Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Breastfeeding Journal
Published in: International Breastfeeding Journal 1/2020

Open Access 01-12-2020 | Sectio Ceasarea | Research

Early feeding practices and associated factors in Sudan: a cross-sectional analysis from multiple Indicator cluster survey

Authors: Manar E. Abdel-Rahman, Asmaa El-Heneidy, Lenka Benova, Laura Oakley

Published in: International Breastfeeding Journal | Issue 1/2020

Login to get access

Abstract

Background

In efforts to reduce neonatal mortality, the World Health Organization (WHO) has included breastfeeding among its recommended packages of interventions. Early initiation of breastfeeding and avoidance of prelacteal feeding are key contributors to optimal feeding practices. This study aims to assess the prevalence and associated factors of early breastfeeding practices in Sudan.

Methods

This study utilises the cross-sectional nationally-representative Sudan Multiple Indicator Cluster Survey (MICS) conducted in 2014. The sample includes women who had a live birth in the two years before the survey and their self-report on early breastfeeding practices, namely early initiation and prelacteal feeding. Percentages of these early breastfeeding practices indicators were estimated accounting for the complex survey design. Multivariable logistic regression analyses were used to examine the factors associated with these outcomes.

Results

Of 5622 mothers, 69% initiated breastfeeding within one hour of birth, 72% avoided prelacteal feeding in the first three days after birth, and 51% met the criteria for both (i.e. practised optimal early feeding practice). Optimal early feeding varied across regions of Sudan. Birth by caesarean section (Adjusted Odds Ratio [AOR] 0.34; 95% CI 0.25, 0.47) and at a health facility (AOR 0.75; 95% CI 0.60, 0.94) were negatively associated with optimal early feeding practice. Mothers with secondary education (AOR 1.62; 95% CI 1.30, 2.02), those who desired their pregnancy at the time (AOR 1.31; 95% CI 1.08, 1.60), those who were assisted by a skilled birth attendant at birth (AOR 1.48; 95% CI 1.19, 1.83), and those who gave birth to female infants (AOR 1.16; 95% CI 1.02, 1.33) had higher odds of use optimal early feeding practice. Similarly, the odds of optimal early feeding increased with parity and maternal age.

