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

Rural versus urban variations of factors associated with early initiation of breastfeeding in Ethiopia

Background

Early initiation of breastfeeding is an important strategy to reduce under-five mortality. Nevertheless, it remains under-practiced in developing countries. In Ethiopia, there were studies done to identify determinants of early initiation of breastfeeding. However, the variation of factors among rural versus urban residents has not been investigated. Therefore, the main objective of this study is to investigate the variation of factors associated with early initiation of breastfeeding among rural versus urban residences.

Methods

The 2016 Ethiopian Demographic and Health Survey data was used to conduct the study. Mothers whose index child aged less than 24 months have participated in the study. We excluded mothers who had fetal death during birth and who didn't live with their child. Accordingly, a total of 3396 weighted samples of mothers from rural residences and 478 weighted samples of mothers from urban residences were included in the final analysis. A multivariable logistic regression analysis has been used to explore determinants of early initiation of breastfeeding. Finally, statistically significant associations have been declared by using AOR with a 95%CI at a p-value of <0.05.

Results

In rural residences, age of mothers 15-24 years (AOR: 1.39, 95 % CI: 1.08, 1.79), mothers who are not currently working (AOR: 1.45, 95 % CI: 1.19, 1.78), large birth size (AOR: 1.49, 95 % CI: 1.17, 1.92), and giving birth at health facility (AOR: 1.25, 95 % CI: 1.01, 1.53) were factors associated with a higher odds of early initiation of breastfeeding. Whereas, in urban residences, being second to third birth order (AOR: 1.94, 95 % CI: 1.01, 3.75), skin-to-skin contact care (AOR: 2.58, 95 % CI: 1.44, 4.63) and antenatal care visit were factors associated with early initiation of breastfeeding. Regardless of residences, vaginal delivery (Rural AOR: 4.06, 95 % CI: 1.75, 9.44; Urban AOR: 2.52, 95 % CI: 1.15, 5.54) and involvement of mothers in health care decisions (Rural AOR: 1.52, 95 % CI: 1.25, 1.85; Urban AOR: 2.62, 95 % CI: 1.33, 5.17) were common determinants of early initiation of breastfeeding.

Conclusions

This study concludes that the factors associated with early initiation of breastfeeding are different among rural versus urban residences. Accordingly, maternal ages, maternal current working status, birth sizes, and place of delivery are identified as factors associated with early initiation of breastfeeding among rural residences. Whereas, antenatal care visits, skin-to-skin contact care, and birth order are identified as factors associated with early initiation of breastfeeding among urban residences. Regardless of residence, mode of delivery, and involvement of mothers in health care decisions are common determinants of early initiation of breastfeeding. Therefore, irrespective of the residence, special emphasis has to be given to newborns delivered by cesarean section to increase the rate of early initiation of breastfeeding.

Multilevel analysis of early initiation of breastfeeding in Ethiopia

Introduction

Breast milk is the ideal food for the infant and is associated with various public health benefits for both the infant and the mother. The recommended time for early initiation of breastfeeding is within one hour after birth. The prevalence of early initiation of breastfeeding was lower than the plan of the Ethiopian Ministry of Health Sector Development program. Thus, the main objective of this study was to identify individual and group-level factors associated with the early initiation of breastfeeding in Ethiopia.

Methods

Secondary data on children was obtained from the 2019 Ethiopia mini-demographic and health survey. The survey was a population-based cross-sectional study and was downloaded from the Measure Demographic and Health Survey website (http://www.measuredhs.com). The study included a random sample of 2,125 last-born infants who were born within 24 months before the survey. A multilevel binary logistic regression analysis was employed to identify the factors associated with the early initiation of breastfeeding in Ethiopia. Statistical data was analyzed using the Statistical Analysis System (SAS 9.4).

