Early Initiation Of Breastfeeding Research Articles

Spatiotemporal patterns and factors contributing to neonatal mortality in Ethiopia: Data from EDHS 2000 to 2019.

Although Ethiopia has substantial improvements in various health indicators such as maternal and child mortality, the burden of neonatal mortality remains high. Between 2016 and 2019, neonatal mortality increased from 29 deaths per 1,000 live births to 33 deaths per 1,000 live births. This study aimed to explore the spatial patterns and factors contributing to neonatal mortality in Ethiopia. Data from the Ethiopian Demographic and Health Surveys (EDHS) for the years 2000, 2005, 2011, 2016, and 2019 were analyzed. The EDHS sampling design uses a two-stage cluster sampling technique, considering census enumeration areas as primary sampling units and households as secondary sampling units. We used the Spatial Scan analysis in SaTScan and Getis-Ord Gi* statistic in Geographic Information System (GIS), to analyse the spatiotemporal patterns of neonatal mortality. Maternal, newborn and health service-related factors contributing to neonatal mortality were also analyzed using a multilevel logistic regression model. Adjusted Odds Rios (AOR) with corresponding 95% CI were presented as a measure of association and a P-value of 0.05 was used to declare statistical significance. During the initial three consecutive surveys, there was a consistent pattern of hot spot clusters in the Amhara and Benshangul Gumuz regions, along with certain parts of the Oromia region. However, in later surveys, these clusters shifted to the eastern parts of the country, notably including the Somali region. Early initiation of breast feeding was associated with reduced chances of neonatal death (Adjusted Odds Ratio [AOR]) = 0.27; 95% Confidence Interval [CI]: 0.23, 0.32). Neonates born at home (AOR = 1.46; 95% CI: 1.16, 1.82) and male babies had a higher likelihood of mortality during the neonatal period compared to their counterparts (AOR = 1.36; 95% CI: 1.24, 1.51). The odds of neonatal mortality increased with the number of children a mother had ever given birth to (AOR = 1.36; 95% CI: 1.24, 1.51). In contrast, longer birth intervals were associated with a reduced risk of neonatal mortality (AOR = 0.76; 95% CI: 0.68, 0.83). The central southern, central-western, north-western, and northern parts of Ethiopia had most of the neonatal death clusters in the first three rounds of DHS while eastern Ethiopia had the highest neonatal mortality clusters in the latest two surveys. Our results underscore the importance for policymakers and health administrators to reassess intervention approaches and reallocate resources to regions identified as hot spots for neonatal mortality. Enhancing the initiation of breastfeeding within the first hour of birth would improve newborn survival rates. Special attention and care need to be given to babies born of smaller sizes.

The relationship between feeding practices and stunting among children under two years in Tanzania mainland: a mixed-method approach

BackgroundProper infant and young child feeding practices have gained attention over the years as one of the interventions to reduce childhood stunting. However, there is still a gap in research to determine these relationships in children under two years and the reasons for improper feeding.ObjectiveThis study aimed to assess the relationship between feeding practices, stunting and barriers among children under two years.MethodologyUtilizing a mixed-method approach, the study involved secondary analysis of 1806 records of children aged 6–23 month, from the Next Generation Nutrition Program conducted in Tanzania (2015–2019). Both quantitative and qualitative data analyses were employed. Frequency distribution tables were utilized to describe study participants stratified by their stunting status. Subsequently, modified Poisson regression models identified predictors of stunting. Qualitative analysis encompassed deductive and inductive approaches, to extract themes that address the behaviors contributing to inappropriate feeding practices.ResultsStunting prevalence was 28.8% among children aged 6–23 months, with the majority (65%) of stunted children aged 1 year or older. Dietary diversity was low: 88.3% and 86.3% of stunted and non-stunted children, respectively, consumed less than 5 food groups. Surprisingly, early initiation of breastfeeding, time of stopping breastfeeding, and minimum dietary diversification were not significantly associated with child stunting (p-value > 0.05). Barriers to proper feeding practices identified were inadequate knowledge of feeding, maternal condition, economic hardship, cultural issues, and seasonality.ConclusionEarly breastfeeding and minimum dietary diversity were not significant predictors of stunting. However, the mother’s age and height > 150 cm reduced stunting risk while child sex, age, birth weight, marital status, and place of delivery also influenced stunting risk. It is crucial for initiatives to emphasize good feeding practices while addressing the complex factors that may hinder optimal feeding practices in this age group to reduce childhood stunting effectively.