Conclusions

Only half of Sudanese mothers practised optimal early feeding practice, with important differences between regions in the country. Early feeding practices in Sudan are associated with various maternal, child and community level factors. The findings suggest the need to develop breastfeeding promotion programs with consideration of regional variations and healthcare system interventions.
Appendix
Available only for authorised users
Literature
1.
United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). Levels & Trends in Child Mortality: Report 2018, Estimates developed by the United Nations Inter-agency Group for Child Mortality Estimation. New York: United Nations Children’s Fund; 2018..
2.
Lassi ZS, Bhutta ZA. Community-based intervention packages for reducing maternal and neonatal morbidity and mortality and improving neonatal outcomes. Cochrane Database Syst Rev. 2015;3:CD007754.
3.
Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475.PubMedCrossRef
4.
World Health Organization. Global Strategy for Infant and Young Child Feeding. Geneva; 2003.
5.
Thompson JF, Heal LJ, Roberts CL, Ellwood DA. Women's breastfeeding experiences following a significant primary postpartum haemorrhage: a multicentre cohort study. Int Breastfeed J. 2010;5:5.PubMedPubMedCentralCrossRef
6.
Debes AK, Kohli A, Walker N, Edmond K, Mullany LC. Time to initiation of breastfeeding and neonatal mortality and morbidity: a systematic review. BMC Public Health. 2013;13 Suppl 3:S19.PubMedCrossRef
7.
Takahashi K, Ganchimeg T, Ota E, Vogel JP, Souza JP, Laopaiboon M, et al. Prevalence of early initiation of breastfeeding and determinants of delayed initiation of breastfeeding: secondary analysis of the WHO global survey. Sci Rep. 2017;7:10.CrossRef
8.
Alzaheb RA. A review of the factors associated with the timely initiation of breastfeeding and exclusive breastfeeding in the middle east. Clin Med Insights Pediatrics. 2017;11:15.
9.
Patel A, Banerjee A, Kaletwad A. Factors associated with prelacteal feeding and timely initiation of breastfeeding in hospital-delivered infants in India. J Hum Lact. 2013;29(4):572–8.PubMedCrossRef
10.
Eidelman AI. Breastfeeding and the use of human milk: an analysis of the American Academy of Pediatrics 2012 breastfeeding policy statement. Breastfeed Med. 2012;7(5):323–4.PubMedCrossRef
11.
Goldman AS. Modulation of the gastrointestinal tract of infants by human milk. Interfaces and interactions. An evolutionary perspective. J Nutr. 2000;130(2S Suppl):426S–31S.PubMedCrossRef
12.
Serizawa A, Ito K, Algaddal AH, Eltaybe RA. Cultural perceptions and health behaviors related to safe motherhood among village women in eastern Sudan: ethnographic study. Int J Nurs Stud. 2014;51(4):572–81.PubMedCrossRef
13.
14.
Berde AS, Ozcebe H. Risk factors for prelacteal feeding in sub-Saharan Africa: a multilevel analysis of population data from twenty-two countries. Public Health Nutr. 2017;20(11):1953–62.PubMedCrossRef
15.
World Health Organization. Indicators for assessing infant and young child feeding practices: part 1: definitions: conclusions of a consensus meeting held 6–8 November 2007 in Washington DC, USA. 2008.
16.
Oakley L, Benova L, Macleod D, Lynch CA, Campbell OMR. Early breastfeeding practices: descriptive analysis of recent demographic and health surveys. Matern Child Nutr. 2018;14(2):e12535.PubMedCrossRef
17.
Hassan AA, Taha Z, Ahmed MAA, Ali AAA, Adam I. Assessment of initiation of breastfeeding practice in Kassala, Eastern Sudan: a community-based study. Int Breastfeed J. 2018;13:34.PubMedPubMedCentralCrossRef
18.
Berde AS, Yalcin SS. Determinants of early initiation of breastfeeding in Nigeria: a population-based study using the 2013 demograhic and health survey data. BMC Pregnancy Childbirth. 2016;16:32.PubMedPubMedCentralCrossRef
19.
Bui QTT, Lee HY, Le ATK, Van Dung D, Vu LTH. Trends and determinants for early initiation of and exclusive breastfeeding under six months in Vietnam: results from the multiple indicator cluster surveys, 2000–2011. Glob Health Action. 2016;9:29433.PubMedCrossRef
20.
United Nations. World Statistics Pocketbook 2010: Least Developed Countries. New York: United Nations; 2011.
21.
22.
23.
World Health Organization. National implementation of the Baby-friendly Hospital Initiative. Geneva; 2017.
24.
Abdel Rahman A, Alkhatim H. Factors affecting the sustainability of the baby friendly hospital initiative in Khartoum state, Sudan: a cross-sectional study. J Community Med Health Educ. 2016;6(4):459.
25.
Tyler L, Kirby R, Rogers C. Infant feeding practices among Sudanese women now living in regional south East Queensland, Australia Breastfeed Rev 2014;22(3):13–19.
26.
27.
Central Bureau of Statistics (CBS) US. Multiple Indicator Cluster Survey 2014 of Sudan, Final Report. 2016.
28.
Adhikari M, Khanal V, Karkee R, Gavidia T. Factors associated with early initiation of breastfeeding among Nepalese mothers: further analysis of Nepal demographic and health survey, 2011. Int Breastfeed J. 2014;9:21.PubMedPubMedCentralCrossRef
29.
Nguyen PH, Keithly SC, Nguyen NT, Nguyen TT, Tran LM, Hajeebhoy N. Prelacteal feeding practices in Vietnam: challenges and associated factors. BMC Public Health. 2013;13:932.PubMedPubMedCentralCrossRef
