Late Initiation Of Breastfeeding Research Articles

Breastfeeding practices within the first six months of age in mid-western and eastern regions of Nepal: a health facility-based cross-sectional study

BackgroundThe World Health Organization recommends initiation of breastfeeding within 1 hour of birth and exclusive breastfeeding up to 6 months of age. Infant feeding practices, including suboptimal breastfeeding practices, are associated with stunting. Rate of stunting was highest in the Mid-western region and lowest in the Eastern region of Nepal. This study aimed to assess the breastfeeding practices in these two regions, as well as to identify factors associated with partial breastfeeding.MethodsWe conducted a health facility-based cross-sectional study in the Mid-western and Eastern regions of Nepal from December 2017 to May 2018. Investigators administered a pre-tested questionnaire among consecutive 574 mother-infant dyads at different levels of health facilities. We dichotomized the breastfeeding pattern to partial breastfeeding and full (exclusive or predominant) breastfeeding. We conducted multivariable logistic regression to identify factors associated with partial breastfeeding within 6 months of age.ResultsThere were 574 infants included in the study, all of which received at least some breastfeeding. Only 23.2% of infants were exclusively breastfed until 6 months, with 28.2% predominantly breastfed and 48.6% partially breastfed. Partial breastfeeding rate was 52.3% in the Mid-western region and 44.4% in the Eastern region. Breastfeeding was initiated within an hour from birth in 67.2% of infants. One-quarter of infants were given pre-lacteal feed, honey being the commonest. Knowledge of the recommended duration of exclusive breastfeeding was inadequate in 16, and 65% of mothers reported breastfeeding problems in the first 6 months. Firstborn and low birth weight infants had a significantly higher rate of partial breastfeeding. Partial breastfeeding was also higher when infants were not breastfed within 1 hour from birth, mothers reported having breastfeeding-related problems or had inadequate knowledge of the duration of exclusive breastfeeding.ConclusionNearly half of the infants were fully breastfed at 6 months of age in Nepal. The rate of partial breastfeeding was higher with inadequate knowledge on duration of exclusive breastfeeding or late initiation of breastfeeding or perceived breastfeeding problems. Hence, programs should address knowledge and practice gaps in breastfeeding practices, particularly among mothers of low birth weight and firstborn infants.

Relationship between caesarean section and breastfeeding: evidence from the 2013 Turkey demographic and health survey

BackgroundThe mode of delivery influences breastfeeding practices. High rates of caesarean section and low breastfeeding rates are important public health concerns for all developing countries. This study aimed to determine the relationship between caesarean section and early breastfeeding practices among primiparae.MethodsData for primiparae with a singleton birth (N = 777) obtained from the 2013 Turkey Demographic and Health Survey were used in this retrospective cohort study. Early initiation of breastfeeding within one hour of delivery and exclusive breastfeeding during the first three days following birth were evaluated. Standardised incidence rates and standardised rate ratios of non-early initiation of breastfeeding and non-exclusive breastfeeding were calculated according to the mode of delivery.ResultsThe late initiation of breastfeeding and non-exclusive breastfeeding incidence rates were 42.7 and 41.0%, respectively. The standardised incidence rate of late initiation of breastfeeding among women with vaginal delivery was 35.34%, versus 50.49% among those with caesarean delivery. The standardised rate ratios for late initiation of breastfeeding and non-exclusive breastfeeding were 1.428 (95% confidence interval (CI): 1.212–1.683) and 1.468 (95% CI: 1.236–1.762), respectively. Women who underwent caesarean section had a higher risk of late initiation of breastfeeding and non-exclusive breastfeeding during the three days following delivery, after controlling for sociodemographic and delivery-related factors.ConclusionsThis study provides useful evidence for the implementation of strategies to prevent unnecessary caesarean sections, which negatively affect not only maternal health but also neonatal health. The promotion of mother-friendly policies by healthcare institutions, implemented in a baby-friendly manner, is essential.