Turmeric Topical Application: An effective solution for reducing breast milk secretion delays in new mothers

Background: The problem of low coverage of exclusive breastfeeding is partly influenced by insufficient breast milk production. The percentage of exclusive breastfeeding in infants under six months of age in Central Kalimantan in 2020 was 52.98%. This percentage was among the lowest nationally. In 2021, the coverage of exclusive breastfeeding in infants under six months of age reached 56.8%, and in 2022 it did 60.5%. The figure in 2022 exceeded the set target, but several regencies/cities still had low coverage. Insufficient breast milk supply impacts on the nutritional status of the child. Low breast milk production also arises due to several other factors during breastfeeding, namely late initiation of breastfeeding, long breastfeeding time, sore nipples, breast pain and swelling, and inverted nipples. Aims: The study sought to measure the level of success of turmeric topical application in shortening the time it takes to initiate breast milk secretion. Methods: The study uses a true experimental posttest-only control group design. A subject of 50 mothers having full-term spontaneous deliveries and with normal breasts was used in the study. The sample was divided into two groups: control and intervention groups. The sample was selected using a matching process based on age, parity, and early initiation of breastfeeding. Subjects who met the inclusion criteria were offered whether they were willing to be given turmeric compresses after the delivery process. Subjects who were willing were included in the intervention group and those who were not willing were included in the control group. Age and parity in the intervention group were all taken, while the control group was selected to match the intervention group. The intervention group was given a treatment with a turmeric compress on the breasts for six hours. All participants were then observed for time of breast milk secretion initiation. In this experiment, we didn't perform blinding, but we managed it by having the midwife administer the turmeric compress just once during the delivery process before sending the client home. Following this, we recorded the results, specifically the initial breast milk release in both the intervention and the control group. Results: The average time periods it took to initiate breast milk secretion in the intervention and control groups were 509.96 minutes (8.5 hours) and 1573.76 minutes (26.2 hours), respectively. There was a significant difference (p = 0.023) in the time of breast milk secretion initiation of 1063.8 minutes or 17.73 hours between both groups. Conclusion: Applying a turmeric compress on the breasts of postpartum mothers may shorten the time it takes to initiate breast milk secretion. Received: 05 August 2024, Reviewed: 23 August 2024, Revised: 21 September 2024, Accepted: 13 October 2024.

Early Initiation of Breastfeeding (EIBF) Practices in Bener Meriah Regency, Aceh, Indonesia: A Cross-Sectional Study on the Role of Midwives in Reducing Infant Mortality

Early initiation of breastfeeding (EIBF) is critical for reducing infant mortality and improving child health outcomes. Midwives play a crucial role in promoting and supporting EIBF. This study investigated EIBF practices in Bener Meriah Regency, Aceh, Indonesia, focusing on the factors associated with midwives' knowledge, attitudes, and practices regarding EIBF. A cross-sectional study was conducted among 150 midwives in Bener Meriah Regency. Data were collected using a structured questionnaire that included items on sociodemographic characteristics, knowledge, attitudes, and practices related to EIBF. Descriptive statistics, chi-square tests, and logistic regression were used to analyze the data. The majority of midwives (87.3%) had good knowledge about EIBF. However, only 62.7% of midwives reported always assisting mothers with EIBF within one hour of birth. Factors significantly associated with midwives' EIBF practices included their age, years of experience, and place of work (urban vs. rural). While midwives in Bener Meriah Regency generally possess adequate knowledge about EIBF, there is a need to improve their practices in assisting mothers with EIBF, especially in rural areas. Targeted interventions, such as training programs and supportive supervision, are necessary to enhance midwives' skills and confidence in promoting and supporting EIBF.

Exclusive Breastfeeding Among Adolescent Mothers in Indonesia: Does Maternal Education Level Matter?

