affect timing of breastfeeding initiation, establishment of milk supply and infant breastfeeding interest compared to vaginal deliveries. The aim of this study was to assess the impact of cesarean delivery on breastfeeding initiation. Methods A cross-sectional study was conducted with a total of 7115 study participants from the 2016 Ethiopian Demographic Health Survey (EDHS). Both descriptive and analytical statistical analysis was employed. Univariable and multivariable logistic regression analyses were used to identify anyassociations between variables. Odds ratios with its corresponding 95% confidence intervals (CI) were reported. During multivariable analysis, variables with p-value < 0.05 were considered as statistically significant. Results The prevalence of late initiation of breast feeding among women with their last live birth was 25.03% (95%CI; 20.5–32.2). Significant factors associated with late initiation of breastfeeding were cesarean delivery [AOR = 4.06 (95%CI, 2.66–6.2)], primipara mother [AOR = 1.45(95%CI, 1.13–1.7)], and having an unplanned pregnancy [AOR = 1.35(95%CI, 1.1–1.65)]. Positively associated with early initiation of breastfeeding was the mother’s age, for women between 20–34 years-old. This association, reported as a negative association of late initiation of breast feeding was [AOR = 0.77(95%CI, 0.61–0.98)]. Conclusion Cesarean delivery adversely affects the initiation of breast feeding. Cesarean delivery, unplanned pregnancy, and being primiparous, were associated with late initiation of breastfeeding. Women between the ages of 20–34 years of age had a reduced chance of late initiation of breastfeeding. Providing counseling regarding the strategy and importance of early initiation of breast feeding, could have crucial importance for the mother and her newborn.
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Habtewold TD, Mohammed SH, Endalamaw A, Mulugeta H, Dessie G, Berhe DF, Birhanu MM, Islam MA, Teferra AA, Asefa NG, Alemu SM. Higher educational and economic status are key factors for the timely initiation of breastfeeding in Ethiopia: A review and meta-analysis. Acta Paediatr 2020; 109:2208-2218. [PMID: 32239528 DOI: 10.1111/apa.15278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 03/18/2020] [Accepted: 03/24/2020] [Indexed: 12/19/2022]
Abstract
AIM To investigate the association between initiation of breastfeeding within 1 hour after birth (TIBF) and maternal educational status, paternal educational status, household income, marital status, media exposure and parity in Ethiopia. METHODS We searched PubMed, EMBASE, Web of Science, SCOPUS, CINAHL and WHO Global health library databases. All studies were conducted in Ethiopia and published from 2000 to 2019 were included. To obtain the pooled odds ratio (OR), data were fitted in random-effects meta-analysis model. Statistical heterogeneity was quantified using Cochran's Q test, τ2 and I2 statistics. This meta-analytic review was reported in compliance with the PRISMA statement. RESULTS Out of 553 studies retrieved, 25 fulfilled our inclusion criteria. High maternal educational status (P < .001), paternal educational status (P = .001) and household income (P = .002), being married (P = .001) and multiparity (P = .01) were significantly associated with TIBF. There was no significant publication bias. CONCLUSIONS Our meta-analysis showed that TIBF was associated with high educational and economic status, being married and multiparity. This suggests that the meta-analysis detected small associations that many previous studies in Ethiopia have not been able to show. Our findings can be useful for comparisons with other countries.
