Timely Initiation Of Breastfeeding Research Articles

Assessment of initiation of breastfeeding practice in Kassala, Eastern Sudan: a community-based study

BackgroundThe World Health Organization (WHO) encourages early initiation of breastfeeding within the first hour after birth with the objective of saving children’s lives. There are few published research papers about factors associated with the initiation of breastfeeding in Sudan.The aim of this study was to investigate the prevalence of and factors associated with the timely initiation of breastfeeding among mothers with children two years and under in Kassala, Eastern Sudan.MethodsA community-based cross-sectional study was conducted from December 2016 to March 2017. Mothers were interviewed using a structured questionnaire.ResultsA total of 250 mother-child pairs participated in the study. The mean (standard deviation) of maternal age and children’s age was 27.1 (5.68) years and 11.9 (6.9) months, respectively.Of the 250 mothers, 218 (87.2%) initiated breastfeeding within the first hour. In multivariable logistic regression analysis, factors associated with the delay of breastfeeding initiation were having a male baby (Adjusted Odds Ratio [AOR] 3.90, 95% Confidence Interval [CI]1.33, 11.47), and mothers with medical disorders (AOR 5.07, 95% CI 1.22, 21.16).ConclusionThere was a high prevalence of early initiation of breastfeeding. An association with delayed initiation of breastfeeding was found amongst mothers who had medical disorders and those who had a male infant. Wherever possible, early initiation of breastfeeding should be promoted for all infants, regardless of gender.

Delayed initiation of breastfeeding in Bukavu, South Kivu, eastern Democratic Republic of the Congo: a cross-sectional study

BackgroundTimely initiation of breastfeeding can decrease neonatal mortality. However, about 50% of newborns are not breastfeed within 1 h of birth in the Democratic Republic of Congo. The aim of this study was to identify factors associated with delayed initiation of breastfeeding in an urban and rural area of Bukavu, South Kivu province, Democratic Republic of Congo.MethodsWe interviewed 396 mother-newborn pairs (185 in the urban area and 211 in the rural area) between 20 July and 10 October 2016. We used descriptive statistics to demonstrate the prevalence of early initiation of breastfeeding. Variables that showed association with delayed initiation of breastfeeding in the bivariate models were entered in a multivariable logistic model.ResultsOverall, the rate of early initiation of breastfeeding was 65.9% (69.7% in the rural area, 61.6% in the rural area). Two hundred and seventy-four (62.9%) mothers (159 in rural area and 115 in urban area) were counselled on early initiation of breastfeeding during prenatal care. Most mothers, 65.2% received counselling by a health professional. On multivariable regression analyses after adjusting for other variables in the model, unmarried mothers [Odds Ratio (OR): 1.5 (95% Confidence Interval (CI): 1.13, 1.95)], cesarean delivery [OR: 2.24 (95% CI: 1.74, 2.88)], no counselling on timely initiation of breastfeeding [OR: 1.71 (95% CI: 1.29, 2.20)] and counselling by a non-health professional [OR: 1.84 (95% CI: 1.08, 3.12)] were associated with delayed initiation of breastfeeding.ConclusionSystemic changes are needed for women having caesarean births to experience skin-to-skin and early initiation. In addition, information, education and communication on the importance of timely initiation of breastfeeding must be supported to improve maternal and infant wellbeing.

Delayed Breastfeeding Initiation Is Associated with Infant Morbidity

To assess the relationship between breastfeeding initiation time and postneonatal mortality, morbidity, and growth through 24 months in a cohort of Tanzanian infants. We included 4203 infants from 2 trials of micronutrient supplementation. We used Cox proportional hazards models or general estimating equations to estimate relative risks. A total of 13% of infants initiated breastfeeding >1 hour after birth (n = 536). There was no association between breastfeeding initiation time and risk of all-cause or cause-specific mortality, nor infant growth failure, from 6 weeks to 2 years of age. However, delayed breastfeeding was associated with an increased risk of several common infectious morbidities in early infancy, including upper respiratory infection symptoms and vomiting. Compared with those who initiated breastfeeding within the first hour of birth, delayed breastfeeding initiation was associated with an 11% increased risk of cough (relative risk 1.11, 95% CI 1.02-1.21) and a 48% increased risk of difficulty breathing (relative risk 1.48, 95% CI 1.09-2.01) during the first 6 months. Delayed initiation was associated with a greater risk of difficulty breathing from 6 to 12 months of age, but it was not associated with risk of any other morbidity during this time, nor any morbidity between 12 and 24 months. Delayed breastfeeding initiation is associated with an increased risk of infant morbidity during the first 6 months of life. Early breastfeeding initiation, along with exclusive and prolonged breastfeeding, should be prioritized and promoted in efforts to improve child health.