Exclusive breastfeeding (EBF) is a vital element in the early stages of life. Feeding newborns solely breast milk from birth until they are six months old is sufficient. However, EBF by adolescent mothers is still not optimal. The study analyzed the effect of maternal education on EBF among babies with adolescent mothers in Indonesia. The cross-sectional study examined 560 babies (a–5 months). We analyzed EBF practice as a dependent variable. We included six mothers' characteristics (education, residence, age, marital, employment, and wealth) and two baby characteristics (sex and early breastfeeding initiation) as independent variables. In this study, the initial stage was a bivariate analysis using chi-square. Then, a multicollinearity test was conducted to ensure no strong relationship between the independent variables. Finally, a multivariate test was conducted to determine the factors of EBF in babies with adolescent mothers. The results showed that adolescent mothers with primary education were 2.920 times more likely than those without education to perform EBF (AOR = 2.920, 95% CI [2.521–3.382]). Moreover, adolescent mothers with secondary education were 2.325 times more likely to achieve EBF than those without (AOR = 2.325, 95% CI [2.001–2.701]). The study concluded that all education levels were likelier to perform EBF than those without formal education. Further research is needed to understand the breastfeeding experience of adolescent mothers. Exceptional support and attention regarding EBF should be directed to adolescent mothers who are without formal education.

A Study to Assess the Effectiveness of Nursing Care Package on Early Initiation of Breast Feeding among LSCS mother admitted at selected Hospital, Puducherry

A Study to Assess the Effectiveness of Nursing Care Package on Early Initiation of Breast Feeding among LSCS mother admitted at selected Hospital, Puducherry

Trends and disparities in ever-breastfeeding practice and early breastfeeding initiation in Ethiopia: a 20-year trend analysis from EDHS datasets

BackgroundEthiopia has had a long-standing national commitment to improving child health for the last five decades. However, evidence on trends of ever-breastfeeding and early initiation remained fragmented, and there existed a paucity of holistic evidence on the extent of the impacts of the policy and the associated factors. This study examined trends, disparities, and factors influencing ever-breastfed and early initiation in the last twenty years.MethodsThe Ethiopian Demographic and Health Surveys (EDHS 2000–2019) datasets were used and extracted for children aged 0–23 months and their mothers. Data analyses were performed using SPSS version 25. Trend and time-series analysis was used to visualize changes over time. Multivariable logistic regression was used to identify associated factors.ResultsPrevalence of ever-breastfeeding declined from 99.4% in 2000, to 84.01% in 2019; and early initiation showed inconsistency, increasing from 48.55% in 2000 to 69.57% in 2016 and remained unchanged (69.78%) in 2019. Maternal age, religion, and maternal healthcare utilization significantly influenced early initiation (p < 0.001). Both ever-breastfeeding and early initiation varied across regional states (< 0.001). Disparities in breastfeeding and early initiation were observed across socio-cultural settings and regional states (p < 0.05).ConclusionThe prevalence of ever-breastfeeding declined nationwide between 2000 and 2019, which was not uniform and early initiation showed inconsistency across socio-cultural settings and regional states. These findings highlight the need to revisit current policies and interventions. Further research is crucial to inform the development of regionally tailored and culturally sensitive strategies that promote equitable and sustained breastfeeding improvement across Ethiopia.

Association between pregnancy intention and completion of newborn and infant continuum of care in Sub-Saharan Africa: systematic review and meta-analysis

