Timely Initiation Of Breastfeeding Research Articles

Kangaroo Mother Care Induced Serum Oxytocin Facilitates Prolactin and IL-10 Among Emergency Cesarean Mothers.

The rate of cesarean section is increasing from 15% to 40% in recent years. The type of delivery influences the hormonal, emotional and mental health of the mother, which correlates positively or negatively with the health benefits of the newborn. There have been many published studies on kangaroo mother care for mothers undergoing elective cesarean section, but there is still a lack of understanding about emergency cesarean section. This study aimed to evaluate the benefits of KMC practice for mothers undergoing emergency cesarean section in terms of hormone levels such as oxytocin, cortisol, prolactin, interleukin-6 and interleukin-10. This retrospective analysis used remnant serum (KMC group = 16; control group = 9), and clinical data such as KMC practice (15-30 minutes three or four times daily until discharge), breastfeeding initiation time, feeding time, crying time and hospital stay were extracted from the electronic database. All hormone and cytokine expressions were quantitatively determined by ELISA. Comparisons within and between groups were performed using appropriate statistical tests. In the KMC group, increased levels of the hormone oxytocin significantly reduced cortisol and IL-6 and negatively influenced prolactin and IL-10 levels. The elevated prolactin facilitates overall lactation behaviour, of which 64% reported breastfeeding directly at the breast. The cytokine analysis revealed a reduction in pro-inflammatory cytokines and thereby an improved wound healing was seen in the KMC group. These quantitative results strongly encourage the use of KMC for mothers undergoing emergency cesarean section. These simple yet effective breastfeeding strategies promote maternal and infant health, which can reduce medication use.

Early initiation of complementary feeding practice and its associated factors among children aged 6 to 24 months in Northeast Ethiopia

BackgroundEven if there is currently no research on food integration practices, there is an unreliable hole in the data for the first motives, especially 6 to 24 months, research at ages varies in different ways, always, but the child’s development affects an important part of both the child and the parents. This gap limits our comprehensive knowledge of strategic choices and—their potential impact on children’s overall health and well-being. Therefore, the aim of this study was factors shaping complementary feeding for 6 to 24-Month-Olds in Northeast Ethiopia.MethodsA community-based survey was conducted in northeastern Ethiopia from June to July 2022. A sample of 409 mothers with infants aged 6 to 24 months was selected using a simple random sampling method. A structured questionnaire was adopted and data were collected by an interviewer. Collected data were entered into Epi Data version 4.6 and subsequently converted to SPSS version 21 for further analysis. Variables with a P-value < = 0.25 in the bivariate analysis were included in the multivariable logistic regression model. Multivariable logistic regression analyses aimed at identifying independent associations between early initiation of supplement feeding and determinants-adjusted odds ratios with corresponding 95% confidence intervals were calculated to determine the strength of associations. P-values less than or equal to 0.05 were considered statistically significant.ResultsA total of 409 mothers with their children were included in the analysis, revealing a prevalence of 38.1% for early initiation of complementary feeding among children aged 6–24 months. Factors associated with -early initiation included place of residence (Adjusted Odds Ratio (AOR) 3.63, 95% Confidence Interval (CI) 1.1–11.95), husband’s educational status (AOR 16.83, 95% CI 1.98–24.8), maternal occupation (AOR 21.2, 95% CI 1.11–46.9), number of antenatal care (ANC) visits (AOR 25.94, 95% CI 22.7–85.67), initial breastfeeding time (AOR 4.98, 95% CI 1.22–14.9), and medical illness (AOR 2.81, 95% CI 1.12–3.6.ConclusionSignificant associations with Complementary Feeding were identified with the number of antenatal care (ANC) visits, postnatal care (PNC) check-ups, current residency, breastfeeding initiation time, maternal medical illness, and occupational status. To mitigate the early initiation of complementary feeding, it is recommended to enhance ANC/PNC services and educate mothers about the precise timing for introducing complementary foods to their infants.