SystEmatic review and meta-aNAlysis of infanT and young child feeding Practices (ENAT-P) in Ethiopia: protocol

IntroductionInfant and young child feeding (IYCF) is the cornerstone of infant and child survival, healthy growth and development, healthy future generations and national development. In spite of the importance of...

Delayed breastfeeding initiation and infant survival: A systematic review and meta-analysis.

ObjectiveTo assess the existing evidence regarding breastfeeding initiation time and infant morbidity and mortality.Study designWe conducted a systematic review and meta-analysis. We searched Pubmed, Embase, Web of Science, CINAHL, Popline, LILACS, AIM, and Index Medicus to identify existing evidence. We included observational studies and randomized control trials that examined the association between breastfeeding initiation time and mortality, morbidity, or nutrition outcomes from birth through 12 months of age in a population of infants who all initiated breastfeeding. Two reviewers independently extracted data from eligible studies using a standardized form. We pooled effect estimates using fixed-effects meta-analysis.ResultsWe pooled five studies, including 136,047 infants, which examined the association between very early breastfeeding initiation and neonatal mortality. Compared to infants who initiated breastfeeding ≤1 hour after birth, infants who initiated breastfeeding 2–23 hours after birth had a 33% greater risk of neonatal mortality (95% CI: 13–56%, I2 = 0%), and infants who initiated breastfeeding ≥24 hours after birth had a 2.19-fold greater risk of neonatal mortality (95% CI: 1.73–2.77, I2 = 33%). Among the subgroup of infants exclusively breastfed in the neonatal period, those who initiated breastfeeding ≥24 hours after birth had an 85% greater risk of neonatal mortality compared to infants who initiated <24 hours after birth (95% CI: 29–167%, I2 = 33%).ConclusionsPolicy frameworks and models to estimate newborn and infant survival, as well as health facility policies, should consider the potential independent effect of early breastfeeding initiation.

Correlates of early neonatal feeding practice\xa0in Dabat HDSS site, northwest Ethiopia

BackgroundDelaying the start of breastfeeding and giving prelacteal feeding leads to a significant increase in neonatal and infant deaths, particularly in a resource limited countries, like Ethiopia. Therefore, this study aimed to assess early neonatal feeding practice and its determinants in Dabat HDSS site, northwest Ethiopia.MethodsThe census for the reconciliation of the surveillance of the Dabat Health and Demographic Surveillance System (HDSS) site was conducted from October to December 2014. Data were entered into the Household Registration System (HRS) version 2.1 and analyzed using Stata version 14. A total of 6,761 mother-child pairs were included in the study. Sociodemographic factors, maternal health care and early neonatal feeding practices (early initiation of breastfeeding and prelacteal feeding) were collected by interviewing the mothers. The prevalence of early/timely initiation of breastfeeding was computed as the ratio of children put to the breast within one hour of delivery to the total number of children. Prelacteal feeding was defined as giving anything to drink other than breast milk in the first three days following birth. Binary logistic regression models were used to identify variables which were associated with the dependent variable. A multivariable logistic regression analysis was carried out to identify factors associated with early initiation of breastfeeding.ResultsThe prevalence of early initiation of breastfeeding was 43.9% (95% CI, 41.6, 46.2). More than half (56%) of the mothers gave prelacteal feeds. An urban residence (Adjusted Odds Ratio [AOR] 1.47, 95% Confidence Interval [CI] 1.25. 1.73) and antenatal care (AOR 1.41, 95% CI 1.24, 1.59) were correlated with early initiation of breastfeeding. Similarly, increased odds of timely initiation of breastfeeding were observed among mothers who didn’t give prelacteal feeds (AOR 5.72; 95% CI, 5.12, 6.40).ConclusionDelayed initiation of breastfeeding and prelacteal feeding still remain public health concerns in this community. The promotion of improved infant and young child feeding (IYCF) practices and the utilization of antenatal care services should be intensified.

