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Reproductive Health
Published in: Reproductive Health 2/2015

Open Access 01-12-2015 | Research

Rates and determinants of early initiation of breastfeeding and exclusive breast feeding at 42 days postnatal in six low and middle-income countries: A prospective cohort study

Authors: Archana Patel, Sherri Bucher, Yamini Pusdekar, Fabian Esamai, Nancy F Krebs, Shivaprasad S Goudar, Elwyn Chomba, Ana Garces, Omrana Pasha, Sarah Saleem, Bhalachandra S Kodkany, Edward A Liechty, Bhala Kodkany, Richard J Derman, Waldemar A Carlo, K Michael Hambidge, Robert L Goldenberg, Fernando Althabe, Mabel Berrueta, Janet L Moore, Elizabeth M McClure, Marion Koso-Thomas, Patricia L Hibberd

Published in: Reproductive Health | Special Issue 2/2015

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Abstract

Background

Early initiation of breastfeeding after birth and exclusive breastfeeding through six months of age confers many health benefits for infants; both are crucial high impact, low-cost interventions. However, determining accurate global rates of these crucial activities has been challenging. We use population-based data to describe: (1) rates of early initiation of breastfeeding (defined as within 1 hour of birth) and of exclusive breastfeeding at 42 days post-partum; and (2) factors associated with failure to initiate early breastfeeding and exclusive breastfeeding at 42 days post-partum.

Methods

Prospectively collected data from women and their live-born infants enrolled in the Global Network’s Maternal and Newborn Health Registry between January 1, 2010-December 31, 2013 included women-infant dyads in 106 geographic areas (clusters) at 7 research sites in 6 countries (Kenya, Zambia, India [2 sites], Pakistan, Argentina and Guatemala). Rates and risk factors for failure to initiate early breastfeeding were investigated for the entire cohort and rates and risk factors for failure to maintain exclusive breastfeeding was assessed in a sub-sample studied at 42 days post-partum.

Result

A total of 255,495 live-born women-infant dyads were included in the study. Rates and determinants for the exclusive breastfeeding sub-study at 42 days post-partum were assessed from among a sub-sample of 105,563 subjects. Although there was heterogeneity by site, and early initiation of breastfeeding after delivery was high, the Pakistan site had the lowest rates of early initiation of breastfeeding. The Pakistan site also had the highest rate of lack of exclusive breastfeeding at 42 days post-partum. Across all regions, factors associated with failure to initiate early breastfeeding included nulliparity, caesarean section, low birth weight, resuscitation with bag and mask, and failure to place baby on the mother’s chest after delivery. Factors associated with failure to achieve exclusive breastfeeding at 42 days varied across the sites. The only factor significant in all sites was multiple gestation.

Conclusions

In this large, prospective, population-based, observational study, rates of both early initiation of breastfeeding and exclusive breastfeeding at 42 days post-partum were high, except in Pakistan. Factors associated with these key breastfeeding indicators should assist with more effective strategies to scale-up these crucial public health interventions.

Trial registration

Registration at the Clinicaltrials.gov website (ID# NCT01073475).
Appendix
Available only for authorised users
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Metadata
Title
Rates and determinants of early initiation of breastfeeding and exclusive breast feeding at 42 days postnatal in six low and middle-income countries: A prospective cohort study
Authors
Archana Patel
Sherri Bucher
Yamini Pusdekar
Fabian Esamai
Nancy F Krebs
Shivaprasad S Goudar
Elwyn Chomba
Ana Garces
Omrana Pasha
Sarah Saleem
Bhalachandra S Kodkany
Edward A Liechty
Bhala Kodkany
Richard J Derman
Waldemar A Carlo
K Michael Hambidge
Robert L Goldenberg
Fernando Althabe
Mabel Berrueta
Janet L Moore
Elizabeth M McClure
Marion Koso-Thomas
Patricia L Hibberd
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Reproductive Health / Issue Special Issue 2/2015
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/1742-4755-12-S2-S10

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