Trends and factors associated to early initiation of breastfeeding, exclusive breastfeeding and duration of breastfeeding in Ethiopia: evidence from the Ethiopia Demographic and Health Survey 2016

BackgroundInitiation of breastfeeding immediately after birth, exclusive breastfeeding, and continuous breastfeeding for at least 2 years lower the risk of newborn deaths. This study was conducted to examine the trends and factors associated with early initiation of breastfeeding, exclusive breastfeeding and duration of breastfeeding in Ethiopia.MethodsData for this study were extracted from the Ethiopian Demographic and Health Survey 2016. A total of 5122 children were included in the analysis. Multivariate logistic regression analysis, and Cox proportional hazards model were fitted to find the factors associated with breastfeeding practices. Reported p - values < 0.05 or a 95% Confidence Interval of Odds Ratio/Hazard Ratio excluding one was considered as significant association with early initiation of breastfeeding, exclusive breastfeeding, duration of breastfeeding and independent variables.ResultsAbout 81.8% of the children initiated breastfeeding within 1 h of birth and during the day before an interview, 47% were exclusively breastfed during the first 6 months. The median duration of breastfeeding was 22 months (22 ± 0.50 months 95% Confidence Interval [CI] 21.01–22.99). Rural residents (Odds Ratio [OR] 0.71, 95% CI 0.51, 0.99), mothers with no antenatal follow up (OR 0.75, 95% CI 0.57, 0.99), caesarean birth (OR 0.80, 95% CI 0.66, 0.96) and home delivery were associated with low initiation of breastfeeding within 1 h of birth. Mothers with no/primary education (OR 0.62, 95% CI 0.40, 0.96), no baby postnatal checkup (OR 0.53, 95% CI 0.39, 0.73), average/larger size of a child at birth (OR 0.80, 95% CI 0.65, 0.99) and deliveries outside of health centers were significantly associated with non-exclusive breastfeeding at the time of the interview. Further, mothers living in Amhara (Hazard Ratio [HR] 1.31, 95% CI 1.05, 1.64), Oromia (HR 1.27, 95% CI 1.04, 1.54), and Benishangul-Gumuz (HR 1.34, 95% CI 1.09, 1.65) regions had a longer duration of breastfeeding while Muslims, employed mothers, multiple births and poor economic level of households were associated with shorter durations of breastfeeding.ConclusionsRural residence, female sex, home delivery, caesarean birth, small birthweight baby and large family size were associated with late initiation of breastfeeding. Living in Affar, Somali, and Harari, primary education level of mothers, giving birth outside of health facilities, no antenatal care follow up, and no postnatal check-up were associated with non-exclusive breastfeeding, while younger age mothers, Muslims, giving birth outside of health facilities, and employed mothers were associated with shorter time to cessation of breastfeeding. Providing health education and counseling for mothers during and after pregnancy should be encouraged.

Clinical Characteristics of a Group of Cameroonian Neonates with Delayed Breastfeeding Initiation

The timely or Early Initiation of Breastfeeding (EIBF) within the first hour following childbirth is known to be a determining factor for the overall breastfeeding process. Nevertheless, in some cases there may exist a considerable delay in its start. This could be responsible for disorders in neonate infants, with varying severity. The main objective of this survey was to determine particular clinical characteristics of a group of neonates with delayed breastfeeding initiation, compared with that of neonates with early breastfeeding initiation (EBFI), during the first week of life. We did an analytical cross-sectional study with the notion of timely breastfeeding initiation according to the World Health Organization (WHO), used to distinguish neonates. The study was conducted at the Yaoundé Gynaeco-Obstetric and Paediatric Hospital from December 2018 to May 2019. All livebirth infants weighing > 2000g were recruited during the period of study. From an overall sample of 250 neonates, 153 (61.2%) had delayed breastfeeding initiation, while 97 others had EIBF. All neonates with delayed breastfeeding initiation had other characteristics of inadequate breastfeeding practices. Although 144 (94%) were in good health immediately after birth, 38 (24.8%) were hospitalized within 7 days, of which 21 (55.2%) were related to sepsis and 6 (15.7%) due to metabolic disorders. They represented 83.3% (15 out of 18) infants with hypotrophy. Therefore, the late initiation of breastfeeding may induce inadequate breastfeeding practices, with significant repercussions on the neonate’s health condition, including nutritional disorders such as metabolic disturbances, growth retardation, increased susceptibility to neonatal infections and eventually, the rate of hospitalization during the given period of time on. Mothers’ education, medical staff and family encouragements may help promote timely breastfeeding initiation, so as to limit adverse neonatal outcomes.

Prevalence and factors associated with neonatal hypothermia on admission to neonatal intensive care units in Southwest Ethiopia - A cross-sectional study.