Individual and community level factors with a significant role in determining child height-for-age Z score in East Gojjam Zone, Amhara Regional State, Ethiopia: a multilevel analysis

BackgroundIn Ethiopia, child undernutrition remains to be a major public health challenge and a contributing factor for child mortality and morbidity. To reduce the problem, it is apparent to identify determinants of child undernutrition in specific contexts to deliver appropriately, targeted, effective and sustainable interventions.MethodsAn agroecosystem linked cross-sectional survey was conducted in 3108 children aged 6–59 months. Multistage cluster sampling technique was used to select study participants. Data were collected on socio-demographic characteristics, child anthropometry and on potential immediate, underlying and basic individual and community level determinants of child undernutrition using the UNICEF conceptual framework. Analysis was done using STATA 13 after checking for basic assumptions of linear regression. Important variables were selected and individual and community level determinants of child height-for-age Z score were identified. P values less than 0.05 were considered the statistical level of significance.ResultsIn the intercept only model and full models, 3.8% (p < 0.001) and 1.4% (p < 0.001) of the variability were due to cluster level variability. From individual level factors, child age in months, child sex, number of under five children, immunization status, breast feeding initiation time, mother nutritional status, diarrheal morbidity, household level water treatment and household dietary diversity were significant determinants of child height for age Z score. Also from community level determinants, agroecosystem type, liquid waste disposal practice and latrine utilization were significantly associated with child height-for-age Z score.ConclusionIn this study, a statistical significant heterogeneity of child height-for-age Z score was observed among clusters even after controlling for potential confounders. Both individual and community level factors, including the agroecosystem characteristics had a significant role in determining child height-for-age Z score in the study area. In addition to the existing efforts at the individual levels to improve child nutritional status, agroecosystem and community WASH related interventions should get more attention to improve child nutritional status in the study area.

Infant feeding practices among nursing mothers at rural tertiary care hospital

Background: Breastfeeding (BF) is nature’s way of providing nutrition required for healthy growth and development of the young infant. The early child growth needs healthy infant feeding practices including exclusive breastfeeding and timely complementary feeds. The present study was carried out to assess the pattern of infant feeding and its relation to certain care practices of maternity and the newborn, and to assess the knowledge of mothers, who had delivered in the last one year.Methods: A cross sectional descriptive study was conducted among 202 mothers in the pediatric and obstetrics department of tertiary care hospital. The mothers with children under the age of 1 year were interviewed following which descriptive statistics were obtained.Results: Out of 202 mothers, majority of the mothers were of age less than 30 years (79.7%) and were Hindus (74.2%). The majority were housewives (98.5%), illiterate (71.7%), multiparous (67.8%). Most of the mothers were belonged to a lower socioeconomic class (95.5%). About 17.8% babies had not received colostrum. Majority of the mothers had initiated breastfeeding (79.2%) within 24 hours of delivery. About 46.5% of the respondents were not aware of the benefits of exclusive breastfeeding. About 25% of the mothers started complementary feeding before the child was six months old. The most common type of complementary food given was semisolid (53.4%). About 14.1% of the mothers had started giving semi-solid foods before the baby was six months of age. A majority of the mothers had no advice on infant feeding.Conclusions: Knowledge regarding the timely initiation of breast feeding, advantages of exclusive breast feeding and proper weaning practice is less among the mothers of rural area. So, advice about breastfeeding and complementary feeding during antenatal check-ups, postnatal, and during Immunization visits might improve feeding practices.