BackgroundThe newborn and infant continuum of care such as essential newborn care, early initiation and exclusive breastfeeding, and immunisation are highly recommended for improving the quality of life and survival of infants. However, newborn and infant mortality remains high across Sub-Saharan African countries. While unintended pregnancies are associated with adverse newborn and infant health outcomes, there is inconclusive evidence on whether pregnancy intention influences newborn and infant continuum of care completion. Therefore, this review aimed to pool findings reported in the literature on the association between pregnancy intention and newborn and infant health care across the continuum of care in Sub-Saharan Africa.MethodsWe searched MEDLINE Complete, EMBASE, CINAHL Complete, and Global Health databases for studies potentially eligible for this systematic review and meta-analysis. Two researchers independently screened the identified articles by abstract and title, and then full-text using Covidence. We used the Newcastle–Ottawa Scale to assess the quality of the included studies. The Cochran’s Q test and I2 were executed to detect and quantify the presence of statistical heterogeneity in the studies. Meta-analysis was done for each outcome when more than one original study reported relevant data, using Stata statistical software version 18.ResultsEleven studies were included from a total of 235 articles identified by the search. The odds of completing essential newborn care (pooled odds ratio: 3.04, 95% CI: 1.56, 5.90), early initiation of breastfeeding (pooled odds ratio: 1.30, 95% CI: 1.13, 1.52), exclusive breastfeeding (pooled odds ratio: 2.21, 95% CI: 1.68, 2.89), and being fully immunised (pooled odds ratio: 2.73, 95% CI: 1.16, 6.40) were higher among infants born to women with intended pregnancies as compared to women with unintended pregnancies.ConclusionIntended pregnancy was positively associated with essential newborn care completion, early initiation and exclusive breastfeeding, and full immunisation of infants in SSA countries. Thus, policy-makers and stakeholders should strengthen the provision of quality family planning services to prevent unintended pregnancy. Furthermore, follow-up of women with unintended pregnancies is needed to increase women’s opportunity to access essential newborn health care services that further reduce the risk of newborn and infant morbidity and mortality.Systematic review registrationPROSPERO registration number CRD42023409148.

Socio-Cultural Study of Nutrition in Families of Stunted Toddlers in Coastal Communities in Jember Regency

Background: Cultures, traditions, or habits that exist in society, such as dietary restrictions and wrong eating patterns, can lead to increased nutritional problems, especially in toddlers, which ultimately impacts their growth and development. Low-income family parenting patterns in feeding and primary health care for toddlers can also increase the incidence of stunting in toddlers. This could be the cause of the stunting rate in the Jember Regency, especially in coastal areas. Dietary problems, including stunting, in coastal areas should be less likely to occur because the availability of high-protein animal foods such as fish is quite high, but Curahnongko Village is included in the stunting locus area in Jember Regency. Aims: This research aims to describe the socio-cultural nutrition and parenting styles of toddlers in Curahnongko Village. Methods: The study used qualitative and research methods with a case study approach. Results: The socio-culture during pregnancy in the coastal communities of Jember Regency regarding TTD consumption, routine check-ups, taboos during pregnancy, and visits to midwives are quite good. Socio-culturally during the breastfeeding period, it can be concluded that all informants carried out Early Breastfeeding Initiation (IMD). Socio-culturally during the feeding period for toddlers, all informants do not give food other than breast milk to babies when they are born. Conclusion: The socio-cultural aspect that appears to influence the occurrence of stunting is during the feeding period for toddlers, namely the frequency of children's snack consumption outside the home.

Social Desirability Bias in a Randomized Controlled Trial That Included Breastfeeding Promotion in Western Kenya

BackgroundBreastfeeding promotion is associated with improved measures of breastfeeding practice; however, most studies rely on participant-reported outcomes. ObjectivesThis study aimed to evaluate the likelihood of bias in self-reported breastfeeding outcomes. MethodsWe used data from the WASH Benefits randomized controlled trial in Kenya (clinicaltrials.gov NCT01704105), which included intervention arms that received infant and young child feeding messages (nutrition group) and arms that did not (non-nutrition group) to examine recall bias in the assessment of early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) duration. Pregnant women were eligible for inclusion, but 40% of infants were born before the first visit by the health promoter. We used the random variability in the timing of the infant birth relative to the first contact with the health promoter to examine recall bias in EIBF. We used ≤5 rounds of repeated surveys to examine bias in recall of EBF duration. ResultsThere was a significant effect of the intervention group on EIBF [prevalence ratio: 1.50, 95% confidence interval (CI): 1.43, 1.57] and a significant difference in the duration of EBF [nutrition group: 6.0 mo; interquartile range (IQR): 3.0–6.0; nonnutrition group: 3.0 mo; IQR: 0.5–6.0; P < 0.001]. There was not a significant interaction with birth timing relative to the first contact with the health promoters (P = 0.915), suggesting that the observed main effect on EIBF was due to recall bias. We found that 75.9% of mothers who initially reported having ceased EBF before 6 mo in the nutrition group changed their response to 6 mo or later in subsequent surveys. Only 32.5% of mothers in the non-nutrition group followed this pattern. ConclusionsThese data provide strong evidence of bias in reporting of breastfeeding practices in this nonblinded intervention trial and should serve as a caution to researchers who rely on self-reported outcomes of behavior change interventions.This trial was registered at clinicaltrials.gov as NCT01704105.