IntroductionNeonatal hypothermia is one of the main underlying factors associated with neonatal deaths.ObjectiveThe objective of this study was to assess the prevalence and factors associated with neonatal hypothermia on admission to neonatal intensive care units in Southwest Ethiopia.MethodsInstitution-based cross-sectional study design was employed between February to September 2017 at intensive care units of Arba Minch and Jinka General Hospitals. All neonates admitted to the two neonatal intensive care units during the study period were included in the study. Data were collected by four nurses who were working in the units of the hospitals through semi-structured pre-tested questionnaire and checklist. Multi-variable logistic regression was used to analyze the relationship between the dependent and independent variables using odds ratio with a confidence interval of 95% and a p-value of 0.05.ResultsThe prevalence of neonatal hypothermia on admission to the neonatal intensive care units in this study area was 50.3%. Admission weight below 2500 gm. (AOR = 3.61, 95% CI: 2.10, 6.18), delay in initiation of breastfeeding (AOR = 2.42, 95% CI: 1.45, 4.02), early bathing (AOR = 2.63, 95% CI: 1.23, 5.63), admissions during cold season (AOR = 1.72, 95% CI: 1.04, 2.84), and presence of obstetrical complication(s) during pregnancy/labor (AOR = 2.46, 95% CI: 1.07, 5.66) were factors significantly associated with hypothermia on admission to the neonatal intensive care units.ConclusionsThe prevalence of neonatal hypothermia on admission to the intensive care units was high. There is a need to create awareness among the community members about the dangers of early bathing and late initiation of breastfeeding. It is also important to give attention to the newborns of mothers with obstetric complications, low-birth-weight babies and babies delivered during the cold season.

Maternal Depression and Breastfeeding Practices in the Maldives.

To assess associations between maternal depression and breastfeeding practices in mothers in the Maldives. A prospective cohort study. The validated questionnaires contained information on demographics, breastfeeding initiation, breastfeeding duration, and the Edinburgh Postnatal Depression Scale. Logistic regression analyses were used to assess association between Edinburgh Postnatal Depression Scale score and breastfeeding practices while adjusting for lifestyle determinants. Cox regression was done to measure the association between maternal depression and breastfeeding duration. Antenatal clinic at Indira Gandhi Memorial and ADK Hospitals in Male', Maldives. A total of 458 mothers from the antennal clinics were interviewed at 36 weeks of gestation and again at 1, 3, and 6 months after birth. Antenatal depression at 36 weeks of gestation was associated with late initiation of breastfeeding (adjusted odds ratio = 3.0, 95% confidence interval = 1.3-6.8). Postnatal depression was associated with shorter duration of exclusive, full, and any breastfeeding ( P < .001). Depression is negatively associated with breastfeeding practices. There is a need to manage antenatal postnatal depression in mothers in order to encourage them to initiate breastfeeding earlier and to breastfeed for longer.

Antenatal depressive symptoms and early initiation of breastfeeding in association with exclusive breastfeeding six weeks postpartum: a longitudinal population-based study

BackgroundDepressive symptoms negatively impact on breastfeeding duration, whereas early breastfeeding initiation after birth enhances the chances for a longer breastfeeding period. Our aim was to investigate the interplay between depressive symptoms during pregnancy and late initiation of the first breastfeeding session and their effect on exclusive breastfeeding at six weeks postpartum.MethodsIn a longitudinal study design, web-questionnaires including demographic data, breastfeeding information and the Edinburgh Postnatal Depression Scale (EPDS) were completed by 1217 women at pregnancy weeks 17–20, 32 and/or at six weeks postpartum. A multivariable logistic regression model was fitted to estimate the effect of depressive symptoms during pregnancy and the timing of the first breastfeeding session on exclusive breastfeeding at six weeks postpartum.ResultsExclusive breastfeeding at six weeks postpartum was reported by 77% of the women. Depressive symptoms during pregnancy (EPDS> 13); (OR:1.93 [1.28–2.91]) and not accomplishing the first breastfeeding session within two hours after birth (OR: 2.61 [1.80–3.78]), were both associated with not exclusively breastfeeding at six weeks postpartum after adjusting for identified confounders. Τhe combined exposure to depressive symptoms in pregnancy and late breastfeeding initiation was associated with an almost 4-fold increased odds of not exclusive breastfeeding at six weeks postpartum.ConclusionsWomen reporting depressive symptoms during pregnancy seem to be more vulnerable to the consequences of a postponed first breastfeeding session on exclusive breastfeeding duration. Consequently, women experiencing depressive symptoms may benefit from targeted breastfeeding support during the first hours after birth.

Barriers to exclusive breastfeeding in rural community of central Gujarat, India.