Results

The prevalence of early breastfeeding initiation was 72%. The higher preceding birth interval (AOR = 1.18, 95% CI: 1.1076, 1.5451), the higher gestational age of infants (AOR = 1.38, 95% CI: 1.2796, 1.4782), the higher number of antenatal care visits (AOR = 1.26, 95% CI: 1.2340, 1.2934), delivery at a health facility (AOR = 1.60, 95% CI: 1.4585, 1.7515), vaginal delivery (AOR = 1.11, 95% CI: 1.1019, 1.1123), mothers with primary education (AOR = 1.14, 95% CI: 1.0204, 1.2738), mothers with secondary education (AOR = 1.54, 95% CI: 1.4678, 1.6190), and mothers with higher education (AOR = 2.62, 95% CI: 2.2574, 3.0526) were associated with higher odds of early initiation of breastfeeding. Being a rural dweller (AOR = 0.63, 95% CI: 0.5684, 0.7038) and the age of mothers (AOR = 0.44, 95% CI: 0.3921, 0.4894) were associated with lower odds of early initiation of breastfeeding.

Conclusion

Since the prevalence of early initiation of breastfeeding was minimal among rural mothers who delivered their child by caesarean section, this study strongly suggests special supportive care for these mothers.

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

OBJECTIVE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

Breastfeeding-Related Practices in Rural Ethiopia: Colostrum Avoidance

The practices of colostrum avoidance and prelacteal feeding, which are common in many developing countries, including Ethiopia, are firmly rooted in ancient traditions. The main objective of this work is to identify the prevalence of colostrum avoidance and study its associated factors among mothers of children aged less than 2 years old in the Oromia region of Ethiopia. A cross-sectional study on the practice of colostrum avoidance/prelacteal feeding was conducted in a rural community with 114 mothers of children under 2 years old. Our results reflected that colostrum avoidance and prelacteal feeding were practiced by 56.1% of mothers. The percentage of women who started breastfeeding in the first hour after birth, as recommended by the WHO, was 2.6%. Of the women who practiced colostrum avoidance, 67.2% gave birth at home, and 65.6% were attended by relatives. The likelihood of avoiding colostrum increases in mothers who have a lower educational level, who did not receive health care at the time of delivery, who think that colostrum is dirty and dangerous and who did not receive information about breastfeeding from healthcare professionals. The knowledge emanating from this work may be useful in designing new breastfeeding education programs and/or interventions in Ethiopia and other developing countries.

Early initiation of breast feeding and associated factors among mother-baby dyads with immediate skin-to-skin contact: cross-sectional study based on the 2016 Ethiopian Demographic and Health Survey data

OBJECTIVE

The study aimed to assess the practice of early initiation of breast feeding (EIBF) and associated factors among mother-baby dyads who practiced immediate skin-to-skin contact in Ethiopia.

DESIGN

Cross-sectional study.

SETTING

The study was conducted nationally in nine regional states and two city administrations.

PARTICIPANTS

In the study, 1420 mother-baby dyads with last-born children (children born in the 2 years preceding the survey, children <24 months old) and children put on the mother's bare skin. The data of the study participants were extracted from the Ethiopian Demographic and Health Survey 2016.

OUTCOME MEASURES

The outcome measure of the study was the proportion of EIBF among mother-baby dyads and associations.

RESULTS

EIBF among mothers and newborns with skin-to-skin contact was 88.8% (95% CI 87.2 to 90.4). EIBF among mother-baby dyads with immediate skin-to-skin contact was more likely among mothers from wealthy families (adjusted OR (AOR)=2.37, 95% CI 1.38 to 4.08), attended secondary and above education (AOR=1.67, 95% CI 1.12 to 2.57), living in Oromia (AOR=2.87, 95% CI 1.11 to 7.46), Harari (AOR=11.60, 95% CI 2.48 to 24.34) and Dire Dawa (AOR=2.93, 95% CI 1.04 to 8.23) regions, gave birth by non-caesarean section (AOR=3.34, 95% CI 1.33 to 8.39), gave birth at hospital (AOR=2.02, 95% CI 1.02 to 4.00), and health centre (AOR=2.19, 95% CI 1.21 to 3.98), and gave birth by midwifery assistance (AOR=1.62, 95% CI 1.06 to 2.49).

CONCLUSION

Nine in ten mother-baby dyads with immediate skin-to-skin contact early initiate breast feeding. The EIBF was affected by educational status, wealth index, region, mode of delivery, place of delivery and delivery assisted by midwifery. Improving healthcare service, institutional delivery and the competency of maternal healthcare providers may aid the EIBF in Ethiopia.

Key correlates of exclusive breastfeeding at three timepoints: Evidence from Ethiopia

Aim

To compare factors associated with exclusive breastfeeding (EBF) within 1 h of birth, within 3 days, and within the first 6 months post-birth.