Measuring breastfeeding prevalence using demographic and health surveys

BackgroundThis study aims to investigate the measurement of breastfeeding prevalence indicators using Demographic and Health Surveys (DHS) data, focusing on early initiation, exclusive breastfeeding, and continued breastfeeding indicators as reported by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) and on the discrepancies arising from small changes in their definition.MethodsTwo hundred sixty DHS samples from 78 countries were analyzed to re-calculate usual indicators reported by WHO and UNICEF: early initiation of breastfeeding (EIB), exclusive breastfeeding under 6 months (EBF), and continued breastfeeding between 1 and 2 years (CBF12 and CBF24). Additionally, alternative estimates of the same indicators, slightly changing their definition, were calculated to test their robustness.ResultsThe WHO and UNICEF indicators for early initiation (EIB) primarily capture cases where breastfeeding is initiated “immediately” after birth, omitting those initiated within 0 or 1 hour. This discrepancy leads to substantial underestimation of levels in some regions, particularly South Asia, and in trends. Furthermore, sizable discrepancies between exclusive breastfeeding (EBF) indicators arise from the inclusion or exclusion of plain water in the definition, with significant variations across regions, especially in West and Middle Africa. However, continued breastfeeding indicators showed consistency across definitions, proving them robust for international comparisons and time trend estimations.ConclusionThis study highlights the importance of understanding how breastfeeding indicators are defined and calculated using DHS data. Researchers should be cautious when using WHO and UNICEF indicators for early initiation and exclusive breastfeeding, as they may underestimate prevalence due to their narrow definition. Continued breastfeeding indicators, on the other hand, are less affected by small changes in definitions and provide reliable measures for cross-country comparisons and trend analyses. These findings underscore the need for standardized robust definitions and transparent reporting of breastfeeding indicators in global health assessments.

Analysis of stunting in East Java, Indonesia using random forest and geographically weighted random forest regression

Stunting is one of the problems that the world focuses on today to be resolved immediately. World Health Organization (WHO) stipulates that a country’s public health problems are said to be chronic if the stunting prevalence rate reaches more than 20%.The prevalence rate of stunting in Indonesia in 2021 reached 24.4%. This study aims to analyze factors that correlate with the prevalence of stunting in East Java Province using machine learning methods: Random Forest Regression (RFR) and Geographically Weighted Random Forest (GWRF) methods. The results of this research are the factors that correlate with the prevalence of stunting based on the RFR method, namely the number of babies who get early breastfeeding initiation, the number of malnourished toddlers, and the number of active integrated health posts. The RFR method results in RMSE values of 3.014, MAPE 11.69%, and R2 0.8168. The factors that correlate with the prevalence of stunting based on the GWRF method are divided into six groups according to the similarity of factors that correlate with stunting in the regency/city. The GWRF method gives better results than the RFR indicated by the resulting RMSE values of 1.023, MAPE 4.45%, and R2 0.9788.

Analysis of Policy Implementation and Availability of Infrastructure on the Implementation of Early Breastfeeding Initiation After Cesarean Section Delivery in Private Hospitals in Kudus District

Early initiation of breastfeeding (IMD) is placing the infant on the mother's chest or abdomen and allowing the infant to seek the mother's nipple within the first hour of birth. Caesarean section (SC) poses challenges to the implementation of Early Breastfeeding Initiation (IMD) in both internationally and nationally recommended hospital programs for maternal and infant care. The purpose of this study was to analyze policy implementation and analyze the availability of hospital facilities in the implementation of Early Breastfeeding Initiation (IMD) after Sectio Caesarean delivery. The research design was descriptive qualitative. The main informants of the study were SPOg doctors, implementing midwives and the Head of the Central Surgical Unit. Supporting informants are laboring mothers, central surgery unit nurses, pediatricians, hospital management. Data collection using in-depth interviews and observation. Data validity strategy using source triangulation. There is a policy contained in the decree of the hospital director and the hospital SOP as a work instruction for the implementing unit, monitoring is carried out every delivery and the division of tasks is carried out situationally. The number, competence and infrastructure are available well enough to support the implementation of IMD after Sectio Caesarea delivery in the hospital