Context:Exclusive breastfeeding (EBF) in first the 6 months of life is the most effective way to satisfy nutritional and psychological needs of a baby. However, EBF rate for India remained low at 54.9% during 2015–2016. It is therefore essential to understand the reasons for such a low EBF rate in the country so that appropriate interventions can be developed and implemented.Objectives:(1) To estimate the prevalence of EBF in rural community of central Gujarat and (2) to identify barriers to EBF in this community.Materials and Methods:A community-based cross sectional study was conducted among mothers of 330 infants of age 6 months to 1 year using pretested questionnaire. Two-stage cluster sampling technique was used to select the sample. χ2 test, t-test, and logistic regression were applied to assess the significance of associations.Results:EBF rate in the studied population was detected to be 49.7%. Early marriage of parents, less educated parents, male child, Christian religion, working mother, less number of antenatal visits, operative delivery, late initiation of breastfeeding, not feeding colostrum, lack of knowledge about EBF, and poor counseling of mother regarding EBF were identified as barriers to EBF.Conclusion:Prevalence of EBF was found to be lower than the national average in the rural community of central Gujarat. Effective strategies at local, state, and national levels should aim at addressing the barriers to EBF that are identified in this study.

Neonatal mortality in the case of Felege Hiwot referral hospital, Bahir Dar, Amhara Regional State, North West Ethiopia 2016: a one year retrospective chart review

BackgroundEthiopia is among the countries with the highest neonatal mortality with the rate of 37 deaths per 1000 live births. In spite of many efforts by the government and other partners, non significant decline has been achieved over the last 15 years. Thus, identifying the prevalence and associated factors of neonatal mortality is very crucial for policy and program improvement. This study was designed to assess neonatal mortality rate in Felege Hiwot referral hospital, North West Ethiopia.MethodsA hospital based chart review was done in Felege Hiwot referral hospital based on patient charts from July 2015 to June 2016. The data were collected using structured checklists. The collected data was coded, filtered and entered in to Microsoft Excel 2007 and transferred to STATA version 12.0 for analysis. Binary logistic regression analysis was used to identify factors associated with neonatal mortality. A p - value of < 0.05 was considered as significant.ResultsThe prevalence of neonatal mortality in Felege Hiwot referral hospital was 13.29% (95% CI: 10.09–17.07). Early age of the newborn (< 7 days) [AOR = 0.39 (0.16–0.97)], gestational age at delivery [AOR = 2.14 (1.0–4.52)], late initiation of breastfeeding [AOR = 2.89 (0.99–8.38)], non exclusive breastfeeding [AOR = 6.77 (3.04–15.07)], inadequate ante natal visit [AOR = 5.02 (1.02–24.70)] were the determinant factors for neonatal death.ConclusionsThis study revealed that neonatal mortality is still high in the study area. Early age of the newborn, late initiation of breastfeeding, exclusive breastfeeding and ante natal vist were the determinant factors for neonatal mortality in the study area. Therefore, giving attention for newborns who are small for age, timely initiation of breastfeeding, exclusive breastfeeding and increasing ante natal visit were recommended to reduce neonatal mortality.

Feeding practice of infant and young children and their nutritional status among tea worker community of West Tripura district, India: an observational study

Background: People working in tea gardens of Tripura differ from other people in terms of ethnicity, culture, food habit, literacy etc. and limited information is available regarding infant feeding practices and its association if any, with nutritional status of under-five children of this community. Methods: This community based cross-sectional study was conducted during 1st July to 31st August 2016, using a validated interview schedule, among 170 women working in different tea estates of West Tripura district, having children aged 6 months to 2 yr, chosen by multistage sampling. Descriptive statistics and χ2 test were used to present data. P value ≤0.05 was considered statistically significant. Results: Breastfeeding initiation rate within one hr of birth was 50.59%, colostrums was fed to 82.35%, prelacteal feeding was given to 30.59%, 65.88% were exclusively breast fed and overall feeding practice was proper in 51.76% of the study children. Khichdi (34.1%) was the commonest complimentary feed and katori and spoon (64.7%) were the commonest feeding utensils. Prevalence of underweight, stunting and wasting was 9.0%, 12.9% and 7.3% respectively and these were found to be more frequent among children who received prelacteal feeding, late initiation of breastfeeding and early complimentary feeding, though statistically these were not significant. Conclusions: Overall infant feeding practice was better among educated mothers and institutional births; hence improvement in literacy and promoting institutional deliveries will further improve feeding practice in this community. Though underweight, stunting and wasting was prevalent but these had no significant association with feeding practices. Hence further studies are required to investigate the causes of malnutrition among children of this community.