Predictors of late initiation of breastfeeding practice in Ethiopia: a multilevel mixed-effects analysis of recent evidence from EDHS 2019

ObjectivesTo identify the predictors of late initiation of breastfeeding practice in Ethiopia.DesignCross-sectional study design.SettingEthiopia.ParticipantsA total of 1982 weighted samples of mothers with children aged under 24 months were included.Outcome measureLate...

Breastfeeding and Neonatal Age Influence Neutrophil-Driven Ontogeny of Blood Cell Populations in the First Week of Human Life.

The first few days of life are characterized by rapid external and internal changes that require substantial immune system adaptations. Despite growing evidence of the impact of this period on lifelong immune health, this period remains largely uncharted. To identify factors that may impact the trajectory of immune development, we conducted stringently standardized, high-throughput phenotyping of peripheral white blood cell (WBC) populations from 796 newborns across two distinct cohorts (The Gambia, West Africa; Papua New Guinea, Melanesia) in the framework of a Human Immunology Project Consortium (HIPC) study. Samples were collected twice from each newborn during the first week of life, first at Day of Life 0 (at birth) and then subsequently at Day of Life 1, 3, or 7 depending on the randomization group the newborn belongs to. The subsequent analysis was conducted at an unprecedented level of detail using flow cytometry and an unbiased automated gating algorithm. The results showed that WBC composition in peripheral blood changes along patterns highly conserved across populations and environments. Changes across days of life were most pronounced in the innate myeloid compartment. Breastfeeding, and at a smaller scale neonatal vaccination, were associated with changes in peripheral blood neutrophil and monocyte cell counts. Our results suggest a common trajectory of immune development in newborns and possible association with timing of breastfeeding initiation, which may contribute to immune-mediated protection from infection in early life. These data begin to outline a specific window of opportunity for interventions that could deliberately direct WBC composition, and with that, immune trajectory and thus ontogeny in early life. This trial is registered with NCT03246230.

Factors Associated with Timely Initiation of Breast Feeding among Mothers Attending Maternal and Child Health Clinic at Government Institutions of Biratnagar

Background: Timely initiation of breastfeeding (TIBF) means giving breast milk to newborn within the first hour after birth, as recommended by WHO. This is an important part of good breast feeding practices that helps to reduce infant illness and death. So, this study is conducted to identify the factors associated with TIBF among mothers having child of 9-15 months attending at government health institutions.&#x0D; Methods: A cross-sectional research design was used among purposively selected 206 mothers having children 9-15 months who were attending the Maternal and Child Health (MCH) clinics at Koshi Hospital and Family Planning Association of Nepal in Morang district. Data was collected through interview using a self-developed structured questionnaire. Data was analyzed using descriptive statistics, additionally factors affecting TIBF were analyzed by bivariate and multivariate logistic regression analysis.&#x0D; Findings: The findings reveal that among 206 mothers, less than half (49%) had initiated breast feeding within one hour of birth and more than half (56.8%) had done exclusive breastfeeding to their baby till 6 months. Mothers belonging to madhesi ethnicity (OR= 2.394, 95% CI=1.219-4.700, p- 0.011), mothers having normal delivery (OR= .461, 95% CI= 0.250- 0.851, p-0.013), multiparous (OR=1.965, 95%, CI= 1.099- 3.514, p- 0.023), lower middle economic class (OR=1.848, 95%CI=1.009-3.382, p- 0.047) were more likely TIBF than others. TIBF is significantly associated with exclusive breastfeeding (p=0.007).&#x0D; Conclusion: The study concludes that ethnicity, mode of delivery, parity and socio-economic status are the factors associated with TIBF. Furthermore, TIBF is connected with practice of exclusively breast feeding.