Efficacy of Evidence Based Practice (EBP) Guideline to Prevent and Treat Breast Engorgement among Post Caesarean Mothers in Selected Hospital in Mangalore

Abstract Introduction: Early initiation of breast feeding has long been recognized as one of the most important contributor to mothers' as well as infants' health. Breast feeding should be initiated within half an hour and two hour of birth in normal vaginal delivery and caesarean section respectively. A recent systematic review regarding the timing of breast feeding initiation shows that if newborns are exposed to breast feeding at the early stage, they are much more likely to adhere to breast feeding and ultimately have better outcome in terms of less incidence of breast engorgement. Objectives: The objectives of the study were to identify the early initiation of breast feeding by post caesarean mothers using observational check list, to train the staff nurses regarding the EBP guideline to prevent and treat breast engorgement among post caesarean mothers, to find the difference between pre test knowledge score and post test knowledge score among staff nurses on prevention and treatment of breast engorgement using structured knowledge questionnaire, to assess the effectiveness of EBP guideline to prevent and treat breast engorgement among post caesarean mothers in terms of reduction in the severity of breast engorgement before and after the implementation of EBP guideline using modified six point engorgement scale. Methods: In this study, one group pre test post test design was chosen. The study was conducted at KMC Hospital Attawar, Mangalore. The population in this study comprised of prime post cesarean mothers and staff nurses who are available at the period of data collection at KMC Hospital, Attawar, Mangalore. The calculated sample size for post caesarean mothers is 50 ad staff nurses are 20. The following tools were used to collect the data from the study samples. 1) Baseline characteristics - post caesarean mothers and staff nurses 2) Structured knowledge questionnaire on prevention and treatment of breast engorgement 3) Observational checklist to identify early initiation of breast feeding 4) Modified six point engorgement scale to assess the severity of breast engorgement. The data were collected and analyzed by using descriptive and inferential statistics by SPSS package version 16. Results: The study results shows, Out of the 50 mothers, 26 (52%) of the mothers had previous information regarding breast engorgement. 14 (53%) of the mothers had received information from family members/ relatives and friends meanwhile 8 (31%) had mass media as a source of information and 4 (16%) had information from their health professionals. Most of the post caesarean mothers were practicing early initiation of breast feeding. Regarding the total practice score for the early initiation of breast feeding it was 6.38 ± 0.696 and it ranged from 5 to 7 with a median 6. Conclusion: The study has revealed that, most of the post caesarean mothers were practicing the early initiation breast feeding practices.

High Prevalence of Undernutrition among Children in Gondar Town, Northwest Ethiopia: A Community-Based Cross-Sectional Study

Objective To assess undernutrition and associated factors among children aged 6–59 months in Gondar Town, northwest Ethiopia. Methods A community-based cross-sectional study was conducted in 2014. Multistage sampling method was used to select study participants. Structured interviewer administered questionnaire and anthropometric measurements were used. Binary logistic regression was fitted to identify associated factors. Results The prevalences of wasting and stunting were 6.8% and 45.7%, respectively. Higher odds of wasting were observed among children whose fathers were daily laborers (AOR = 2.63), children who had eating problem (AOR = 2.96), and those who were not exclusively breast-fed for the first six months (AOR = 5.63). Similarly, higher odds of stunting were found among female children (AOR = 1.65), children who lived in households having four to six families (AOR = 2.14), and children who did not start breast-feeding within one hour of birth (AOR = 0.67). Conclusion Childhood undernutrition was a significant problem. Child eating problem, paternal occupation, and exclusive breast-feeding were associated with wasting, whereas family size, child sex, and breast-feeding initiation time were associated with stunting. Therefore, strengthening of early initiation and exclusive breast-feeding, promoting healthcare seeking behavior, and designing social support programme for poor family are recommended to reduce undernutrition.

Timely initiation of breastfeeding is associated with the practice of exclusive breastfeeding in Indonesia.

Exclusive breastfeeding has been proven to be essential for optimal health, and for reducing infections and mortality in children. However, exclusive breastfeeding coverage both in Indonesia and in globalremains low. This study evaluated the relationship between the timely initiation of breastfeeding and the practice of exclusive breastfeeding in Indonesia. This cross-sectional study used Riskesdas 2013 data. Participants were 7,667 mothers whose children were aged 6-23 months in Indonesia, and were selected based on the completeness of the variables. The data were analysed using descriptive statistics, chisquare tests, and a multiple logistic regression that considered the sampling weight. STATA 13.0 was used for the analyses, and the significance level was set at p<0.05. Timely initiation of breastfeeding within 1 hour of parturition (OR=3.66, 95% CI: 2.14-3.64), timely initiation of breastfeeding at or after 1 hour following parturition (OR=2.79, 95% CI: 3.00-4.46), and neonatal illness (OR=0.69, 95% CI: 0.53-0.91) were significantly associated with an exclusive breastfeeding history among children aged 6-23 months. Other factors, such as the mother's age, mother's educational level, child's birth weight, household economic status, and residential area were not associated with an exclusive breastfeeding history. Timely initiation of breastfeeding and the prevention of neonatal illness should be the main interventions to improve exclusive breastfeeding coverage in Indonesia.