Infant and Young Child Feeding (IYCF) Practices by Rural Mothers of Bangladesh

Background: Infant and young child feeding (IYCF) practices play vital role for the growth &amp; development in the early months of life. Objective: The purpose of the present study was to determine and to identify the patterns and influencing factors of feeding practices in infant and young children of 0-2 years old in Bangladesh. Methodology: A descriptive type of cross sectional study was carried out to assess the pattern of infant &amp; young child feeding practices by the rural mothers of Bangladesh with a sample size of 450 during the months of January to December of 2015.Result: Out of 450 children, 51.1% are female &amp; 48.9% are male. The proportions of infants with early initiation of breastfeeding (13.6%) and exclusive breastfeeding fewer than six months (57.3%) and infants who received complementary feeding at the age of 6–8 months (55.7%) were low. It showed that 90.4% of mothers have knowledge on exclusive breast feeding but only 57.3% of them have practiced it for 4-6 months. It further revealed that only 8.4% of mothers &amp; 13.6 % of fathers were illiterate. The main problems revealed from the study were late initiation of breastfeeding, low rates of exclusive breastfeeding, and inappropriate complementary feeding practices. It further revealed that 69.3% of the respondents had two or less children and 30.7% had three or more children.Conclusion: Majority of the respondents have the knowledge on complementary feeding, knowledge on preparation of complementary feeding, knowledge on preparation of food by grains, knowledge on preparation of food by milk and milk products and knowledge on preparation of food by meat, fish, poultry, liver.Journal of National Institute of Neurosciences Bangladesh, 2016;2(1):19-25

Nutritional status and its correlates in under five children of labour population in urban slums of Lucknow, Uttar Pradesh, India

Background: Malnutrition has a long-term effect on physical and cognitive development of a child. Addressing nutritional problems of urban poor living in slums is of paramount importance for overall development. Effective measures could be taken if we know their sociodemographic profile, burden of malnutrition and infant feeding practices.Methods: A prospective cross sectional study was conducted in under five children living in urban slums of Lucknow around Era’s Lucknow Medical College and Hospital after taking consent from the parents and approval by institute’s ethical committee. The objective of the study was to know the prevalence of malnutrition and assess the feeding practices, immunization status and morbidities in under five children of labour population in urban slums of Lucknow.Results: 250 children aged 6 months to 5 years were analysed. 34.4%were underweight, 58.8% stunted and 17.6%. Wasted 17.6% infants were exclusively breast fed till 6 months 42.0% fed colostrum. 20.0% children received proper complementary feeding. Education status of mother was significantly associated with the prevalence of underweight children. (p &lt;0.05) Late initiation of breastfeeding in 13.2% infants was significantly associated with underweight (p value &lt;0.05, OR (95% CI=1.58 (0.60-2.72) and stunting OR (95% CI=0.62 (0.29-1.29). 55.6% children were fully immunized and 16% unimmunized. Presence of Morbidities like ARI, diarrhea, worm expulsion, pallor and vitamin A deficiency was high.Conclusions: Burden of malnutrition and poor feeding practices, poor vaccination coverage makes children in this slum susceptible to illnesses. Prompt measures should be taken to address it.

Child wasting is a severe public health problem in the predominantly rural population of Ethiopia: A community based cross\u2013sectional study