Comparison of different cesarean delivery techniques: A systematic review and meta-analysis

&lt;b&gt;Background: &lt;/b&gt;The purpose of this systematic review and meta-analysis study was to compare various caesarean delivery methods.&lt;br /&gt; &lt;b&gt;Methods: &lt;/b&gt;A search for available articles published since January 2023 was accomplished in PubMed, Medline, Embase, and Cochrane literature databases. The search method that encompassed all pertinent publications was developed using terms from the medical subject headings thesaurus and keywords from related literature. We also used the PICO method (where P is population, I is intervention, C is comparator/control, and O is outcome for our study) to establish research question. Whereas Cochrane handbook of “systematic reviews of interventions” was used for risk of bias assessment.&lt;br /&gt; &lt;b&gt;Results: &lt;/b&gt;The results showed a significant difference in patient gratification between the gentle/natural/skin-to-skin contact caesarean and the traditional/conventional/standard caesarean. In assessing the satisfaction with delivery mode, the mean variance for these studies similarly revealed a significant difference between the natural caesarean and the conventional one. A skin-to-skin contact caesarean delivery takes less time to start nursing than a conventional delivery, according to the results of the study on the time of breastfeeding initiation after a natural caesarean. There was a low-risk bias among the selected studies.&lt;br /&gt; &lt;b&gt;Conclusions: &lt;/b&gt;As a result of greater satisfaction with delivering experience the natural caesarean delivery was most preferred method. The enhanced skin-to-skin contact and breastfeeding suggested that natural caesarean is beneficial over the conventional method.

Assessing universal maternal health service coverage and their determinants in India: A multicentric cross-sectional study.

Universal maternal health coverage (UHC) envisages access to quality healthcare services by pregnant and lactating women without any financial hardship. Our present study attempts to assess the UHC for maternal health services and their determinants, including access to quality antenatal care (ANC), quality postnatal care (PNC), and child immunization among the marginalized populations of India. It was a community-based cross-sectional study across five states of India among pregnant or lactating women. Quality ANC score was calculated using four indicators, including ANC registration month, attendance of four or more ANC visits, receiving at least one tetanus toxoid injection, and consumption of 100 iron-folic acid (IFA) tablets. Similarly, quality PNC care score was calculated using four indicators, including PNC within 48 h, breastfeeding initiation time, institutional delivery, and accessing conditional maternity benefit scheme. Logistic or generalized linear regression was used to depict associations depending on the outcome variables. A total of 12,976 pregnant women's and 18,061 lactating mothers' data were analyzed. Illiterate women, women from below the poverty line, and rural areas had low-quality ANC and PNC scores compared with their counterparts. Marginalized women had lower odds of immunization of children and lower quality PNC scores than nonmarginalized. Sociodemographic factors, such as caste, education of women, area of residence, and economic status, are major determinants of quality ANC and PNC scores and immunization of children. Hence, interventionists ought to design community-based interventions that address the challenges in the uptake of health services.

The Effect of breastfeeding training on TIB in a Baby-Friendly Hospital in Turkey

Purpose: Although it is known that timely initiation of breastfeeding (TIB) has beneficial effects on newborn and maternal health as well as increasing exclusive breastfeeding for first 6 months, global and regional desired TIB rates have not been reached yet. This study aimed to evaluate the effect of the “Neonatal Baby Service” (NBS) on TIB.&#x0D; Material and Methods: The descriptive and cross-sectional study was carried out at NBS and obstetrics and gynecology service (OGS) of Aksaray University Training and Research Hospital in Turkey between September 01 and December 31, 2021. A total of 486 newborns who were born between 32-40 weeks, weighed over 2000 g and were not separated from their mothers during the first 2 hours were included in the study&#x0D; Results: The overall rate of TIB was in the study was 80.5% (n=391). TIB rate were found to be significant as 83.1% (n=296) in the NBS, and 73.1% (n=95) in the OGS (p=0.013). When breastfeeding problem were analysed, it was found to be 46.9% in OGS and 28.9% in the NBS (p

Factors associated with breastfeeding initiation time in a Baby-Friendly Hospital

International health authorities recommend skin-to-skin care (SSC) at birth and that breastfeeding should be started as soon as possible, within the first hour after birth. This article aimed to review the benefits of breastfeeding initiation for mothers and newborns, the global status of breastfeeding initiation, the determinants of breastfe- eding initiation and SSC, and interventions to improve breastfeeding initiation. The positive effects of breastfeeding initiation result from the contact between the baby and the mother and the components found in breast milk. Several factors related to the family, mother, child, and health institution affect the time of initiation of breastfeeding. It should be ensured that pregnant women have access to accurate and effective information about the benefits of breastfeeding initiation in healthcare facilities, communities, and different settings, including the media. Taking advantage of opportunities to counsel and support the mother in prenatal care and childbirth, and improving the rate of breastfeeding initiation can be achieved by implementing infant and young child feeding policies and programs with the Baby-Friendly Hospital Initiative.