Predictors of appropriate breastfeeding knowledge among pregnant women in Moshi Urban, Tanzania: a cross-sectional study

BackgroundKnowledge on infant feeding among pregnant women is essential when promoting optimal breastfeeding practices. This study aimed to assess the knowledge of women on optimal breastfeeding during pregnancy and associated factors as well as performance of the health system in reaching women with information on breastfeeding and infant feeding issues.MethodsA cross-sectional study was conducted from October 2013 to April 2014 among pregnant women, in their third trimester, attending for routine care at two primary health care facilities in Moshi urban, northern Tanzania.ResultsA total of 536 women were enrolled, with mean age of 25.9 (SD 5.7) years. Only 51% (n = 274) reported to have received counselling on breastfeeding from their healthcare providers during the current pregnancy.More than seven out of ten pregnant women were knowledgeable about key issues regarding appropriate breastfeeding practices: importance of colostrum (95%), time of breastfeeding initiation (71%), exclusive breastfeeding (EBF) (81%), and time of introducing complementary feeding (83%).Receiving counselling on breastfeeding during the current pregnancy (Adjusted Odds Ratio [AOR] 3.7; 95% Confidence Interval [CI]: 2.4, 5.7), having two children (AOR 2.6; 95% CI: 1.5, 4.4), having three or more children (AOR 3.5; 95% CI: 1.8, 6.9) and intention to breastfeed the child exclusively (AOR 3.6; 95% CI: 2.0, 6.5) were significantly associated with appropriate breastfeeding knowledge.ConclusionsThe health system failed to reach the 49% of women who did not receive counselling on infant feeding. Pregnant women who had received counselling on optimal breastfeeding and women with more than one child were more likely to have knowledge of optimal breastfeeding practices.

A Study on the Feeding Practices among Under-Five Children in Urban Slum dwellers of District Dehradun, India

Background: Breast milk feeding is the first fundamental right of the child. However, there are many cultural practices associated with infant feeding of which certain undesirable practices need to be discouraged.Objectives: To assess the feeding practices of under five year children in urban slum and to determine the factors influencing it, if any.Methodology: Community based analytical cross sectional study was conducted in urban slums amongst mothers over one-year period. A house to house survey was conducted and Data was collected using a pre-tested, structured questionnaire on breastfeeding practices &amp; data pertaining to breastfeeding practices was asked in detail from mothers of babies who were breastfed.Results: A total of 381 children were studied. A total of 87.0% of the children were delivered at health facilities and the rest at home. 65.9% received prelacteal feed in the form of water, infant milk formula, cow milk and honey. Most of the children (54.1%) received breast milk within 24 hrs of birth. 95.0% received colostrum and 67.2% received exclusive breast feeding for 6 months. It was observed that children who were exclusively breastfed for six months were found to be better nourished (51.3%).Conclusions: Majority of the mothers were practicing exclusive breast feeding, however a significant proportion of children was deprived of timely initiation of breast feeding. About 2/3 of the mothers were still practicing pre-lacteal feeds to their children. The study documents that there was significantly increased risk of PEM if the child is not exclusive breastfed for 6 months.Bangladesh Journal of Medical Science Vol.15(1) 2016 p.15-19

Timing of initiation, patterns of breastfeeding, and infant survival: prospective analysis of pooled data from three randomised trials.