BackgroundIn Ethiopia, child wasting has remained a public health problem for a decade’s, suggesting the need to further monitoring of the problem. Hence, this study aimed at assessing the prevalence of wasting and associated factors among children aged 6–59 months at Dabat District, northwest Ethiopia.MethodsA Community based cross-sectional study was undertaken from May to June, 2015, in Dabat District, northwest Ethiopia. A total of 1184 children aged under five years and their mothers/caretakers were included in the study. An interviewer-administered, pre-tested, and structured questionnaire was used to collect data. Standardized anthropometric body measurements were employed to assess the height and weight of the participants. Anthropometric body measurements were analyzed by the WHO Anthro Plus software version 1.0.4. Wasting was defined as having a weight–for–height of Z–score lower than two standard deviations (WHZ < −2 SD) compared to the WHO reference population of the same age and sex group. In the binary logistic regression, both bivariate and multivariate analyses were done to list out factors associated with wasting. All variables with P–values of < 0.2 in the bivariate analysis were earmarked for the multivariate analysis. Both Crude Odds Ratio (COR) and Adjusted Odds Ratio (AOR) at 95% Confidence Interval (CI) were computed to determine the strength of association. In the multivariate analysis, variables at P–values of < 0.05 were identified as determinants of wasting.ResultsThe overall prevalence of wasting was 18.2%; 10.3% and 7.9% of the children were moderately and severely wasted, respectively. Poor dietary diversity [AOR = 2.08, 95% CI: 1.53, 4.46], late initiation of breastfeeding [AOR = 1.43, 95% CI: 1.04, 1.95], no postnatal vitamin-A supplementation [AOR = 1.55, 95% CI: 1.04, 2.30], and maternal occupational status [AOR = 2.31, 95% CI: 1.56, 3.42] were independently associated with wasting in the study area.ConclusionWasting is a severe public health problem in Dabat District. Therefore, there is a need to strengthen the implementation of optimal breastfeeding practice and dietary diversity. In addition, improving the coverage of mothers’ postnatal vitamin-A supplementation is essential to address the burden of child wasting.

Infant and Young Child Feeding (IYCF) Practices by Rural Mothers of Bangladesh

A descriptive type of cross sectional study was carried out to assess the pattern of infant &amp; young child feeding practices by the rural mothers of Bangladesh with a sample size of 450 during the months of January, 2015 to December, 2015. Out of 450 children, 51.1% are female &amp; 48.9% are male. The proportions of infants with early initiation of breastfeeding (13.6%) and exclusive breastfeeding fewer than six months (57.3%) and infants who received complementary feeding at the age of 6-8 months (55.7%) were low. It showed that 90.4% of mothers have knowledge on exclusive breast feeding but only 57.3% of them have practiced it for 4-6 months. It further revealed that only 8.4% of mothers &amp; 13.6 % of fathers are illiterate. The main problems revealed from the study were late initiation of breastfeeding, low rates of exclusive breastfeeding and inappropriate complementary feeding practices. It further revealed that 69.3% of the respondents had two or less children and only 30.7% had three or more children.Medicine Today 2016 Vol.28(1): 1-5

Prevalence of and risk factors for delayed onset of lactation in Chinese lactating women in 2013

Objective: To study the prevalence of delayed onset of lactation (later than 3 days) in lactating women in China and to analyze its influencing factors. Methods: Data were extracted from Chinese National Nutrition and Health Surveillance-Mothers, from mothers with children under 2 years of age (in 2013). A total of 11 178 women who were lactating or had lactated were selected from 55 counties of 30 provinces (excluding the Tibet Autonomous Region) in China, using the multi-stage stratified cluster randomization sampling method. Basic information, including onset of lactation, initiation of breastfeeding, breastfeeding difficulties and breastfeeding knowledge were collected using a questionnaire investigation. The prevalence of delayed onset of lactation were analyzed by the weighted processing of complex sampling from the 6th national population census data. A multiple logistic regression was used to analyze the factors associated with delaged onset of lactation. Results: Among 11 178 lactating women, 3 388 had an onset of lactation later than 3 d. The prevalence of delayed onset of lactation was 30.3%. After complex weighting, the prevalence of delayed onset of lactation was 31.2% (95% CI: 25.7%-36.8%) for lactating women in China. Delivery by Caesarean section (OR=1.28, 95%CI: 1.06-1.53) and initiating breastfeeding ≥4 h (OR= 2.34, 95%CI: 1.76-3.11) were the negative factors for delayed onset of lactation. Compared with those living in large cities, lactating women living in medium or small cities (OR=1.39, 95%CI: 1.05-1.84) had a higher risk of delayed onset of lactation. Compared with the lactating women doing housework, the risk of delayed onset of lactation was lower (P<0.05) among those whose occupations were as leaders of Enterprises/Institutions (OR=0.68, 95%CI: 0.47-0.99), in catering and service trades (OR=0.61, 95%CI: 0.43-0.86), in agriculture/forestry/fishery/herdsmen fields (OR=0.65, 95%CI: 0.44-0.96) and who were unemployed (OR= 0.64, 95%CI: 0.46-0.90). Breastfeeding education during pregnancy might lower the risk of delayed onset of lactation (OR=0.78, 95% CI: 0.62-0.98). Conclusion: The prevalence of delayed onset of lactation was relatively high for Chinese lactating mothers. Caesarean section and late initiation of breastfeeding were the primary risk factors. Lactating mothers living in medium or small cities and those doing housework appear to be high-priority groups for intervention. Based on our findings, breastfeeding education during pregnancy is recommended to lower the risk of delayed onset of lactation.