30.
Rutstein SO, Johnson K. The DHS wealth index. DHS comparative reports no. 6. Calverton: ORC Macro; 2004.
31.
Hosmer DW Jr, Lemeshow S, Sturdivant RX. Applied logistic regression. NewYork: Wiley; 2013.
32.
World Health Organization. Global nutrition targets 2025: breastfeeding policy brief (WHO/NMH/NHD/14.7). Geneva: World Health Organization; 2014.
33.
Federal Ministry of Health and Central Bureau of Statistics. Multiple Indicator Cluster Survey 2010 of Sudan, Final Report; 2012.
34.
Issaka AI, Agho KE, Renzaho AMN. Prevalence of key breastfeeding indicators in 29 sub-Saharan African countries: a meta-analysis of demographic and health surveys (2010-2015). BMJ Open. 2017;7(10):e014145.PubMedPubMedCentralCrossRef
35.
Al-Nuaimi N, Katende G, Arulappan J. Breastfeeding trends and determinants: implications and recommendations for gulf cooperation council countries. Sultan Qaboos Uni Med J. 2017;17(2):e155–61.CrossRef
36.
Bergamaschi N, Oakley L, Benova L. Is childbirth location associated with higher rates of favourable early breastfeeding practices in sub-Saharan Africa? J Glob Health. 2019;9(1):010417.PubMedPubMedCentralCrossRef
37.
Tongun JB, Sebit MB, Ndeezi G, Mukunya D, Tylleskar T, Tumwine JK. Prevalence and determinants of pre-lacteal feeding in South Sudan: a community-based survey. Glob Health Action. 2018;11(1):1523304.PubMedPubMedCentralCrossRef
38.
Belachew AB, Kahsay AB, Abebe YG. Individual and community-level factors associated with introduction of prelacteal feeding in Ethiopia. Arch Public Health. 2016;74:6.PubMedPubMedCentralCrossRef
39.
Nankumbi J, Muliira JK. Barriers to infant and child-feeding practices: a qualitative study of primary caregivers in rural Uganda. J Health Popul Nutr. 2015;33(1):106–16.PubMedPubMedCentral
40.
ELyas TB. The knowledge, attitude and practices of mothers regarding the breast-feeding in Sinkat locality. IJSR. 2016;5(9):566–9.
41.
Shirima R, Gebre-Medhin M, Greiner T. Information and socioeconomic factors associated with early breastfeeding practices in rural and urban Morogoro, Tanzania. Acta Paediatr. 2001;90(8):936–42.PubMedCrossRef
42.
Temple Newhook J, Newhook LA, Midodzi WK, Murphy Goodridge J, Burrage L, Gill N, et al. Poverty and breastfeeding: comparing determinants of early breastfeeding cessation incidence in socioeconomically marginalized and privileged populations in the FiNaL study. Health Equity. 2017;1(1):96–102.PubMedPubMedCentralCrossRef
43.
Mohammed SGS. Infants feeding and weaning practices among mothers in northern Kordofan state, Sudan. Eur Sci J. 2014;10(24):165–81.
44.
Bililign N, Kumsa H, Mulugeta M, Sisay Y. Factors associated with prelacteal feeding in north eastern Ethiopia: a community based cross-sectional study. Int Breastfeed J. 2016;11:13.PubMedPubMedCentralCrossRef
45.
Acharya P, Khanal V. The effect of mother’s educational status on early initiation of breastfeeding: further analysis of three consecutive Nepal demographic and health surveys. BMC Public Health. 2015;15:1069.PubMedPubMedCentralCrossRef
46.
Skafida V. The relative importance of social class and maternal education for breast-feeding initiation. Public Health Nutr. 2009;12(12):2285–92.PubMedCrossRef
47.
Tongun JB, Sebit MB, Mukunya D, Ndeezi G, Nankabirwa V, Tylleskar T, et al. Factors associated with delayed initiation of breastfeeding: a cross-sectional study in South Sudan. Int Breastfeed J. 2018;13:7.CrossRef
48.
Khanal V, Adhikari M, Sauer K, Zhao Y. Factors associated with the introduction of prelacteal feeds in Nepal: findings from the Nepal demographic and health survey 2011. Int Breastfeed J. 2013;8:9.PubMedPubMedCentralCrossRef
49.
Albokhary AA, James JP. Does cesarean section have an impact on the successful initiation of breastfeeding in Saudi Arabia? Saudi Med J. 2014;35(11):1400.PubMedPubMedCentral
Metadata
Title
Early feeding practices and associated factors in Sudan: a cross-sectional analysis from multiple Indicator cluster survey
Authors
Manar E. Abdel-Rahman
Asmaa El-Heneidy
Lenka Benova
Laura Oakley
Publication date
01-12-2020
Publisher
BioMed Central
Published in
International Breastfeeding Journal / Issue 1/2020
Electronic ISSN: 1746-4358
DOI
https://doi.org/10.1186/s13006-020-00288-7

Other articles of this Issue 1/2020

International Breastfeeding Journal 1/2020 Go to the issue

Research

Timely initiation of breastfeeding in Zimbabwe: evidence from the demographic and health surveys 1994–2015

Research

Estimating the rate and determinants of exclusive breastfeeding practices among rural mothers in Southern Ghana

Research

Perceptions and experiences of nurse managers of the implementation of the baby and mother friendly initiative in Namibia: a qualitative study

Research

Exclusive breastfeeding for the first six months of life and its associated factors among children age 6-24 months in Burao district, Somaliland

Research

“I was determined to breastfeed, and I always found a solution”: successful experiences of exclusive breastfeeding among Chinese mothers in Ireland

Research

Determinants of excessive weight loss in breastfed full-term newborns at a baby-friendly hospital: a retrospective cohort study