Although the benefits of exclusive breastfeeding for child health and survival, particularly in the post-neonatal period, are established, the independent beneficial effect of early breastfeeding initiation remains unclear. We studied the association between timing of breastfeeding initiation and post-enrolment neonatal and post-neonatal mortality up to 6 months of age, as well as the associations between breastfeeding pattern and mortality. We examined associations between timing of breastfeeding initiation, post-enrolment neonatal mortality (enrolment 28 days), and post-neonatal mortality up to 6 months of age (29-180 days) in a large cohort from three neonatal vitamin A trials in Ghana, India, and Tanzania. Newborn babies were eligible for these trials if their mother reported that they were likely to stay in the study area for the next 6 months, they could feed orally, were aged less than 3 days, and the primary caregiver gave informed consent. We excluded infants who initiated breastfeeding after 96 h, did not initiate, or had missing initiation status. We pooled the data from both randomised groups of the three trials and then categorised time of breastfeeding initiation as: at ≤1 h, 2-23 h, and 24-96 h. We defined breastfeeding patterns as exclusive, predominant, or partial breastfeeding at 4 days, 1 month, and 3 months of age. We estimated relative risks using log binomial regression and Poisson regression with robust variances. Multivariate models controlled for site and potential confounders. Of 99 938 enrolled infants, 99 632 babies initiated breastfeeding by 96 h of age and were included in our prospective cohort. 56 981 (57·2%) initiated breastfeeding at ≤1 h, 38 043 (38·2%) at 2-23 h, and 4608 (4·6%) at 24-96 h. Compared with infants initiating breastfeeding within the first hour of life, neonatal mortality between enrolment and 28 days was higher in infants initiating at 2-23 h (adjusted relative risk 1·41 [95% CI 1·24-1·62], p<0·0001), and in those initiating at 24-96 h (1·79 [1·39-2·30], p<0·0001). These associations were similar when deaths in the first 4 days of life were excluded (1·32 [1·10-1·58], p=0·003, for breastfeeding initiation at 2-23 h, and 1·90 [1·38-2·62], p=0·0001, for initiation at 24-96 h). When data were stratified by exclusive breastfeeding status at 4 days of age (p value for interaction=0·690), these associations were also similar in magnitude but with wider confidence intervals for initiation at 2-23 h (1·41 [1·12-1·77], p=0·003) and for initiation at 24-96 h (1·51 [0·63-3·65], p=0·357). Exclusive breastfeeding was also associated with the lower mortality during the first 6 months of life (1-3 months mortality: exclusive vs partial breastfeeding at 1 month 1·83 [1·45-2·32], p<0·0001, and exclusive breastfeeding vs no breastfeeding at 1 month 10·88 [8·27-14·31], p<0·0001). Our findings suggest that early initiation of breastfeeding reduces neonatal and early infant mortality both through increasing rates of exclusive breastfeeding and by additional mechanisms. Both practices should be promoted by public health programmes and should be used in models to estimate lives saved. Bill & Melinda Gates Foundation through a grant to the WHO.

Factors associated with breastfeeding initiation time in a baby-friendly hospital in Istanbul

AimTo investigate perinatal factors that affect breastfeeding of newborns delivered at a baby-friendly public hospital in Turkey, including the time of the first physical examination by a pediatrician, the first union with their mothers, and the first breastfeeding time after delivery. MethodThe research was conducted from May 2nd through June 30th, 2011, in a baby-friendly public hospital in Istanbul. The sample consisted of 194 mothers and their full-term newborns.The data were collected via an observation form developed by the researchers. In analyzing the data, the average, standard deviation, minimum, maximum values, Chi-square, and percentages were used. ResultsThe results revealed that the first physical examinations of the newborns were performed approximately 53.02±39min (range, 1–180 min) after birth. The newborns were given to their mothers approximately 69.75±41min (range, 3–190 min) after birth. Consequently, the first initiated breastfeeding took place approximately 78.58±44min following birth, and active sucking was initiated after approximately 85.90±54min. A large percentage of the newborns (64.4%) were not examined by a specialist pediatrician within half an hour of birth, and 74.7% were not united with their mothers within the same period. Also, the newborns who initiated breastfeeding within the first half hour had significantly earlier success with active sucking and required significantly less assistance to achieve successful breastfeeding. ConclusionThe newborns in our study met with their mothers late in the birth ward because examinations of the newborns were delayed. The newborns began initial sucking later, and this chain reaction negatively impacted the breastfeeding success of the newborns.

