Effect of gender of new-born, antenatal care and postnatal care on breastfeeding practices in Ethiopia: Evidence from systematic review and meta-analysis of national studies

Abstract

Objective: The aim of this systematic review and meta-analysis was to investigate the association of gender of new-born, antenatal care (ANC) and postnatal care (PNC) with TIBF and EBF. Design: Systematic review and meta-analysis Methods: PubMed, EMBASE, CINAHL, WHO Global Health Library, Web of Science and SCOPUS databases systematically searched for all available literature, complemented by manual searches. Newcastle-Ottawa Scale (NOS) was used for quality check; Egger's regression test for publication bias at p-value threshold ≤ 0.01; and Cochran's Q X 2 test and I 2 statistics for heterogeneity. A meta-analysis using a weighted inverse variance random-effects model was performed.Results: Of 523 articles retrieved, 16 studies on TIBF and 23 on EBF fulfilled the eligibility criteria. Antenatal care (Odds ratio (OR) = 1.61, 95% CI 1.01 -2.57) was significantly associated with TIBF but not gender of new-born (OR = 1.03, 95% CI 0.84 -1.26). In addition, antenatal (OR = 2.25, 95% CI 1.63 -3.10) and postnatal care (OR = 1.86, 95% CI 1.41 -2.47) significantly associated with exclusive breastfeeding (EBF) but not gender of new-born (OR = 1.08, 95% CI 0.86 -1.36). Conclusions:Optimal care during pregnancy and after birth is important to ensure adequate breastfeeding. In addition, there was no difference in breastfeeding between male and female new-born. This meta-analysis study provided evidence on breastfeeding practice and its associated factors in an Ethiopian context, which can be useful for cross-country and crosscultural comparison and for breastfeeding improvement initiative in Ethiopia. Strengths and limitations of this study• This systematic review and meta-analysis was conducted based on the registered and published protocol, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for literature reviews.• Since it is the first study of its kind in Ethiopia, the information could be helpful for future researchers and public health practitioners.• Almost all included studies were observational which may hinder causality inference.• Based on the conventional methods of heterogeneity test, a few analyses suffer from high between-study variation.

Optimal breastfeeding practice and associated factors among mothers of children 24-36 months of age in Tehuledere District, Northeast Ethiopia

“…The prevalence of timely initiation of breastfeeding in this study was 242 (46.4%) (95%CI = 42.2, 50.8). This nding is consistent with the global prevalence (45%) (33).This nding is below the study in Ethiopia (57.2%),(83.1%), (82.5%), (83.7%), (67.5%) and (66.5%), WHO goal(70%), in Afghanistan (54.3%), Nepal (57%) (16,26,(29)(30)(31)(34)(35)(36)(37); On the contrary, the nding is higher than the study in Nigeria (38%), Afganistan(40.9%) and India (10%) (1,26,38).This discrepancy might be due to the difference in the study period, study design, study setting and sample size.…”

Proximal and distal factors predicting timely initiation of breast feeding in Ethiopia: a systematic review and meta-analysis

“…This might be due to wealthier mothers are more likely to follow the recommended level of antenatal care visits, deliver at health institution and receive adequate postnatal care which can help them to timely initiate breast feeding, whereas poor mothers are deprived of those economic advantages. (88-90) In our previous meta-analyses(30, 40, 41), we affirmed that antenatal care, health institution delivery, and postnatal care significantly associated with optimal breast feeding. In contrast, evidence from Timor-Leste demographic and health survey showed that income was not associated with TIBF.…”

“…(31-39) In our previous systematic review of 70 observational studies, we identified 18 predictors categorized into four groups: proximal (maternal occupational status, maternal knowledge on TIBF, and breast feeding guidance and counselling), proximal-intermediate (place of delivery, mode of delivery, birth attendant and sex of newborn), distal-intermediate (antenatal care, postnatal care, prelacteal feeding, and colostrum feeding) and distal (paternal educational status, household income, marital status, media exposure, family size, breast feeding experience, place of residence, birth order, parity, and iron-folate supplementation). (30) In the follow-up meta-analyses(30, 40, 41), we confirmed that breast feeding guidance and counselling, mode of delivery, place of delivery, antenatal care visit and colostrum discarding significantly associated with TIBF practice, whereas maternal occupational status, maternal or caregiver’s age and sex of newborn not significantly associated with TIBF.…”

Multidimensional factors predicting exclusive breastfeeding in Ethiopia: evidence from a meta-analysis of studies in the past 10 years

“…18 The follow-up meta-analyses confirmed that maternal occupational status, gender of newborn, age of newborn, guidance and counseling on breastfeeding, colostrum discarding, ANC, PNC, vaginal delivery, health institution delivery, timely initiation of breastfeeding significantly increased the odds of EBF. 18,27,28 There is no doubt regarding the multiple benefits of breastfeeding for infants and Essential Nutrition Actions / Integrated Infant and Young Feeding Counseling Services. 30 Despite the reduced under-five mortality, the rate of malnutrition, rate of stunting and rate of underweight 31 , the rate of EBF has fallen short of the Health Sector Transformation Plan 2016-2020 30 , National Nutrition Program 2016-2020 32 and WHO global target.…”

“…18 The follow-up meta-analyses confirmed that maternal occupational status, gender of newborn, age of newborn, guidance and counseling on breastfeeding, colostrum discarding, ANC, PNC, vaginal delivery, health institution delivery, timely initiation of breastfeeding significantly increased the odds of EBF. 18,27,28…”