Maternal and birth risk factors for children screening positive for autism spectrum disorders on M-CHAT-R.

This study was carried out to screen children aged 16-30 months, attending pediatric outpatient department of JIPMER, Puducherry, during June to August 2014, for ASD using modified checklist for autism in toddlers-revised (MCHAT-R) and to find association between maternal, birth and postnatal risk factors with risk of ASD. A total of 350 mother-child pairs with children aged between 16 and 30 months were recruited. M-CHAT-R was administered to all mothers to screen for ASD along with risk checklist. Based on screen result children were classified as ASD (high risk) and no ASD (low and medium risk) group. The association between risk factors and screen positivity for ASD was studied using odds ratio. According to our study, 33 (9.4%) screened positive for ASD. Mean age was 21 months. High mean paternal age at birth (P value 0.025), need for resuscitation at birth (OR 3.4, 95% CI 1.47-8.10), NICU stay >12h (OR 4.7, 95% CI 2.26-9.94), late initiation of breastfeeding (OR 3.9, 95% CI 1.83-8.39), neonatal seizures (OR 11.8, 95% CI 5.38-26.25) were associated with screen positivity for ASD. After adjusting for confounding, neonatal seizures, and maternal concern about child development were associated with increased odds of screening positive for ASD whereas exclusive breast feeding in the first 6 months of life is associated with decreased odds. Screening for ASD in children with above risk factors might help in early initiation of remedial interventions.

Determinants of suboptimal breastfeeding practice in Debre Berhan town, Ethiopia: a cross sectional study.

BackgroundOptimal breastfeeding is inextricably linked to the achievement of Millennium Development Goals (MDGs) of eradicating extreme poverty and hunger, reducing child mortality and improving maternal health. Breastfeeding is safe, promotes sensory and cognitive development and contains antibodies that protect infants from common childhood illnesses. The objective of this study was to assess suboptimal breastfeeding and its determinants factors among mothers who have children below 23 months old in Debre Berhan, Ethiopia.MethodsA community based cross sectional study was conducted from 1 March 2015 until 30 March 2015. Five hundred forty eight mothers were included in the study using a two stage sampling technique. The data was collected by trained data collectors through pretested semi structured questionnaire. The collected data were cleaned, coded, entered and then analyzed using SPSS version 20 windows program. Descriptive statistics, binary and multivariable regression analysis with 95 % confidence interval was carried out and p value less than 0.05 used to determine the significant association. Late initiation of breastfeeding was defined as initiation of breastfeeding after one hour of delivery while early cessation of breastfeeding was to stop breastfeeding before 24 months of age. According to World Health Organization exclusive breastfeeding was defined as the practice of feeding breast milk only, including expressed breast milk, to infants and excluding water, other liquids, breast milk substitutes, and solid foods. Vitamin drops, minerals, oral rehydrating solution (ORS) and medicines may be given.ResultsThe prevalence of late initiation of breastfeeding, not exclusively breastfeeding and early cessation of breastfeeding were 17.5 % (95 % Confidence Interval [CI] 15.2 %, 19.4), 49.8 % (95 % CI 46.3, 50.5) and 12.8 % (95 % CI 11.7, 14.1) respectively. Birth at home was significantly associated with late initiation of breastfeeding (Adjusted Odds Ratio [AOR] 3.0; 95 % CI 1.5, 6.0). No advice during antenatal care was a predictor of not exclusively breastfeeding (AOR1.7; 95 % CI 1.2, 2.5). Being illiterate (AOR 3.2; 95 % CI 1.2, 8.3) and no advice during antenatal care about breastfeeding (AOR 1.9; 95 % CI 1.0. 3.4) were significantly associated with early cessation of breastfeeding.ConclusionEducational status, age, antenatal and postnatal follow up, resident and place of delivery were predictors of suboptimal breastfeeding. Integrated and targeted interventions were recommended to achieve a better outcome in minimizing the late initiation, non-exclusive and early cessation of breastfeeding.

Individual and community-level factors associated with introduction of prelacteal feeding in Ethiopia.