Timely Initiation of Breastfeeding and Its Associated Factors among Mothers in Tiyo Woreda, Arsi Zone, Ethiopia: A Community- Based Cross Sectional Study

Background- Timely initiation of breastfeeding is a recommended practice by the World Health Organization since 1992 which says “initiate breastfeeding within one hour of delivery, though it is not a usual practice in Ethiopia. Untimely initiation of breastfeeding has negative effect on child health, survival, growth and development. Therefore, this study was assessed the timely initiation of breastfeeding and its associated factors among mothers who have child less than one year age in Tiyo Woreda, Arsi zone, Ethiopia . Methods- A community based cross sectional study design was employed in Tiyo District from October to November 2014. The sample size was 386. Households with mothers who had just delivered within the past year were identified through census and sampling frame was developed. Finally study subjects were addressed through simple random sampling. Data were collected using interviewer administered pre-tested and structured questionnaire. The data were cleaned, coded and entered into Epi-Data version 3.1 and then exported SPSS version 21windows for analyses. Descriptive analysis was done to determine the prevalence and logistic regression analysis was used to identify determinants of timely initiation of breast feeding and P value <0.05 was considered as statistically significant. Results-The prevalence of timely initiation of breastfeeding of this study is 67.3%. Mothers with formal education were more likely to initiate breastfeeding timely (AOR=4.501, CI: 1.08, 18.76). Mothers who gave birth at home were less likely to start breastfeeding timely than mothers who delivered at health institution with (AOR= 0.13, 95% CI: 0.05, 0.35). Advice about timely initiation of breast feeding provided to mothers immediately after delivery was independently associated with timely initiation of breastfeeding(AOR=3.71,95% CI:1.45,9.48). Prevalence of timely initiation of breastfeeding of this study is encouraging. Conclusions-The advice for mothers on timely initiation of breastfeeding immediately after delivery and education had a positive impact, whereas a poor health status (such as mothers transported to hospitals) and home delivery had a negative impact on timely initiation of breastfeeding.

Birth and breastfeeding dynamics in a modernizing indigenous community.

Changes in health care access and birthing practices may pose barriers to optimal breastfeeding in modernizing rural populations. We evaluated temporal and maternal age-related trends in birth and breastfeeding in a modernizing Maya agriculturalist community. We tested 2 hypotheses: (1) home births would be associated with better breastfeeding outcomes than hospital births, and (2) vaginal births would be associated with better breastfeeding outcomes than cesarean births. We interviewed 58 Maya mothers (ages 21-85) regarding their births and breastfeeding practices. General linear models were used to evaluate trends in birthing practices and breastfeeding outcomes (timing of breastfeeding initiation, use of infant formula, age of introduction of complementary feeding, and breastfeeding duration). We then compared breastfeeding outcomes by location (home or hospital) and mode of birth (vaginal or cesarean). Timing of breastfeeding initiation and the rate of formula feeding both increased significantly over time. Younger mothers introduced complementary foods earlier, breastfed for shorter durations, and formula fed more than older mothers. Vaginal hospital births were associated with earlier breastfeeding initiation and longer breastfeeding durations than home births. Cesarean births were associated with later breastfeeding initiation, shorter breastfeeding durations, and more formula feeding than vaginal hospital births. We have observed temporal and maternal age-related trends toward suboptimal breastfeeding patterns in the Maya community. Contrary to our first hypothesis, hospital births per se were not associated with negative breastfeeding outcomes. In support of our second hypothesis, cesarean versus vaginal births were associated with negative breastfeeding outcomes.

Assessment of Breastfeeding Initiation And Pre-Lacteal Use Among Young Infants In Awo-omamma, Southeast Nigeria