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Affiliation(s)
- Tesfa Dejenie Habtewold
- Department of Nursing College of Health Science Debre Berhan University Debre Berhan Ethiopia
- Department of Epidemiology University Medical Centre Groningen University of Groningen Groningen The Netherlands
- Department of Quantitative Economics School of Business and Economics Maastricht University Maastricht Netherlands
| | - Shimels Hussien Mohammed
- Department of Community Nutrition School of Nutritional Sciences and Dietetics Tehran University Tehran Iran
| | - Aklilu Endalamaw
- Department of Pediatrics and Child Health Nursing College of Medicine and Health Sciences Bahir Dar University Bahir Dar Ethiopia
| | - Henok Mulugeta
- Department of Nursing College of Health Science Debre Markos University Debre Markos Ethiopia
| | - Getenet Dessie
- Department of Nursing School of Health Science College of Medicine and Health Science Bahir Dar University Bahir Dar Ethiopia
| | - Derbew Fikadu Berhe
- School of Pharmacy College of Health Science Mekelle University Mekelle Ethiopia
| | - Mulugeta Molla Birhanu
- School of Clinical Sciences Department of Medicine, Epidemiology and Prevention Division Monash University Melbourne Vic. Australia
| | - Md. Atiqul Islam
- Department of Statistics Shahjalal University of Science and Technology Sylhet Bangladesh
| | - Andreas A. Teferra
- Division of Epidemiology College of Public Health The Ohio State University Columbus OH USA
| | - Nigus Gebremedhin Asefa
- Department of Epidemiology University Medical Centre Groningen University of Groningen Groningen The Netherlands
| | - Sisay Mulugeta Alemu
- Global Health Unit University Medical Centre Groningen University of Groningen Groningen The Netherlands
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Seidu AA, Ameyaw EK, Ahinkorah BO, Bonsu F. Determinants of early initiation of breastfeeding in Ghana: a population-based cross-sectional study using the 2014 Demographic and Health Survey data. BMC Pregnancy Childbirth 2020; 20:632. [PMID: 33076852 PMCID: PMC7574209 DOI: 10.1186/s12884-020-03308-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 10/02/2020] [Indexed: 11/12/2022] Open
Abstract
Background The World Health Organisation (WHO) recommends that breastfeeding should be initiated within the first hour of delivery followed by exclusive breastfeeding up to 6 months. This study examined the determinants of early initiation of breastfeeding in Ghana using data from the 2014 Ghana Demographic and Health Survey. Methods A sample size of 4219 was used for the study. Descriptive statistics was conducted to ascertain the proportion of children who had early initiation of breastfeeding after which binary logistic regression analysis was carried out. Results were presented using frequencies, percentages, unadjusted and adjusted odds ratios. Statistical significance was pegged at p<0.05. Results Children of first birth order [AOR = 0.71, CI = 0.61–0.84], those who were delivered by non-professionals [AOR = 0.51, CI = 0.30–0.88] and those whose mothers were Traditionalists [AOR = 0.65, CI = 0.46–0.92] and Mole-Dagbanis [AOR = 0.69, CI = 0.54–0.89] were less likely to go through early initiation of breastfeeding compared to those of 2–4 birth order, those who were delivered by health professionals, those whose mothers were Christians and Akan, respectively. Conversely, children born to mothers who read newspaper/magazine at least once a week were more likely to go through early initiation of breastfeeding, compared to those who never read newspaper/magazine [AOR = 1.40, CI = 1.01–1.95]. Children born to mothers who watched television less than once a week were more likely to go through early initiation of breastfeeding compared to those who watched television at least once a week [AOR = 1.40, CI = 1.01–1.95]. Finally, women from the Northern [AOR = 2.40, CI = [1.77–3.26] and Upper East regions [AOR = 2.57, CI = [1.86–3.56] practiced early initiation of breastfeeding compared to those from the Ashanti region. Conclusions Empowering healthcare providers to be consistent in early breastfeeding initiation advocacy and effective community engagement on the need to embrace and practice early initiation of breastfeeding can improve the situation.
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Affiliation(s)
- Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Freda Bonsu
- Asutifi South District Health Directorate, Hwidiem, Ghana
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Kasaye HK, Yilma MT, Bobo FT, Fekadu G. <p>Poor Universal Coverage of Immediate Essential Newborn Care at Hospitals of Wollega Zones, The Case of Western Ethiopia</p>. RESEARCH AND REPORTS IN NEONATOLOGY 2020. [DOI: 10.2147/rrn.s260369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Sen KK, Mallick TS, Bari W. Gender inequality in early initiation of breastfeeding in Bangladesh: a trend analysis. Int Breastfeed J 2020; 15:18. [PMID: 32178697 PMCID: PMC7075039 DOI: 10.1186/s13006-020-00259-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 02/27/2020] [Indexed: 11/25/2022] Open
Abstract
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.