Prevalence of early initiation of breastfeeding at Georgetown Public Hospital Corporation in Guyana

AbstractObjectiveTo assess the prevalence and factors associated with early initiation of breastfeeding at Georgetown Public Hospital Corporation (GPHC).MethodsThis study used data from an institution‐based cross‐sectional study conducted at GPHC from July to September 2022. A structured pretested questionnaire was used to collect the data. A total of 1276 mothers were interviewed and provided data on early initiation of breastfeeding. Early initiation of breastfeeding was defined as mothers who breastfed their babies within the first hour after birth. We performed descriptive analyses for both the outcome and the independent variables. Logistic regression and backward selection procedure were used to assess factors associated with early initiation of breastfeeding.ResultsThe prevalence of early breastfeeding at GPHC was 27.8% (95%CI: 25.4–30.3). Mothers who were primigravida (AOR: 0.52; 95%CI: 0.36–0.75), who had urinary tract infections during pregnancy (AOR: 0.72; 95%CI: 0.52–0.99), and who delivered by caesarean section (AOR: 0.06; 95%CI: 0.03–0.11) were less likely to breastfeed their babies in the first hour after birth. Likewise, babies who were diagnosed with any health problems after birth (AOR: 0.34; 95%CI: 0.21–0.54) had a lesser chance to receive breastfeeding in the first hour after birth, compared with their counterparts.ConclusionLess than one‐third of mothers who delivered at GPHC breastfed their babies within the first hour after birth. Targeted intervention focuses on promoting early initiation of breastfeeding, immediate skin‐to‐skin contact between mothers and babies, timely diagnosis and treatment of urinary tract infections during pregnancy are essential to improve the prevalence of early initiation of breastfeeding at GPHC.

Pengaruh Stimulasi Janin dan Inisiasi Menyusui Dini terhadap Bonding Attachment

Fetal stimulation and early initiation of breastfeeding (IMD) have great benefits for the baby's development. This study aims to examine the effect of fetal stimulation and IMD on attachment bonding. This research used a quasi-experimental design, posttest only control design. The experimental group consisted of carrying out fetal stimulation by pregnant women and IMD, while the control group consisted of IMD. Post test to measure bonding attachment. Research location at PMB Wiwik Sumarni, Wonogiri, Central Java in November 2022 – April 2023. Purposive sampling technique with 15 per group. Respondents: Pregnant women with gestational age &gt; 24 weeks were normal and were observed until the IMD process. The result of the independent t-test is significant with a p value of 0.002 (&lt;0.05), the experimental group's posttest score have a lower mean value of 21.60 compared to the control group of 32.67, both groups are in the strong attachment bonding category. ANACOVA results of fetal stimulation and IMD have an attachment bonding score 7 points lower than the control group (b = -7; 95% CI; -13 to -1; p &lt; 0.001). Adjusted R2 = 48.1%. In conclusion, there is an influence of fetal stimulation and IMD on bonding attachment.

Inequality in breastfeeding and complementary feeding practices in Argentina by household income level in 2018-2019.

Introduction. Diet quality is a right related to survival, healthy growth, prevention of chronic diseases, and malnutrition in all its forms. The objective of this study was to analyze breastfeeding and feeding practices in children younger than 2 years from urban areas of Argentina in 2018-2019 according to their household income level. Population and methods. Secondary analysis of data of the Second National Survey on Nutrition and Health (ENNyS2) of 2018-2019. Breastfeeding and complementary feeding indicators proposed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) were analized. Data were stratified by household income level. Results. The analysis included 5763 children younger than 24 months old. Although 97% was ever breastfed, only 47% of infants younger than 6 months were exclusively breastfed the previous day and 48% continued with breastfeeding after 1 year old, with a higher prevalence in low-income children. The previous day, 23% of children aged 6 to 23 months did not eat any fruit or vegetable, 60% consumed unhealthy foods, and 50% consumed sweet beverages. The consumption of sweet beverages and the absence of fruit and vegetables were higher in low-income households. Conclusion. The quality of children's diet is far from the recommendations and is conditioned by income. Early initiation of breastfeeding, minimum dietary diversity, fruit and vegetable consumption are lower and sweet beverage consumption is greater in impoverished sectors.