Methods

We used multivariate logistic regression models and data from "The Alive and Thrive Phase 2 Amhara Baseline Survey 2015" from Ethiopia (N = 3113).

Results

Giving colostrum was strongly associated with EBF at all three time points, controlling for multiple confounders. Putting the baby to the breast before cleaning the baby and before cleaning the mother was significantly associated with EBF within 1 h and for the first 3 days. EBF within an hour of birth was more likely for girl babies than boy babies. Having a healthcare professional check whether the baby was sucking well was significantly associated with EBF 3 days post-birth.

Conclusions

The World Health Organization recommends breastfeeding within 1 h of birth and exclusively thereafter for 6 months, which can improve health outcomes for infants and children. In Ethiopia, many factors influence breastfeeding practices, but little is known about how these factors differ at various key timepoints in the 6 months after birth. Our study provides important information on correlates of EBF at three timepoints and shows that factors that are significantly correlated with EBF vary over time. Future research should assess the potential causal links among statistically significant associations between EBF and risk factors at various times between birth and 6 months of age. Ultimately, these findings have the potential to inform areas of intervention related to promoting EBF.

Determinants of early initiation of breast feeding among mothers of children aged less than 24 months in Ethiopia: A community-based cross-sectional study

OBJECTIVE

This study aims to assess the prevalence of early initiation of breast feeding (EIBF) and associated factors among mothers having children less than 2 years of age in Ethiopia.

DESIGN

Community-based cross-sectional study.

SETTING

In this analysis, data from 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) was used. The survey included all the nine regional states and two city administrations of Ethiopia.

PARTICIPANTS

We extracted data of 2054 mothers who had last-born children and those mothers who ever breast fed or still breast feeding their children during the survey from the 2019 EMDHS datasets.

MAIN OUTCOME MEASURES

We performed a two-stage multilevel mixed-effects logistic regression to identify individual and community-level determinants of EIBF. In the final model, variables with a p-value less than 5% and an adjusted OR with a 95% CI were reported as statistically significant variables with EIBF.

RESULT

The prevalence of EIBF among mothers having children aged 0-23 months was 73.56% (95% CI: 71.65% to 75.47%). Women who delivered at a health facility (adjusted OR (AOR)=1.98; 95% CI: 1.39 to 2.79) and have children with birth order second-fourth (AOR=1.76; 95% CI: 1.24 to 2.49) were more likely to initiate early breast feeding than their counterparts. On the other hand, women who gave birth by caesarean section (AOR=0.21; 95% CI: 0.13 to 0.33), had multiple births (AOR=0.35; 95% CI: 0.13 to 0.92) and had postnatal check-up (AOR=0.62; 95% CI: 0.44 to 0.91) were less likely to practise EIBF as compared with their counterparts. Region of residence of women was also significantly associated with EIBF.

CONCLUSION

In this study, the overall prevalence of EIBF was good. Place of delivery, mode of delivery, postnatal check-up, type of birth, birth order and region were factors significantly associated with EIBF. Therefore, government and stakeholders need to show commitment to improve access and utilisation of basic maternal health services to increase the practice of EIBF.

Effect of antenatal depression on the initiation of breastfeeding in South Gondar zone, Northwest Ethiopia: A population-based prospective cohort study

BACKGROUND

Delayed initiation of breastfeeding has been found to increase early neonatal morbidity, mortality, and impaired mother-infant bonding. However, there is no study that revealed the effect of antenatal depression on breastfeeding initiation in Ethiopia. This study aimed to see the effect of antenatal depression on the practice of initiation of breastfeeding among women in urban Ethiopia.

METHODS

The Edinburgh Postnatal Depression Scale (EPDS) was administered to 970 women in the second and third trimesters of pregnancy to screen for antenatal depression. Information was collected on initiation of breastfeeding of newborns and mother's socio-demographic, obstetric, clinical, psychosocial, and behavioral factors. A logistic regression model was used to adjust for the confounders and determine association between antenatal depression and initiation of breastfeeding.

