Abstract
BackgroundEarly initiation of breastfeeding (EIBF) lowers the risk for all-cause mortality in babies, including those with low birth weight. However, rates of neonatal mortality and delayed initiation of breastfeeding remain high in most low- and middle-income countries. This study aimed to assess the trends and factors associated with EIBF in Namibia from 2000 to 2013.MethodsAn analysis of EIBF trends was conducted using data from three Namibia Demographic Health Surveys. The present sample included singleton children younger than 2-years from 2000 (n = 1655), 2006–2007 (n = 2152) and 2013 (n = 2062) surveys. Descriptive statistics were used to analyse respondents’ demographic, socioeconomic and obstetric characteristics. Factors associated with EIBF were assessed using univariate analysis and further evaluated using multivariable logistic regression analysis.ResultsEIBF significantly decreased from 82.5% (confidence interval [CI]: 79.5–85.0) in 2000 to 74.9% (72.5–77.2) in 2013. Factors associated with EIBF in 2000 were urban residence (adjusted odds ratio 0.58, 95% CI: 0.36–0.93), poorer household wealth index (1.82, 1.05–3.17), lack of antenatal care (0.14, 0.03–0.81), small birth size (0.38, 0.24–0.63) and large birth size (0.51, 0.37–0.79). In 2013, factors associated with EIBF were maternal age of 15–19 years (2.28, 1.22–4.24), vaginal delivery (2.74, 1.90–3.93), married mothers (1.57, 1.16–2.14), delivery assistance from health professionals (3.67, 1.23–10.9) and birth order of fourth or above (1.52, 1.03–2.26).ConclusionsNamibia has experienced a declining trend in EIBF rates from 2000 to 2013. Factors associated with EIBF differed between 2000 and 2013. The present findings highlight the importance of continued commitment to addressing neonatal health challenges and strengthening implementation of interventions to increase EIBF in Namibia.
Highlights
Initiation of breastfeeding (EIBF) lowers the risk for all-cause mortality in babies, including those with low birth weight
The proportion is even lower in the African region (44%); this rate is “fair” according to World Health Organization (WHO) classification of early initiation of breastfeeding (EIBF) but falls below “very good” (90–100%) [2]
High Early initiation of breastfeeding (EIBF) rates are associated with health facility delivery, Ndirangu et al BMC Pregnancy and Childbirth (2018) 18:171 large birth size, formal education, urban residence, wealthier household index, non-working mothers, higher birth order and female babies [9, 13,14,15]
Summary
Initiation of breastfeeding (EIBF) lowers the risk for all-cause mortality in babies, including those with low birth weight. The benefits of EIBF for both mother and baby are well-documented, including reduced Despite these benefits, the rate of EIBF in most middleincome countries remains low, including in Namibia. Low EIBF rates are associated with unskilled birth attendance [11], non-health facility [12] and caesarean deliveries [10, 13] and maternal complications [10]. High EIBF rates are associated with health facility delivery, Ndirangu et al BMC Pregnancy and Childbirth (2018) 18:171 large birth size, formal education, urban residence, wealthier household index, non-working mothers, higher birth order and female babies [9, 13,14,15]
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