Association of antenatal counselling with breastfeeding outcomes: a comparative analysis

Background: Breastfeeding is an art and a skill which needs to be learnt and mastered. Breastfeeding practice gets affected by many factors like Social, cultural, biophysical, demographic and psychological. One of the important factors for ineffective breastfeeding is the lack of adequate knowledge of women regarding breastfeeding, such as the time of initiation of feeding, feeding of colostrum and mother’s position while feeding the baby. Objective of the study was to find out association of antenatal counselling with the preference for breastfeeding positions, early initiation of breastfeeding and feeding of colostrum. Methods: This was a prospective cohort study where 120 primigravida who had taken structured counseling on breastfeeding during their antenatal period and ended up with vaginal delivery at labour room of SSG Hospital, Baroda were recruited. With every such mother, the next woman who delivers vaginally and has not taken structured counselling during ANC was taken as the control. After delivery, all the mothers were observed for early initiation of breastfeeding, feeding of colostrum and adoption of cross-cradle breastfeeding position in comparison with other positions. Results: The rate of early initiation of breastfeeding (EIBF) and number of mothers who fed colostrum to their babies was significantly higher in case group compared to the control group. The number of mothers preferring the cross cradle position was also higher in case group. Conclusions: Antenatal counseling on breastfeeding helps mothers to raise the rate of early initiation of breastfeeding and feeding of colostrum to babies. It also helped mothers to choose cross cradle position as their preferred method of breast feeding.

Early initiation of breastfeeding and associated factors among post-natal mothers in selected healthcare sectors, Rohtas, Bihar

Background: Breastfeeding is the best natural feeding and breast milk is the best milk. The basic food of an infant is the mother’s milk. The study aimed to determine the estimated time of breastfeeding initiation among normal delivery mothers, identify the contribution factor for delayed initiation of breastfeeding among normal delivery mothers, and to find out the association between the selected demographic variables and initiation timing of breastfeeding. Methods: The present study constituted a cross-sectional research design, involving 100 postnatal mothers from selected healthcare centers. A purposive sampling technique was employed to select the participants, and a semi-structured questionnaire was utilized to collect the data. The data was gathered through a self-administered questionnaire. Subsequently, inferential statistics, such as chi-square, were applied to determine the objective and hypothesis of the study. Results: In the research, it was found that 56% of mothers-initiated breastfeeding within the first hour after giving birth. Furthermore, 30% of mothers-initiated breastfeeding between 1 and 24 hours, and 14% initiated breastfeeding 24 hours after giving birth. The study also revealed a categorical association (as determined via chi-square test, p value &lt;0.005) between the timing of breastfeeding and certain socio-demographic factors, such as the occupational status of mothers (χ2=11.65, p value &lt;0.005), their educational level (χ2=17.7, p value &lt;0.005), and the family’s monthly income (χ2=13.7, p value &lt;0.005). Conclusions: Adopting breastfeeding-friendly policies at scale and utilizing monitoring data to increase accountability and improve service delivery can significantly reduce delayed breastfeeding initiation.