Objective: To determine the practice of breastfeeding initiation time among mothers of very young infants; the prelacteal contents given to babies and the motivations for giving them prelacteal. Study Design, Setting and Participants: Descriptive cross sectional study in a typical rural setting of Government Primary Healthcare facility where most mothers give birth and avail health services for themselves and the new born in southeast Nigeria. Outcome, Measures and Analysis: Percentage of mothers that initiated breastfeeding within thirty (30) minutes of delivery; Percentage of mothers that introduced prelacteal feeds according to types. Analysis was descriptive using Scientific Package for the Social Sciences (SPSS version 16) and data presented in percentages and frequencies. Result: Results show that of the 113 mothers studied, only 17% initiated breastfeeding within 30 minutes of delivery while a poor 19%were informed of appropriate early initiation time during antenatal care visits prior to delivery; prevalence of prelacteal feeding practice was common at 75% where water (47%) and glucose water (18%) were the most predominant. Three factors were mostly responsible for early introduction of prelacteal namely, nothing (21% and 8%), baby crying (26% and 9%) and no breast milk yet (17% and 5%) for water and glucose water respectively. Conclusion and Implications: The early introduction ofprelacteal feedsbymothers is premisedon thestrongdesire to give something to the new born soon after delivery while waiting for full breastmilk coming andflow. Itmaybe further spurred by baby crying – a sign mothers and care providers culturally interpret as baby being desperate for something to eat drink. Unfortunately, poor sanitation and hygiene as with lack of access to clean water then results in the huge burden of malnutrition, infection and death of neonates and infants given prelacteal feeds at moments they are yet so delicate and vulnerable as moments following delivery. The studydemonstrates theneed for the development of appropriate information education and communication materials for behavior change targeted at care providers and then mothers with strong emphasis on breastfeeding initiation time and the dangers associated with introduction of prelacteal feeds on the very young infants. Funding: None

Timing of breastfeeding initiation and exclusivity of breastfeeding during the first month of life: effects on neonatal mortality and morbidity--a systematic review and meta-analysis.

The purpose of this study was to review the evidence on the effect of initiation of breastfeeding early after birth and of exclusive breastfeeding during the first month in reducing neonatal mortality and morbidity. We searched Cochrane and PubMed databases for all available papers addressing our review questions and identified eleven papers. Data were extracted using a standard abstraction form. Evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation system. Meta-analysis was done using STATA 11.0. Early initiation of breastfeeding was associated with a reduced risk of neonatal mortality. Initiating breastfeeding after the first hour doubled the risk of neonatal mortality. Exclusively breastfed neonates had a lower risk of mortality and infection-related deaths in the first month than partially breastfed neonates. Exclusively breastfed neonates also had a significantly lower risk of sepsis, diarrhea and respiratory infections compared with those partially breastfed. The pooled evidence indicates that substantial benefits in reducing neonatal mortality and morbidity can be achieved with effective promotion of early initiation of breastfeeding and exclusive breastfeeding during the first month of life.

Cell phone based peer counselling can support exclusive breastfeeding: a randomized controlled trial in Kenya (119.5)

Objective: To test whether exposure to community‐based continuous cell phone based peer support (CPS) or monthly peer‐led support groups (PSG) increases adoption and duration of exclusive breastfeeding (EBF), as compared to current standard of facility‐based support (Control).Methods: We randomized low‐income women attending antenatal care at a large hospital to receive one of three support strategies from late pregnancy (32‐26 weeks) to 3 months postpartum: CPS, PSG or Control. We compared EBF estimated by maternal 24 h recall of infant foods at 3 months age by intervention group.Results: Participant flow was adequate for power (753 women enrolled, 81% of eligible; 504 infants completed, including twins, 66.6%). Both interventions were associated with a higher proportion of EBF CPS: 90.9%, PSG: 82.8%, Control: 78.2%, p=0.007). Pairwise comparisons of 24 h EBF indicated a significant association of CPS with an 12.7% higher prevalence than Control (90.9 versus 78.2, a 16.2% greater EBF response rate than Control; Chi‐square = 9.8201, p=0.0017) and an 8.1% higher prevalence than PSG (90.9 versus 82.8, a 9.8% greater EBF response rate than PSG; Chi‐square = 4.5768, p=0.0324). Differences could not be attributed to baseline indicators, dropout rates or biases, prevalence and timing of breastfeeding initiation, or EBF prevalence one week after birth. They may be attributed to the frequency of advice.Conclusions: Cell phone based counselling approaches can be at least as effective in supporting EBF as peer support group and facility‐based approaches.Supported by Bill &amp; Melinda Gates Foundation to FHI 360, through the Alive &amp; Thrive Small Grants Program managed by UC Davis; Global Alliance for Improved Nutrition; Canada Research Chair program award.