Cesarean delivery and maternal knowledge are important predictors of early breastfeeding practices in Bangladesh, Ethiopia and Vietnam

Abstract

Early breastfeeding (BF) practices have major health consequences. We compared predictors of early BF practices among children <24 mo of age in Bangladesh (BD), Ethiopia (ET) and Vietnam (VN), using data from baseline household surveys conducted in 2010. Multivariable logistic regression models were used to model predictors of early initiation (< 1 h) of breastfeeding (EIBF), no prelacteal feeding (NPF) and 0–3 day exclusive BF (D3EBF). Rates of EIBF, NPF and D3EBF were 64%, 52% and 47% in BD, 67%, 91% and 85% in ET and 59%, 43% and 33% in VN, respectively. Cesarean delivery was related to lower EIBF in all 3 countries (OR; 95% CI: 0.44; 0.27–0.72 in BD; 0.04; 0.01–0.28 in ET and 0.08; 0.05–0.11 in VN). Poor awareness of optimal BF initiation timing was related to low rates of EIBF (OR; 95% CI: 0.25; 0.19–0.33 in BD; 0.03; 0.02–0.06 in ET and 0.18; 0.14–0.23 in VN). Other factors linked to lower EIBF in at least 2 countries were fewer children <5 y in the household, minority religious affiliation, mother's age >;25 y and lower knowledge of colostrum feeding. Similar predictors were found for NPF and D3EBF, including Cesarean delivery in VN and poor awareness of EIBF (for NPF) in BD and ET.Rates of early BF practices are suboptimal in all 3 settings and should be improved via interventions prior to and at the time of birth, regardless of mode of delivery care. Funding: Bill & Melinda Gates Foundation through Alive & Thrive, managed by FHI 360.Grant Funding Source: Bill & Melinda Gates Foundation through Alive & Thrive