Delayed onset of breastfeeding: what is stopping us?

Abstract

Background: Breastfeeding is the best meal for a new born child. Various initiatives are in place for early initiation of breastfeeding. The effectiveness of these interventions is put to question when a large number of neonates fail to receive breast milk soon after birth. This study analyses the parameters likely to affect the time of onset of breastfeeding and evaluate the scope for interventions. It is important to assess the factors affecting initiation of breastfeeding, determine the relationship of these factors with the time of initiation and to analyse if counselling by health care workers has any benefit on outcome.Methods: This is a hospital based cross sectional observational study in 200 lactating mothers from a pre-designed questionnaire. Main outcome measure- early onset (<1 hour of birth) of breastfeeding.Results: Only 55% neonates included in this study were breastfed within the first 30 minutes. Positive influence for early initiation of breastfeeding was found with non primi mothers aged more than 26 years, with secondary or higher education, who had vaginal birth with institutional delivery. Early oral intake of mother with professional women living in joint family started early breastfeeding. Use of pre lacteal feeds delayed the onset of breastfeeding. Infants fed earlier were males, weight >2.2 kg. Women counselled by health care workers fed their babies earlier. Conclusions: This study surmises that pre lacteal feeds should be discouraged and active health care workers’ participation should be encouraged for early breastfeeding. Breastfeeding should be initiated as soon as possible for healthy neonatal outcome.

Exploration of Breastfeeding Practices in India: A Systematic Review

“…Furthermore, full-text papers were reviewed for eligibility and based on the prespecified inclusion criteria, 24 studies were included for systematic review, which was published between 2001 to 2020 from different regions of India (Table 4). Out of 24 selected studies, most articles were crosssectional [5,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Aligarh has a population of 40,000 living in 5,480 households. Mothers delivering babies in September 2007 were identified from records of social mobilization workers Community Mobilization Coordinators or (CMCs), and others had had qualitative cohort or mix method design.…”

“…Most studies reported that initiation of breastfeeding was within 1-6 hours after the delivery. In seven studies, many participants had initiated breastfeeding within one hour of newborn's life [15,24,25,27,29,30,33]. In contrast, few participants in another study [15] reported delayed breastfeeding initiation; the quoted reasons were baby separation as the commonest reason (45%), followed by mother's illness (27.3%).…”

“…Madhu et al stated that 13% of the babies are fed for more than 48 hours of sugar water alone. Also, honey (6%) and ghee (3%) were widely used as prelacteal feeds [25]. About 62% of mothers practiced EBF, and 28.2% discarded colostrum.…”

“…On-de-mand feeding practices and rooming-in were followed by 84% of mothers. The commonest food for breastfed infants for less than 6 months was cow's milk (26%) [25].…”

“…In contrast, a study revealed that participants started the weaning practice in less than 4 months and followed the on-demand feeding [15]. Studies from different parts of India have found that the EBF practice was not followed by mothers [17,18,21,25]. Saxena Y et al found multiple hindering factors for EBF: inadequate mother's milk, cesarean sections, and coercion from elders in the family to start top milk [40].…”