Breastfeeding Practices (Initiation, Exclusivity, Duration) During the First Six Months of an Infant’s Life among Caesarean Mothers in Selangor

Introduction: During the first six months of an infant’s life, breastfeeding practices are essential for an infant’s growth as recommended by the World Health Organisation (WHO). Breastfeeding also helps to strengthen the bond between mother and child. In accordance with this, infants can obtain optimal nutrition through initiation, exclusivity, and optimal duration of breastfeeding practices. However, it is shown that a mother who undergoes caesarean delivery has higher chances to experience difficulties in breastfeeding than vaginal delivery mothers. Therefore, this study is aimed to determine the prevalence of breastfeeding practices among caesarean mothers during the first six months after delivery. Methods: This cross-sectional study was conducted in chosen government Health Clinics in Selangor from July to December 2021. A total of 424 mothers were recruited, and data on socio-demographic and breastfeeding practices were obtained. Results: In the first six months after birth, 50.9% of caesarean mothers exclusively breastfed their infants, and the prevalence of breastfeeding practices was 37%. Approximately 55.9% of mothers initiated breastfeeding between one and 24 hours, while 31.1% and 13.0% initiated breastfeeding within one hour and after 24 hours, respectively. Breastfeeding initiation is found to have a significant effect on the duration of breastfeeding (χ2(4)=9.751,p-value=.045) while, breastfeeding exclusivity is found significantly dependent on the time of breastfeeding initiation and duration, (χ2(4)=11.88, p-value&lt;.05). Conclusion: From these findings, breastfeeding exclusivity is influenced by early initiation and predicts a longer duration of breastfeeding. Therefore, breastfeeding support during early postpartum from family members and healthcare providers are important in predicting positive breastfeeding outcomes.

Delayed secretory activation and low milk production in women with gestational diabetes: a case series

BackgroundGestational diabetes mellitus (GDM) is major pregnancy complication that is associated with short- and long-term consequences for both mother and infant, including increased risk of diabetes later in life. A longer breastfeeding duration has been associated with a reduced risk of diabetes, however, women with GDM are less likely to exclusively breastfeed and have shorter breastfeeding duration. While the timing of breastfeeding initiation and milk removal frequency affects subsequent breastfeeding outcomes, little is known about early infant feeding practices and milk production in women with GDM. This case series offers detailed prospective breastfeeding initiation data, as well as the first report of objective measures of milk production in women with GDM.Case presentationIn this case series, we present the early infant feeding practices of eight women with GDM that gave birth at term gestation. Women recorded the timing of initiation of breastfeeding and secretory activation, as well as their breastfeeding, expression and formula feeding frequencies on postpartum days 1, 7 and 21. Measurement of 24 h milk production volume was performed at 3 weeks postpartum using the test weight method. We observed a delayed first breastfeed (> 1 h) in 6 (75%) cases, formula use in hospital in 5 (63%) cases and delayed secretory activation in 3 (38%) cases. At 3 weeks postpartum, 2 cases had measured milk productions that were insufficient to sustain adequate infant weight gain.ConclusionsOur data suggest that despite early and frequent milk removal, women with GDM are at greater risk of delayed secretory activation and low milk supply. Cohort studies that consider co-morbidities such as obesity are needed to determine the lactation outcomes of women with GDM.

Pooled prevalence and associated factors of diarrhea among under-five years children in East Africa: A multilevel logistic regression analysis.