Geospatial determinants and spatio-temporal variation of early initiation of breastfeeding and exclusive breastfeeding in Ethiopia from 2011 to 2019, a multiscale geographically weighted regression analysis

BackgroundBreastfeeding offers numerous benefits for infants, mothers, and the community, making it the best intervention for reducing infant mortality and morbidity. The World Health Organization (WHO) recommends initiating breastfeeding within one hour after birth and exclusively breastfeeding for the first six months. This study investigated the trend, spatio-temporal variation, and determinants of spatial clustering of early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) in Ethiopia from 2011 to 2019.MethodsData from the Ethiopian Demographic and Health Survey (EDHS), which was conducted in 2011, 2016, and 2019, were analyzed utilizing a weighted sample of 10,616 children aged 0–23 years for EIBF and 2,881 children aged 0–5 months for EBF. Spatial autocorrelation analysis was used to measure whether EIBF and EBF were dispersed, clustered, or randomly distributed and Kriging interpolation was employed to predict the outcome variables in the unmeasured areas. Spatial scan statistics were used to identify spatial clusters with a high prevalence of cases. Both global and local regression modeling techniques were employed to examine the spatial relationships between the explanatory variables and the dependent variables.ResultsThe trend analysis revealed a notable increase in the prevalence of EIBF from 51.8% in 2011 to 71.9% in 2019. Similarly, the prevalence of EBF increased from 52.7% in 2011 to 58.9% in 2019. Spatial analysis demonstrated significant spatial variation in both EIBF and EBF throughout the country. Cold spots or clusters with a low prevalence of EIBF were observed consistently in the Tigray and Amhara regions, and significant cold spot areas of EBF were observed consistently in the Afar and Somali regions. Multiscale geographically weighted regression analysis revealed significant predictors of spatial variations in EIBF, including the religious affiliation of being a follower of the orthodox religion, parity of 1–2, absence of antenatal care visits, and delivery via cesarean section.ConclusionsDespite the increase in both EIBF and EBF rates over time in Ethiopia, these rates still fall below the national target. To address this issue, the government should prioritize public health programs aimed at improving maternal healthcare service utilization and maternal education. It is essential to integrate facility-level services with community-level services to achieve optimal breastfeeding practices. Specifically, efforts should be made to promote breastfeeding among mothers who have delivered via cesarean section. Additionally, there should be a focus on encouraging antenatal care service utilization and adapting maternal healthcare services to accommodate the mobile lifestyle of pastoralist communities. These steps will contribute to enhancing breastfeeding practices and achieving better outcomes for maternal and child health.

Specialized nutritious foods and behavior change communication interventions during the first 1000 d of life to prevent stunting: a quasi-experimental study in Afghanistan

BackgroundConsiderable evidence supports the effectiveness of nutritional supplementation with or without nutrition education in preventing stunting in developing countries, but evidence from Afghanistan is scarce. ObjectivesThis project aimed to assess the effectiveness of specialized nutritious food (SNF), social and behavior change communication (SBCC) intervention to prevent stunting among children under 2 y during the first 1000 d of life in Badakhshan, Afghanistan. MethodsWe used a community-based quasi-experimental pre–post study design with a control group. Pregnant and lactating women received a monthly ration of 7.5 kg of super cereal (250 g/d) during pregnancy and the first 6 mo of breastfeeding. Children aged 6–23 mo received 30 sachets of medium-quantity lipid-based nutrient supplement (50 g/sachet/d) monthly. We compared pre- and postintervention assessments of the intervention and control groups to isolate the effect of the intervention on key study outcomes at the endline by difference-in-differences (DID) estimates. ResultsA total of 2928 and 3205 households were surveyed at baseline and endline. DID estimates adjusted for child, maternal, and household characteristics indicated a significant reduction in stunting (DID: −5% (95% confidence interval [CI]: −9.9, −0.2) and underweight (DID: −4.6% (95% CI: −8.6, −0.5) among children <2 y of age. However, DID estimates for wasting among children in the intervention and control groups were not significantly different (DID: −1.7 (95% CI: −5.1, 1.6). Furthermore, exposure to the SBCC messages was associated with improvements in the early initiation of breastfeeding (DID: 19.6% (95% CI: 15.6, 23.6), exclusive breastfeeding under 6 mo (DID: 11.0% (95% CI: 2.3, 19.7), minimum meal frequency (DID: 23% (95% CI: 17.7, 28.2), and minimum acceptable diet (DID: 13% (95% CI: 9.8, 16.3). ConclusionsThe provision of SNF in combination with SBCC during the first 1000 d of life was associated with reduction in stunting and underweight and improvements in infant and young child feeding practices among children under 2 y of age.This trial was registered at clinicaltrials.gov as NCT04581993.