BackgroundEthiopia is a country with low optimal breast feeding practice, and prelacteal feeding is still a norm. Introduction of prelacteal feeding is a known barrier for optimal breast feeding practices. However, knowledge on determinants of introduction of prelacteal feeding is minimal. This study aimed to identify the effects of individual and community-level factors in the introduction of prelacteal feeding in Ethiopia.MethodsData for this study was extracted from the nationally representative 2011 Ethiopia Demographic and Health Survey (EDHS) and focused on a sample from child data, with a sample from 576 clusters of 7692 children who were last-born in the past five years preceding the survey. The data was collected using two-stage cluster design, in which enumeration areas forming the first stage and households making the second stage. A two-level mixed effect multivariable logistic regression model was fitted to determine the individual and community-level factors associated with introduction of prelacteal feeding.ResultsFrom the total sample of children 28.92 % were fed prelacteals. Butter (n = 1143), plain water (n = 395) and milk-other than breast milk (n = 323) were commonly used prelacteals. In multivariable two-level mixed effect model; caesarean mode of delivery (Adjusted odds ratio (AOR) = 1.87; 95 % CI 1.28, 2.73), and late initiation of breastfeeding (AOR = 5.32; 95 % CI 4.65, 6.09) were both positively associated with the odds of giving prelacteals. Higher economic status 28 % (AOR = 0.72; 95 % CI 0.54, 0.98), giving birth at hand of non-health personnel birth assistance (AOR = 0.68; 95 % CI 0.54, 0.87), large birth size of child (AOR = 0.80; 95 % CI 0.68, 0.95) and high community antenatal care use (AOR = 0.58; 95 % CI 0.38, 0.87) were negatively associated with the odds of giving prelacteals. Significant variation in prelacteal feeding practice was also seen among ethnic and religious groups, and across regions.ConclusionsThe prevalence of prelacteal feeding was high that remained a challenge for optimal breastfeeding in Ethiopia. Not only individual-level factors, but also community-level factors contribute to prelacteal feeding practice. Increasing access to health education through increasing maternal health care service coverage and community involvement is crucial.

Early initiation of breast feeding in baby friendly hospital initiative set up - how feasible is it?

Background: The baby friendly hospital initiative (BFHI) was started in India in 1993. Under this, the hospital with maternity services, have to follow the ten steps to successful breastfeeding. The World Health Organization also recommends early initiation of breastfeeding. IMNCI strategy recommended systematic assessment of breastfeeding and emphasized counseling of mothers. Breast feeding in India is universal, but the initiation of breast feeding is late. Objectives: To assess the pattern of breast feeding in a baby friendly hospital initiative setup. Methods: A cross sectional study was conducted among 209 post-partum women of aged 18-35 years delivered in Obstetrics and Gynaecology Department, Guwahati Medical College. Analysis of collected data was done using software Epi Info 7, Chi-square test and percentages. Results: It was observed that only 5.26% women initiated breast feeding within one hour, of which majority 3.38% were illiterate (p<0.05). Late initiation of breast feeding was high amongst mothers (42.1%) kept too long under observation. Most of the Primiparous (55.98%) knew about the advantage of early and exclusive breast feeding than Multiparus (24.88%), which was statistically significant (p<0.05). 80.86% women had received antenatal counseling on breastfeeding but only 58.85% knew that exclusive breastfeeding should be continued for 6 months. Conclusions: Awareness on early initiation of breastfeeding was low despite most of the women received antenatal counseling on breastfeeding. Single strategies, such as providing breastfeeding support or written materials to women or educating health professionals, are unlikely to increase breast feeding initiation as stand-alone measures.

Factors associated with late initiation of breastfeeding in the Brazilian Unified National Health System in the city of Rio de Janeiro, Brazil, 2009

This study aimed to analyze factors associated with delayed initiation of breastfeeding (lack of breastfeeding in the first hour of life). This was a cross-sectional study conducted in 2009 with 673 postpartum women at hospitals belonging to the Brazilian Unified National Health System (SUS) in the city of Rio de Janeiro, Brazil. Statistical analysis used multilevel logistic regression, with two levels (individual and hospital). Prevalence of delayed initiation of breastfeeding was 49.2%. Delivery in a Baby-Friendly Hospital (BFH) had a protective effect against late initiation of breastfeeding (OR = 0.17; 95%CI: 0.05-0.55), while cesarean section (OR = 5.95; 95%CI: 3.88-9.12) and ignorance of HIV status until delivery (OR = 2.16; 95%CI: 1.04-4.50) increased the odds of delay. Reduction in cesarean rates, adherence to protocols to prevent vertical HIV transmission, and expanded accreditation of hospitals in the BFH are important strategies to promote breastfeeding in the first hour of life.