Worldwide, diarrhea is the second most common cause of death and morbidity among under -five years' children. In sub-saran Africa, access to water, sanitation, and hygiene are very scanty and the burden of diarrhea diseases is countless relative to the rest of the world. Prior studies conducted in East Africa vary in design, sample size, and other data collection tools. Through those studies, it is hard to make regional comparisons. Combining datasets that are studied on similar people and having common variable identified enhances statistical power due to the large sample size, advance the ability to compare outcomes, and create the opportunity to develop new indicators. Hence, this study aimed to assess the prevalence and associated factors of diarrhea among under five years' children using the most recent national representative Demographic and Health Surveys from 12 East African countries. The information generated from this pooled datasets will give good insight into the sub-regional prevalence of diarrhea. This study utilized secondary data from 12 East African countries' most recent demographic health survey. Variables were extracted and appended together to assess the pooled prevalence of diarrhea and associated factors. A total of 90,263 under-five years of age children were encompassed in this study. STATA version was used to cross-tabulate and fit the models. To account for the hierarchical nature of the demographic health survey, multilevel logistic regression was calibrated. BIC, AIC, deviance, and LLR were used as Model comparison parameters. Variables with a p-value of <0.2 were considered for multivariable analysis. Adjusted odds ratio with 95% CI and p-value <0.05 were used to declare statistical significances of factors. The pooled prevalence of diarrhea in under five years children was 14.28% [95%CI; 14.06%, 14.51%]. Being child whose mother age is 15-24 years [AOR = 1.41, 95% CI; 1.33, 1.49], 25-34 years[AOR = 1.17, 95%CI; 1.10, 1.23], being 7-12 months child [AOR = 3.10, 95%CI; 2.86, 3.35], being 12-24 months child [AOR = 2.56, 95%CI; 2.38, 3.75], being 25-59 months child [AOR = 0.88, 95%CI; 0.82, 0.95], being child from poor household [AOR = 1.16, 95%CI; 1.09, 1.23], delayed breast feeding initiation (initiated after an hour of birth) [AOR = 1.15, 95%CI; 1.10, 1.20], and being a child from community with low educational status [AOR = 1.10, 95%CI; 1.03, 1.18] were factors associated with diarrheal diseases. The pooled prevalence of diarrhea among under five years of children in East African countries is high. Maternal age, child's age, wealth status of the household, the timing of breast feeding initiation, sex of the child, community level of educational status, working status of the mother, and the number of under five children were factors that were associated with diarrheal diseases. Scaling up of maternal and child health services by government and other concerned bodies should consider those economically marginalized communities. Additionally, awareness should be created for those uneducated mothers concerning the nature of childhood diarrhea.

&gt;Early initiation of breastfeeding: Antenatal, peripartum, and neonatal correlates

Introduction: The World Health Organization recommends early initiation of breastfeeding (EIBF). This is because breastfeeding is important for the child's development and has maternal benefits. Current literature has focused on sociodemographic factors, and the evidence supporting antenatal, peripartum, and neonatal variables is limited and contradicting. The main aim of this study is to report the rates of early breastfeeding initiation and their antenatal, peripartum, and neonatal correlates. Materials and Methods: A prospective observational study of pregnant women who attended the labor ward of the Specialty Hospital in Amman, Jordan between September 1, 2019, and June 1, 2020, was conducted. Inclusion criteria required women to be 18 years of age or more. Demographic, antenatal, peripartum, and neonatal data were collected. The timing of breastfeeding initiation was recorded in the 1st h and between 1 and 24 h and then data were analyzed. Results: A total of 300 women were recruited with mean age of 29.5 years and mean gestational age being 38.6 weeks. In addition, breastfeeding initiation rates were 26.3% and 65.5% within the 1st h and between 1 and 24 h, respectively. Antenatal, peripartum, and neonatal variables that were associated with lower rates of EIBF (P < 0.05) include antenatal obstetrics complications, induction of labor, assisted vaginal delivery, caesarean section (CS), CS performed on maternal request, CS under general anesthesia, surgical site pain, mother's perception of inadequate pain management, preterm delivery, low Apgar scores, low birth weight, neonatal intensive care unit admission, and less frequent rooming-in. Conclusion: Rates of breastfeeding initiation within the first hour and between 1 and 24 h of delivery were 26.3% and 65.5%, respectively. Compared to antenatal variables, the peripartum and neonatal variables are more likely to have significant effects on EIBF. Therefore, more obstetric attention should focus on these factors to improve rates of initiating breastfeeding early.