RESULTS

The cumulative incidence of late initiation of breastfeeding (LIBF) was found to be 166 (18.34%). The cumulative incidence of LIBF in those born from depressed pregnant women was 37% as compared to 8.4% in nondepressed. Antenatal depression at the second and third trimester of pregnancy remained a potential predictor of late initiation of breastfeeding after adjusting for potential confounders (AOR = 6.42: (95% CI 3.72, 11.05)). A significant association was also seen between infants who were born by cesarean section, a complication of current pregnancy, inadequate ANC follow-up, lack of advice about the importance of early initiation of breastfeeding (EIBF), home delivery, and low quartile of wealth index and late initiation of breastfeeding.

CONCLUSIONS

These findings suggest that screening for antenatal depression can help to identify women at risk for late initiation of breastfeeding. Health care providers shall have to give emphasis on the treatment of antenatal depression to benefit both the mother and the physical health, growth, and development of the fetus.

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

BACKGROUND

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

RESEARCH AIM

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

Higher educational and economic status are key factors for the timely initiation of breastfeeding in Ethiopia: A review and meta-analysis

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.

Trends and determinants of early initiation of breastfeeding and exclusive breastfeeding in Ethiopia from 2000 to 2016

Background

At the national level in Ethiopia, there is limited knowledge of trends and factors associated with early initiation of breastfeeding and exclusive breastfeeding (EBF), particularly during the Millenium Development Goal (MDG) era (2000–2015). The study aimed to examine the trends and determinants of early initiation of breastfeeding and EBF in Ethiopia between 2000 and 2016.

Methods

Using the Ethiopia Demographic and Health Survey (EDHS) data for the years: 2000 (n = 3680), 2005 (n = 3528), 2011 (n = 4037) and 2016 (n = 3861), trends in early initiation of breastfeeding and EBF were estimated. Multivariate logistic regression models that adjusted for confounders, sampling weight, clustering and stratification were used to examine the association between socioeconomic, demographic, health service and community level factors with early initiation of breastfeeding and EBF from 2000 to 2016.

Results

The prevalence of early initiation of breastfeeding increased from 48.8% in 2000 to 75.7% in 2016 in Ethiopia. Improvement in EBF prevalence was not statistically significant (from 54.5% in 2000 to 59.9% in 2016). Over the study period, informal maternal employment (Adjusted Odds Ratio [aOR] 0.75; 95% Confidence Interval [CI] 0.68, 0.83), frequent antenatal care visits (aOR 0.74; 95% CI 0.65, 0.85), and cesarean birthing (aOR 0.22; 95% CI 0.17, 0.30) were associated with delayed initiation of breastfeeding. Birthing in the health facility (aOR 1.35; 95% CI 1.05, 1.75) and residing in the metropolis region (aOR 1.95; 95% CI 1.65, 2.32) were associated with timely initiation of breastfeeding. In a similar period, informally employed mothers (aOR 1.37; 95% CI 1.15, 1.63) and those with six or more family size (aOR 1.46; 95% CI 1.10, 1.93) were more likely to exclusively breastfeed their babies.

Conclusion

Early initiation of breastfeeding improved in Ethiopia during the MDG era but it is still below the national target; progress in EBF remained slow. To improve breastfeeding outcomes and meet the global breastfeeding targets in Ethiopia, infant feeding efforts should focus on improving key modifiable factors, including place and mode of birthing and socioeconomic status of mothers.

Maternal Factors and the Utilization of Maternal Care Services Associated with Infant Feeding Practices among Mothers in Rural Southern Nepal

This study aimed to investigate the maternal factors and utilization of maternal care services associated with infant feeding practices in rural areas of Southern Nepal. Data from a cluster randomized controlled trial 'MATRI-SUMAN'(Maternal Alliance for Technological Research Initiative on Service Utilization and Maternal Nutrition) conducted between 2015-2016 were analyzed. A total of 426 pregnant women in their second trimester were recruited from the MATRI-SUMAN trial, which was conducted on six villages in rural areas of the Dhanusha district, Nepal. A total of 379 mothers that had ever breastfed their infants, and followed for at least seven months after birth were included in the analysis. Multivariate logistic regression analysis was used to identify independent risk factors associated with child feeding practices after controlling for potential confounders. Of the 379 mothers, 41.4%, 53%, and 43% initiated breast feeding within the first hour of birth (EIBF), practiced exclusive breastfeeding (EBF), and initiated timely complementary feeding (CF) at six months, respectively. Multiple logistic regression results revealed that maternal education (secondary or higher), an occupation in the service/business/household sectors, receipt of MATRI-SUMAN intervention, more than four ANC (antenatal care) visits, and delivery in a health facility were associated with higher odds ratios of EIBF. Similarly, mothers with a primary, secondary and higher level of education, that worked in the service/business/household sectors, primiparous mothers, those that received MATRI-SUMAN intervention, visited ANC more than four times, and made a PNC (postnatal care) visit had higher odds ratios of EBF, while mothers who were 35-45 years of age were less likely to have used EBF. In addition, education to the secondary or a higher level, a male baby, receipt of MATRI-SUMAN intervention and a PNC visit had higher odds ratios of CF initiation at six months. The promotion of maternal ANC visits, birth at a health institution, and postnatal visits should be recommended in order to improve child feeding practices in Nepal.

