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

Vasanthakumar Namasivayam,Ravi Prakash,Deepa Sankaran,John Anthony,Shajy Isac,Pankaj Kumar,Manish Kumar,Bidyadhar Dehury,Ties Boerma,Lisa Avery,Marissa Becker,James Blanchard,B M Ramesh

doi:10.1186/s13006-021-00372-6

Abstract

BackgroundTimely initiation of breastfeeding, also known as early initiation of breastfeeding, is a well-recognized life-saving intervention to reduce neonatal mortality. However, only one quarter of newborns in Uttar Pradesh, India were breastfed in the first hour of life. This paper aims to understand the association of community-based prenatal counselling and postnatal support at place of delivery with early initiation of breastfeeding in Uttar Pradesh, India.MethodsData from a cross-sectional survey of 9124 eligible women (who had a live birth in 59 days preceding the survey) conducted in 25 districts of Uttar Pradesh, India, in 2018, were used. Simple random sampling was used to randomly select 40 Community Development Blocks (sub district administrative units) in 25 districts. The Primary Sampling Units (PSUs), health service delivery unit for frontline workers, were selected randomly from a linelisting of PSUs in each selected Community Development Block. Bivariate and multivariate logistic regression analyses were performed to assess the association of prenatal counselling and postnatal support on early initiation of breastfeeding in public, private and home deliveries.ResultsOverall 48.1% of mothers initiated breastfeeding within an hour, with major variation by place of delivery (61.2% public, 23.6% private and 32.6% home). The adjusted odds ratio (aOR) of early initiation of breastfeeding was highest among mothers who received both counselling and support (aOR 2.67; 95% CI 2.30, 3.11), followed by those who received only support (aOR 1.99; 95% CI 1.73, 2.28), and only counselling (aOR 1.40; 95% CI 1.18, 1.67) compared to mothers who received none. The odds of early initiation of breastfeeding was highest among mothers who received both prenatal counselling and postnatal support irrespective of delivery at public health facilities (aOR 2.49; 95% CI 2.07, 3.01), private health facilities (aOR 3.50; 95% CI 2.25, 5.44), or home (aOR 2.84; 95% CI 2.02, 3.98).ConclusionsA significant association of prenatal counselling and postnatal support immediately after birth on improving early initiation of breastfeeding, irrespective of place of delivery, indicates the importance of enhancing coverage of both the interventions through community and facility-based programs in Uttar Pradesh.

Highlights

Initiation of breastfeeding, known as early initiation of breastfeeding, is a well-recognized life-saving intervention to reduce neonatal mortality
Antenatal Check-ups (ANC), newborn and childbirth practices differed significantly among mothers who delivered at public health facilities, private health facilities and home (Table 1)
The adjusted odds ratio (aOR) of early initiation of breastfeeding in Models 11, 111, 1 V including the interaction of both the interventions depicted that the likelihood of early initiation of breastfeeding among mothers who delivered at public health facilities was 2.49 if mothers received both interventions, 1.24 if mothers received only prenatal counselling, and 1.79 if mothers received only postnatal support compared to those who received none

Summary

Introduction

Known as early initiation of breastfeeding, is a well-recognized life-saving intervention to reduce neonatal mortality. This paper aims to understand the association of community-based prenatal counselling and postnatal support at place of delivery with early initiation of breastfeeding in Uttar Pradesh, India. Uttar Pradesh (UP), the most populous state in India, requires a substantial reduction in Neonatal Mortality Rate (NMR) to attain the Sustainable Development Goal of 12 neonatal deaths per 1000 live births by 2030. Initiation of breastfeeding, defined as the initiation of breastfeeding within 1 h after delivery [2], is a well-recognized life-saving intervention to reduce NMR. It is estimated that early initiation of breastfeeding could avert approximately 22% of neonatal deaths globally [3]. Early initiation of breastfeeding has several other health benefits for both mothers and newborns as it stimulates breast milk production, reduces postpartum haemorrhage, protects newborns against diarrhoea and respiratory infections, improves mother-child bonding, and promotes the establishment of continued and exclusive breastfeeding [8, 9]

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