Predictors for timely initiation of breastfeeding after birth in the hospitals of Nepal- a prospective observational study

BackgroundTimely initiation of breastfeeding can reduce neonatal morbidities and mortality. We aimed to study predictors for timely initiation of breastfeeding (within 1 h of birth) among neonates born in hospitals of Nepal.MethodA prospective observational study was conducted in four public hospitals between July and October 2018. All women admitted in the hospital for childbirth and who consented were included in the study. An independent researchers observed whether the neonates were placed in skin-to-skin contact, delay cord clamping and timely initiation of breastfeeding. Sociodemographic variables, obstetric and neonate information were extracted from the maternity register. We analysed predictors for timely initiation of breastfeeding with Pearson chi-square test and multivariate logistic regression.ResultsAmong the 6488 woman-infant pair observed, breastfeeding was timely initiated in 49.5% neonates. The timely initiation of breastfeeding was found to be higher among neonates who were placed skin-to-skin contact (34.9% vs 19.9%, p - value < 0.001). The timely initiation of breastfeeding was higher if the cord clamping was delayed than early cord clamped neonates (44.5% vs 35.3%, p - value < 0.001). In multivariate analysis, a mother with no obstetric complication during admission had 57% higher odds of timely initiation of breastfeeding (aOR 1.57; 95% CI 1.33, 1.86). Multiparity was associated with less timely initiation of breastfeeding (aOR 1.56; 95% CI 1.35, 1.82). Similarly, there was more common practice of timely initiation of breastfeeding among low birthweight neonates (aOR 1.46; 95% CI 1.21, 1.76). Neonates who were placed skin-to-skin contact with mother had more than two-fold higher odds of timely breastfeeding (aOR 2.52; 95% CI 2.19, 2.89). Likewise, neonates who had their cord intact for 3 min had 37% higher odds of timely breastfeeding (aOR 1.37; 95% CI 1.21, 1.55).ConclusionsThe rate of timely initiation of breastfeeding practice is low in the health facilities of Nepal. Multiparity, no obstetric complication at admission, neonates placed in skin-to-skin contact and delay cord clamping were strong predictors for timely initiation of breastfeeding. Quality improvement intervention can improve skin-to-skin contact, delayed cord clamping and timely initiation of breastfeeding.

Breastfeeding in Turkey: A Systematic Review

Objective: This study was carried out to systematically review the studies conducted on breastfeeding in Turkey and to provide information on&#x0D; the breastfeeding status.&#x0D; Methods: This study is a systematic review and conducted by examining 47 studies carried out in Turkey between January 2008-December 2018 and published in national and international journals. The methodological quality of the studies was examined according to the evaluation criteria of the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was used while reporting the review.&#x0D; Results: According to the obtained study results, it was determined that the time of breastfeeding initiation and the mean duration of breastfeeding were in quite a wide range. Among breastfeeding-related factors, maternal age, education, employment status, the number of living children, the type of birth, preterm birth, receiving professional support on breastfeeding, early postnatal breastfeeding, and giving complementary feeding or formula were frequently listed. The most common reason for starting complementary feeding or was determined to be the idea that breast milk was insufficient.&#x0D; Conclusion: No common language and unity of definition were observed in the studies reviewed. The studies were conducted in different samples. It is thought that the systematization of studies on breastfeeding will be scientifically useful for determining the current situation, determining the scope of future studies, and making the necessary arrangements.

Maternal and child factors associated with timely initiation of breastfeeding in sub-Saharan Africa