Breastfeeding performance in Afar regional state, northeastern Ethiopia: a cross sectional study

Background

In Ethiopia fewer than 20% of infants aged less than six months are appropriately fed. This study aimed to identify predictors of poor breastfeeding performance among mother-infant pairs in Samara-Logia city administration, Afar Regional State, Ethiopia.

Methods

Five hundred and seventy six mothers of infants aged less than six months were recruited to participate in face-to-face structured interviews at their home. Infant feeding practices were measured by breastfeeding performance index (BPI). Infants who scored 0–3 BPI were classified as achieving ‘Low BPI’, 4–5 as ‘Medium BPI’, and 6–7 scores as ‘High BPI’. A pre-tested instrument was used to assess demographic characteristics of mothers and their experiences of infant feeding. EpiData version 3.02 was used to enter, clean and code the data. Then, data were analyzed using SPSS version 20.

Results

Five hundred thirty six (93.1%) of the study mothers had ever breastfed their infants. About 83% [95% CI: 80.0, 86.0%] of infants had achieved low or medium BPI scores. Being older than 34 years [AOR: 4.55; 95% CI (1.33, 15.73)], having an infant aged 4–5 months [AOR: 2.49; 95% CI (1.08, 5.76)], giving birth at home [AOR: 4.25; 95% CI (1.37, 13.23)] or by caesarean section [AOR: 8.00; 95% CI (2.78, 23.09)] and receiving advice on proper infant feeding practices at postnatal checkup [AOR:0.28; 95% CI (0.13,0.59)] were independent predictors of low/medium BPI scores.

Conclusion

This study revealed that nearly eight in ten infants aged less than six months achieved low/medium BPI scores. Being older than 34 years, having an infant aged 4–5 months, giving birth at home or by caesarean section and lack of advice on proper infant feeding practices were associated with higher odds of low/medium BPI scores.

Breast and complementary feeding in Ethiopia: new national evidence from systematic review and meta-analyses of studies in the past 10 years

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.

Assessment of initiation of breastfeeding practice in Kassala, Eastern Sudan: a community-based study

Background

The World Health Organization (WHO) encourages early initiation of breastfeeding within the first hour after birth with the objective of saving children’s lives. There are few published research papers about factors associated with the initiation of breastfeeding in Sudan.

The aim of this study was to investigate the prevalence of and factors associated with the timely initiation of breastfeeding among mothers with children two years and under in Kassala, Eastern Sudan.

Methods

A community-based cross-sectional study was conducted from December 2016 to March 2017. Mothers were interviewed using a structured questionnaire.

Results

A total of 250 mother-child pairs participated in the study. The mean (standard deviation) of maternal age and children’s age was 27.1 (5.68) years and 11.9 (6.9) months, respectively.

Of the 250 mothers, 218 (87.2%) initiated breastfeeding within the first hour. In multivariable logistic regression analysis, factors associated with the delay of breastfeeding initiation were having a male baby (Adjusted Odds Ratio [AOR] 3.90, 95% Confidence Interval [CI]1.33, 11.47), and mothers with medical disorders (AOR 5.07, 95% CI 1.22, 21.16).

Conclusion

There was a high prevalence of early initiation of breastfeeding. An association with delayed initiation of breastfeeding was found amongst mothers who had medical disorders and those who had a male infant. Wherever possible, early initiation of breastfeeding should be promoted for all infants, regardless of gender.