Abstract
BackgroundIrrespective of the place and mode of delivery, ‘delayed’ initiation of breastfeeding beyond the first hour of birth can negatively influence maternal and newborn health outcomes. In Bangladesh, 49% of newborns initiate breastfeeding after the first hour. The rate is higher among deliveries at a health facility (62%). This study investigates the maternal, health service, infant, and household characteristics associated with delayed initiation of breastfeeding among health facility deliveries in Bangladesh.MethodsWe used data from the 2014 Bangladesh Demographic and Health Survey. We included 1277 last-born children born at a health facility in the 2 years preceding the survey. ‘Delayed’ breastfeeding was defined using WHO recommendations as initiating after 1 h of birth. We performed univariate and multivariable logistic regression to determine factors associated with delayed initiation.ResultsAbout three-fifth (n = 785, 62%) of the children born at a health facility delayed initiation of breastfeeding beyond 1 h. After adjusting for potential confounders, we found delayed initiation to be common among women, who delivered by caesarean section (adjusted Odds Ratio (aOR): 2.93; 95% CI 2.17, 3.98), and who were exposed to media less than once a week (aOR: 1.53; 95% CI 1.07, 2.19). Women with a higher body mass index had an increased likelihood of delaying initiation (aOR: 1.05; 95% CI 1.01, 1.11). Multiparous women were less likely to delay (aOR: 0.71; 95% CI 0.53, 0.96).ConclusionsDelayed initiation of breastfeeding following caesarean deliveries continues to be a challenge, but several other health facility and maternal factors also contributed to delayed initiation. Interventions to promote early breastfeeding should include strengthening the capacity of healthcare providers to encourage early initiation, especially for caesarean deliveries.
Highlights
Irrespective of the place and mode of delivery, ‘delayed’ initiation of breastfeeding beyond the first hour of birth can negatively influence maternal and newborn health outcomes
We included all the 1277 children who were born to women aged 15–49 years at any health facility and had information on the time of breastfeeding initiation
As we analyzed women who delivered at a health facility, 94% of the mothers had been to at least one Antenatal care (ANC) visit, but only 48% of these women had been to all four recommended ANC visits
Summary
Irrespective of the place and mode of delivery, ‘delayed’ initiation of breastfeeding beyond the first hour of birth can negatively influence maternal and newborn health outcomes. Initiation of breastfeeding within the first hour of birth is a crucial step towards ensuring optimal breastfeeding practices sustained throughout infancy. Recent systematic reviews [5, 6] and a global report by WHO and UNICEF [1, 7] suggest that delaying initiation of breastfeeding beyond the first hour of birth increases the risk of neonatal death by 33%. Studies suggest that timely initiation of breastfeeding enhances newborns immune system [8] It is associated with reduced likelihood of mortality by protecting against infection [5, 9], sepsis and severe illnesses during early newborn [10], neonatal and infancy period
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