BackgroundThe probability of not breastfeeding within the first hour after delivery (timely initiation of breastfeeding) is particularly pronounced in sub-Saharan Africa. In this study, we examined the maternal and child factors associated with timely initiation of breastfeeding in sub-Saharan Africa.MethodsWe pooled data from 29 sub-Saharan African countries’ Demographic and Health Surveys conducted from 2010 to 2018. A total of 60,038 childbearing women were included. Frequencies, percentages, and binary logistic regression analyses were carried out. Binary logistic regression was used to examine the maternal and child factors associated with timely initiation of breastfeeding and the results were presented as adjusted odds ratios (aOR) at 95% confidence interval (CI). ResultsWe found a prevalence of 55.81% of timely initiation of breastfeeding in the sub-region. The country with the highest prevalence of timely initiation of breastfeeding was Burundi (86.19%), whereas Guinea had the lowest prevalence (15.17%). The likelihood of timely initiation of breastfeeding was lower among married women, compared to never married women (aOR 0.91; 95% CI 0.85, 0.98); working women compared to non-working women (aOR 0.90; 95% CI 0.87, 0.93); women who watched television at least once a week, compared to those who never watched television (aOR 0.74; 95% CI 0.70, 0.78); women who delivered through caesarean section, compared to vaginal birth (aOR 0.30; 95% CI 0.27, 0.32); and those with multiple births, compared to those with single births (aOR 0.67; 95% CI 0.59, 0.76). Women who lived in Central Africa were less likely to initiate breastfeeding timely compared to those who lived in West Africa (aOR 0.80; 95% CI 0.75, 0.84).ConclusionsThe findings call for the need for a behavioural change communication programmes, targeted at timely initiation of breastfeeding, to reverse and close the timely initiation of breastfeeding gaps stratified by the maternal and child factors. Prioritising policies to enhance timely initiation of breastfeeding is needed, particularly among Cental African countries where timely initiation of breastfeeding remains a challenge. Sufficient supportive care, especially for mothers with multiple births and those who undergo caesarean section, is needed to resolve timely initiation of breastfeeding inequalities.

Impact of cesarean section on timely initiation of breastfeeding in Ethiopia: a systematic review and meta-analysis

BackgroundTimely initiation of breastfeeding is feeding of breast milk within one hour of birth, however, three in five babies were not breastfed in the first hour of birth globally. There is evidence that cesarean section is the major constraint for this low prevalence, but the impact of cesarean section on timely initiation of breastfeeding in Ethiopia is limited. Therefore, this meta-analysis aimed to provide evidence for policy makers, health professionals and program implementers.MethodsThis systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. Electronic bibliographic databases such as PubMed/Medline, EMBASE, PsycINFO, CINHAL, Scopus, Google Scholar, Science Direct and Cochrane Library were used to search relevant studies and was conducted up to February 2021. Random effects model meta-analysis was applied to estimate the pooled impact of cesarean section on timely initiation of breastfeeding with 95% confidence intervals (CI). I2 statistical test and, funnel plot and Egger’s test were used to check heterogeneity and publication bias across included studies respectively.ResultsAccording to meta-analysis of 17 studies, the pooled estimate of timely initiation of breastfeeding among women who had cesarean section in Ethiopia was 40.1% (95% CI 33.29, 46.92). The meta-analysis of 29,919 study participants showed that cesarean section was associated with a 79% lower odds of timely initiation of breastfeeding compared with vaginal birth (OR 0.21; 95% CI 0.16, 0.28).ConclusionsIn Ethiopia, almost only one-third of mothers who gave birth by cesarean section initiate breastfeeding within one hour of birth, much lower than the pooled prevalence among general population. Special health promotion, intervention and healthcare provider support during immediate or early skin to skin contact, and having focused breastfeeding guidelines for post-operative patient and trained health professionals should be considered for mothers who give birth through cesarean section.

Knowledge and Practice about Pre-lacteal Feeding and Weaning of Mother’s in a Slum Area in Rajshahi, Bangladesh

