Abstract
The aim of this study was to describe early breastfeeding practices (initiation within 1 hr of birth, no prelacteal feeding, and a combination of both—“optimal” early breastfeeding) according to childbirth location in low‐ and middle‐income countries. Using data from the most recent Demographic and Health Survey (2000–2013) for 57 countries, we extracted information on the most recent birth for women aged 15–49 with a live birth in the preceding 24 months. Childbirth setting was self‐reported by location (home or facility) and subtype (home delivery with or without a skilled birth attendant; public or private facility). We produced overall world and four region‐level summary statistics by applying national population adjusted survey weights. Overall, 39% of children were breastfed within 1 hr of birth (region range 31–60%), 49% received no prelacteal feeding (41–65%), and 28% benefited from optimal early breastfeeding (21–46%). In South/Southeast Asia and Sub‐Saharan Africa, early breastfeeding outcomes were more favourable for facility births compared to home births; trends were less consistent in Latin America and Middle East/Europe. Among home deliveries, there was a higher prevalence of positive breastfeeding practices for births with a skilled birth attendant across all regions other than Latin America. For facility births, breastfeeding practices were more favourable among those taking place in the public sector. This study is the most comprehensive assessment to date of early breastfeeding practices by childbirth location. Our results suggest that skilled delivery care—particularly care delivered in public sector facilities—appears positively correlated with favourable breastfeeding practices.
Highlights
Breastfeeding has numerous benefits for both mothers and children, and offers crucial protection against infectious morbidity and mortality in children (Victora et al, 2016)
Respondents were asked to list all people who assisted with the delivery; we considered the person with the highest level of qualification, and classified home‐ based births as having been attended by a skilled birth attendant (SBA) or not, according to country‐level criteria (Benova et al, 2015; Footman et al, 2015)
Low‐income countries, such as the majority of those included in the South/Southeast Asian and Sub‐Saharan Africa grouping used here, clearly have the most to gain from improvements in breastfeeding
Summary
Breastfeeding has numerous benefits for both mothers and children, and offers crucial protection against infectious morbidity and mortality in children (Victora et al, 2016). Scaling up breastfeeding to near universal levels could prevent up to an estimated 13.8% of deaths in children younger than 24 months globally each year (Black et al, 2013; Victora et al, 2016). The burden of suboptimal breastfeeding disproportionately affects low‐and middle‐income countries (Unicef, 2016); in the 2010 Global Burden of Disease Study, suboptimal breastfeeding was one of the three leading causes of disease across much of Sub‐Saharan Africa (Lim et al, 2012). Many low‐ and middle‐income countries (LMICs) have strong breastfeeding traditions, adherence to World Health Organization (WHO) Infant and Young Child Feeding recommendations is poor, in terms of timely initiation and breastfeeding exclusivity.
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