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Affiliation(s)
- Kanchan Kumar Sen
- Department of Statistics, University of Dhaka, Dhaka, 1000, Bangladesh.
| | | | - Wasimul Bari
- Department of Statistics, University of Dhaka, Dhaka, 1000, Bangladesh
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Yaya S, Bishwajit G, Shibre G, Buh A. Timely initiation of breastfeeding in Zimbabwe: evidence from the demographic and health surveys 1994-2015. Int Breastfeed J 2020; 15:10. [PMID: 32070375 PMCID: PMC7029501 DOI: 10.1186/s13006-020-00255-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 02/12/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Timely initiation of breastfeeding or breastfeeding within 60 min of birth has been shown to be associated with significantly lower risk of infant mortality. The World Health Organization recommends starting breastfeeding within the first hour of birth, yet many women in sub-Saharan Africa do not observe this recommendation. To date, there is limited evidence of timely initiation of breastfeeding for Zimbabwe. Therefore, we undertook this study with the aim of calculating the trend in timely initiation of breastfeeding and to explore the correlates. METHODS We used five rounds of Zimbabwe Demographic and Health Survey data conducted between 1999 and 2015. Participants were 15,923 mothers currently breastfeeding or who had a childbirth within five years preceding the surveys. Outcome variable was self-reported timing of timely breastfeeding for singleton births which was categorized as early (< 60 min), late (≥ 60 min to < 2 4 h) and very late (≥ 24 h). RESULTS Prevalence of timely initiation of breastfeeding was 60.3% (95% Confidence Interval [CI] 57.44, 63.02) in 1999, 66.9% (95% CI 64.32, 69.4) in 2006, 65.8% (95% CI 63.7, 67.8) in 2011 and 58.3% (95% CI 56.3, 60.4) in 2015. It increased by 27 and 22% in 2006 and 2011 compared with that of the 1999 level respectively. We found no socio-economic and gender-based differentials in the prevalence of timely initiation of breastfeeding. Compared with women aged 15-19 years old, women 25-29 and 30-34 years old had higher odds of practicing timely initiation of breastfeeding. The odds of practicing timely initiation of breastfeeding among Muslim women (adjusted odds ratio [aOR] 1.2, 95% CI 1.07, 1.36) was 20% higher when compared with Christian mothers. Women who wanted to have their last child later (aOR 0.89, 95% CI 0.81, 0.97) had 11% lower odd of practicing timely initiation of breastfeeding when compared with women who wanted children then. CONCLUSIONS The prevalence of timely initiation of breastfeeding in Zimbabwe was 58.3% in 2015, well over the 50% target recommended by WHO for all countries to attain by 2025.
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Affiliation(s)
- Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, 120, University Private, Ottawa, ON K1N 6N5 Canada
- The George Institute for Global Health, The University of Oxford, Oxford, UK
| | - Ghose Bishwajit
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, 120, University Private, Ottawa, ON K1N 6N5 Canada
| | - Gebretsadik Shibre
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Amos Buh
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Hernández-Vásquez A, Chacón-Torrico H. Determinants of early initiation of breastfeeding in Peru: analysis of the 2018 Demographic and Family Health Survey. Epidemiol Health 2020; 41:e2019051. [PMID: 31962038 PMCID: PMC6976726 DOI: 10.4178/epih.e2019051] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 12/25/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Early initiation of breastfeeding (EIBF) is one of the most cost-effective strategies to reduce neonatal mortality. We sought to determine the prevalence and determinants of EIBF in Peru. METHODS We performed a cross-sectional analytical study of the 2018 Peruvian Demographic and Family Health Survey as a secondary data source. In total, 19,595 children born during the 5 years prior to the survey were included in the study. The dependent variable (EIBF status), socio-demographic variables, and pregnancy-related variables were analyzed using a multivariate logistic regression model to identify the determinants of EIBF. RESULTS The prevalence of EIBF in the study population was 49.7%. Cesarean deliveries were associated with a lower likelihood of EIBF (adjusted odds ratio [aOR], 0.06; 95% confidence interval [CI], 0.05 to 0.07) than were vaginal deliveries. Newborns born at public health centers (aOR, 1.37; 95% CI, 1.15 to 1.65) had a higher rate of EIBF than those not born at public or private health centers. Women from the jungle region (aOR, 2.51; 95% CI, 2.17 to 2.89) had higher odds of providing EIBF than those from the coast. Mothers with more than a secondary education (aOR, 0.65; 95% CI, 0.55 to 0.76) were less likely to breastfeed during the first hour of the newborn’s life than women with primary or no education. CONCLUSIONS More than half of Peruvian children do not breastfeed during the first hour after birth. The major determinants of EIBF status were the delivery mode and the region of maternal residence. Strategies are needed to promote early breastfeeding practices.