Background: A pre-lacteal feed is any food other than mother's milk provided to a new-born before breastfeeding begins. It has an effect on the timing of breastfeeding initiation and exclusive breastfeeding activities. Pre-lacteal feeding decreases the immunological benefits derived from colostrum while also increasing the risk of infection. Pre-lacteal feeding is a dangerous infant feeding technique that is commonly used in the developing world, including Bangladesh. The present study might help us to become well aware of the correct weaning practices by the rural mothers, their beliefs and their customs and thus may guide us regarding the ways to improve the nutritional status of the rural children as well as to improve the knowledge and practice regarding pre-lacteal feeding and weaning of the mothers. Materials and Methods: This was a cross-sectional type of descriptive study carried out with a view to assess knowledge and practice about pre-lacteal feeding and weaning of the mothers living in slums areas in Rajshahi, Bangladesh, duration was 8 months from May, 2014 to December, 2014. All the mothers living in slum areas in Rajshahi constituted the study population, sample size was 350 and purposive sampling technique was followed. A partially structured questionnaire duly pre-tested was used to collect data by face to face interview. Results: In this study most (57.7%) of the respondent had two children, (48.6%) mentioned honey as pre-lacteal food, (47.5%) of the respondents told that pre-lacteal feeding was given due to tradition and (49.7%) considered malnutrition as the effect of not giving colostrum’s. Regarding time of weaning, (55.7%) of the respondents mentioned that the babies should be weaned at the time of more than 6 months, hotchpotch (khichuri) was considered as common weaning food consisting of (40.0%). About 49.0% of the respondents considered malnutrition as the effect of improper weaning, most (67.6%) of the respondents considered honey as pre lacteal food and hotchpotch (37.8%) was regarded as the common type of weaning food, most (73.71%) of the respondents knew about pre-lacteal food, weaning was known to almost all (99.14%) of the respondents, pre-lacteal food was given to the baby by majority (73.14%) of the respondents and almost all (99.71%) of the respondents weaned their babies. There was relationship between occupation of the respondent's husband and giving pre-lacteal food to their babies (p &lt; 0.05). Conclusion: Pre-lacteal feeding was found to be more prevalent in slums in Rajshahi. Pre-lacteal feeding activity was closely linked to lower levels of schooling, increased family size, failure to attend ANC, and refusal to feed colostrum. As a result, improving mothers' educational status, reducing family size, encouraging ANC follow-up, and colostrum feeding are all effective ways to avoid prelacteal feeding.

Association between mode of delivery and breastfeeding practices in Egypt: secondary analysis of Egypt Demographic and Health Survey.

The rise in caesarean deliveries constitutes a major public health concern in low- and middle-income countries (LMICs). Evidence on the influence of caesarean delivery on breastfeeding practices in LMICs is currently lacking. To examine the association between mode of delivery and breastfeeding initiation and prelacteal feeding practices in a nationally representative sample of Egyptian women. A cross-sectional study was carried out on 3773 women from the 2014 Egypt Demographic and Health Survey. The outcomes of interest were the timing of breastfeeding initiation and prelacteal feeding practices. Descriptive statistics and multivariable logistic regression models were performed. Overall, 25.1% of mothers initiated breastfeeding within 1 hour of birth and 63.5% practised prelacteal feeding within 3 days of birth. Mothers who had caesarean delivery had higher odds of delayed breastfeeding initiation [adjusted odds ratio (AOR) 2.25; 95% confidence interval (CI): 1.84-2.74] and were more likely to engage in prelacteal feeding (AOR: 1.44; 95% CI, 1.19-1.74). Moreover, the relationship between caesarean delivery and delayed breastfeeding initiation varied by parity with stronger association among multiparous (AOR: 2.57; 95% CI, 2.04-3.24) compared with primiparous mothers (AOR: 1.52; 95% CI, 1.03-2.25). Caesarean delivery significantly increased the likelihood of delayed breastfeeding initiation and increased prelacteal feeding practices. Breastfeeding support and guidance should target women considering caesarean delivery.

Too little and too late. Initiation of breast feeding in Odisha, India: An observational study.

Objectives:To assess of the time of breastfeeding initiation, identify reasons for delay, if any and to assess if any prelacteal feeds were offered.Methods:An observational study was conducted among the inpatients of a tertiary care centre in Bhubaneswar, India. A total of 385 mothers, without contraindications to breastfeeding were interviewed at the earliest after childbirth.Results:Only 36.4% mothers initiated breastfeeding “timely.” Those who had undergone vaginal delivery scored better than cesarean sections with 41.3% (CI 95%; P = 0.016). Rooming in helped at 37.6% (CI 95%; P = 0.006). Multiparous homemakers from nuclear families and those who had previously breast fed initiated earlier than their counterparts. Less than 5% (CI 95%; P = 0.056) offered prelacteal feeds, mostly water.Conclusions:Our study reveals an alarming decline in the timely initiation of breastfeeding in Odisha, India from 68.5% to 41.6%.