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Affiliation(s)
- Akram Hernández-Vásquez
- Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Lima, Peru
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Community-Based Essential Newborn Care Practices and Associated Factors among Women of Enderta, Tigray, Ethiopia, 2018. Int J Reprod Med 2020; 2020:2590705. [PMID: 32099841 PMCID: PMC6995491 DOI: 10.1155/2020/2590705] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 12/13/2019] [Accepted: 01/10/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction. Neonatal mortality contributes a higher percentage of infant mortality, especially in developing countries including Ethiopia where the rate of institutional delivery is low. In Ethiopia, scientific evidences on the level of community-based essential newborn care practice were scanty and inconclusive.
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Huang Y, Ouyang YQ, Redding SR. Previous breastfeeding experience and its influence on breastfeeding outcomes in subsequent births: A systematic review. Women Birth 2019; 32:303-309. [DOI: 10.1016/j.wombi.2018.09.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 08/31/2018] [Accepted: 09/10/2018] [Indexed: 10/28/2022]
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Association of age and colostrum discarding with breast-feeding practice in Ethiopia: systematic review and meta-analyses. Public Health Nutr 2019; 22:2063-2082. [PMID: 30846022 DOI: 10.1017/s1368980019000314] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate whether maternal/caregiver's age, infant age (0-6 months) and discarding colostrum affects timely initiation of breast-feeding (TIBF) and exclusive breast-feeding (EBF) in Ethiopia. DESIGN A systematic search of PubMed, SCOPUS, EMBASE, CINHAL, Web of Science and WHO Global Health Library electronic databases was done for all articles published in English from 2000 to January 2018. Two reviewers independently screened, extracted and graded the quality of studies using Newcastle-Ottawa Scale. A weighted inverse-variance random-effects model meta-analysis, cumulative meta-analysis and mixed-effects meta-regression analysis were done. SETTING All observational studies conducted in Ethiopia.ParticipantsMothers of children aged less than 2 years.ResultA total of forty articles (fourteen studies on TIBF and twenty-six on EBF) were included. TIBF was associated with colostrum discarding (OR=0·38; 95 % CI 0·21, 0·68) but not with maternal/caregiver's age (OR=0·98; 95 % CI 0·83, 1·15). In addition, colostrum discarding (OR=0·53; 95 % CI 0·36, 0·78) and infant age (OR=1·77; 95 % CI 1·38, 2·27) were significantly associated with EBF but not maternal/caregiver's age (OR=1·09; 95 % CI 0·84, 1·41). CONCLUSIONS There was no association between maternal/caregiver's age and breast-feeding practice (EBF and TIBF). Colostrum discarding was associated with both EBF and TIBF. This evidence could be helpful to counsel all mothers of reproductive age and who discard colostrum.
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Mukora-Mutseyekwa F, Gunguwo H, Mandigo RG, Mundagowa P. Predictors of early initiation of breastfeeding among Zimbabwean women: secondary analysis of ZDHS 2015. Matern Health Neonatol Perinatol 2019; 5:2. [PMID: 30675366 PMCID: PMC6332660 DOI: 10.1186/s40748-018-0097-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 12/19/2018] [Indexed: 02/03/2023] Open
Abstract
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.
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Affiliation(s)
- Fadzai Mukora-Mutseyekwa
- 1Lifestyle & Prevention Medicine Unit, Africa University Clinical Research Centre, Mutare, Zimbabwe.,JSI Research & Training Institute, MCHIP Project, Harare, Zimbabwe
| | - Hilary Gunguwo
- 3National University of Science & Technology, Bulawayo, Zimbabwe
| | | | - Paddington Mundagowa
- 1Lifestyle & Prevention Medicine Unit, Africa University Clinical Research Centre, Mutare, Zimbabwe
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Habtewold TD, Mohammed SH, Endalamaw A, Akibu M, Sharew NT, Alemu YM, Beyene MG, Sisay TA, Birhanu MM, Islam MA, Tegegne BS. Breast and complementary feeding in Ethiopia: new national evidence from systematic review and meta-analyses of studies in the past 10 years. Eur J Nutr 2018; 58:2565-2595. [PMID: 30229308 DOI: 10.1007/s00394-018-1817-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 08/07/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE The aim of this systematic review and meta-analysis was to provide a national estimate of breast and complementary feeding practices and its predictors in Ethiopia. METHODS PubMed, SCOPUS, EMBASE, CINHAL, Web of Science and WHO Global Health Library electronic databases were searched for all available literature published until April 2018. Observational studies including cross-sectional, case-control and cohort studies were included. Newcastle-Ottawa Scale was used to assess the quality of studies. Heterogeneity of studies was quantified using Cochran's Q χ2 statistic and Higgins's method (I2). A meta-analysis using a weighted inverse variance method was performed. Subgroup analysis was carried out based on region and study area. RESULTS In total, 70 studies that involved > 55,000 women from nine regions and two chartered cities in Ethiopia were included. The pooled national prevalence for timely initiation of breastfeeding (TIBF), exclusive breastfeeding (EBF) and timely initiation of complementary feeding was 66.5%, 60.1% and 62.5%, respectively. Guidance and counselling on breastfeeding, vaginal delivery and health institution delivery significantly increased the odds of TIBF and EBF. In addition, TIBF significantly associated with high EBF practice. Maternal occupational status significantly associated with low EBF practice, but not TIBF. CONCLUSIONS Based on the WHO standard, the current breast and complementary feeding practice in Ethiopia is good and improving. Integrated intervention is still required for further improvement and minimizing the effect of occupational status.
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Affiliation(s)
- Tesfa Dejenie Habtewold
- Department of Nursing, College of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia. .,Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
| | - Shimels Hussien Mohammed
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences-International Campus (TUMS-IC), Tehran, Islamic Republic of Iran
| | - Aklilu Endalamaw
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Akibu
- Department of Nursing, College of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Nigussie Tadesse Sharew
- Department of Nursing, College of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Yihun Mulugeta Alemu
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Tesfamichael Awoke Sisay
- Department of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mulugeta Molla Birhanu
- Department of Adult Health Nursing, School of Nursing, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Md Atiqul Islam
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Balewgizie Sileshi Tegegne
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
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Bruno Tongun J, Sebit MB, Mukunya D, Ndeezi G, Nankabirwa V, Tylleskar T, Tumwine JK. Factors associated with delayed initiation of breastfeeding: a cross-sectional study in South Sudan. Int Breastfeed J 2018; 13:28. [PMID: 30002722 PMCID: PMC6034205 DOI: 10.1186/s13006-018-0170-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 06/11/2018] [Indexed: 12/17/2022] Open
Abstract
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.
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Affiliation(s)
- Justin Bruno Tongun
- 1Centre for International Health, University of Bergen, Bergen, Norway.,2Department of Paediatrics and Child Health, College of Medicine, University of Juba, Juba, South Sudan
| | - Mohammed Boy Sebit
- 3Department of Internal Medicine, College of Medicine, University of Juba, Juba, South Sudan
| | - David Mukunya
- 1Centre for International Health, University of Bergen, Bergen, Norway
| | - Grace Ndeezi
- 4Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Victoria Nankabirwa
- 1Centre for International Health, University of Bergen, Bergen, Norway.,5School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - James K Tumwine
- 4Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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Ngoma-Hazemba A, Ncama BP. The role of community volunteers in PMTCT programme: Lessons from selected sites in Zambia to strengthen health education on infant feeding and follow-up of HIV-positive mother-infant pair. Afr J Prim Health Care Fam Med 2018; 10:e1-e8. [PMID: 29943606 PMCID: PMC6018380 DOI: 10.4102/phcfm.v10i1.1665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 02/14/2018] [Accepted: 03/13/2018] [Indexed: 11/10/2022] Open
Abstract
Background A global debate surrounding health care delivery at the lowest level of the community has aroused interest among researchers. In settings where skilled health workforce is scarce, the community relies on volunteers to provide care. Aim To explore the role of community-based volunteers (CBVs) and their perspectives on human immunodeficiency virus (HIV) and infant feeding to gain insights into the implementation of prevention of mother-to-child transmission (PMTCT) interventions at community level. Setting The study was conducted in Lusaka using Ngombe and Chelstone health facilities to recruit participants. Fieldwork took place from January 2014 to September 2014. Methods An exploratory descriptive qualitative study employing focus group discussions was conducted with CBVs. Convenient sampling was used to recruit 10 participants from each site. All transcribed interviews were imported into the Nvivo 10 for open coding and analysis. Results Although the role of community volunteers was to support and teach mothers on infant feeding in relation to HIV, the known cultural norms and practices had a bearing on how they tailored their information on breastfeeding to mothers. However, their link of the community to the health facilities cannot be overemphasised in these settings. Conclusion The role of community volunteers in PMTCT interventions can be strengthened by improving their training through use of appropriate educational materials and support of required resources. Lessons from these sites can inform future research to design community-based interventions and develop health education materials that are sensitive to cultural norms and practices in this and similar settings.
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