Factors associated with Early Initiation of Breastfeeding in Western Nepal

Khanal, Vishnu; Jordan, Scott; Lee, Andy H.; Karkee, Rajendra; Binns, Colin

doi:10.3390/ijerph120809562

Cited by 86 publications

(134 citation statements)

References 27 publications

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“…These results have been shown elsewhere: a recent meta-analysis indicated that early initiation of breastfeeding is low globally [30], and an additional systematic review identified prelacteal feeding as a major barrier to early initiation of breastfeeding in South Asia [31]. Other studies have shown a delay in breastfeeding associated with prelacteal feeding in Ethiopia [23, 32] and western Nepal [33]. …”

Section: Discussionsupporting

confidence: 57%

Early newborn ritual foods correlate with delayed breastfeeding initiation in rural Bangladesh

et al. 2016

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BackgroundEarly and exclusive breastfeeding may improve neonatal survival in low resource settings, but suboptimal breastfeeding still exists in areas with high infant mortality. Prelacteal feeding, the practice of giving a non-breastmilk food as a neonate’s first food, has been associated with suboptimal breastfeeding practices. We examined the association of feeding a non-breastmilk food in the first three days of life (early neonatal food, or ENF) with time from birth to initiation of breastfeeding among 25,286 Bangladeshi mother-neonate pairs, in a secondary analysis of a randomized controlled trial in northwestern rural Bangladesh conducted from 2001–2007.MethodsTrained interviewers assessed the demographic characteristics during pregnancy. At three months postpartum, the interviewers visited participants again and retrospectively assessed demographic and breastfeeding characteristics surrounding the birth. We assessed the relationship between ENF and time to initiation of breastfeeding in hours in both unadjusted and adjusted linear regression analyses. We also calculated reverse cumulative distribution curves for time to initiation of breastfeeding and analyses were stratified by an infant’s ability to breastfeed normally at birth.ResultsThe mean ± SD time from birth to initiation of breastfeeding was 30.6 ± 27.9 hours. Only 2,535 (10.0%) of women reported initiating breastfeeding in the first hour after birth and 10,207 (40.4%) reported initiating breastfeeding in the first 12 hours after birth. In adjusted linear regression analyses, feeding ENF was associated with a significant increase in time, in hours, to breastfeeding initiation both among children not able to breastfeed at birth (37.4; 95% CI 33.3, 41.5) and among children able to breastfeed at birth (13.3; 95% CI 12.7, 14.0).ConclusionsFeeding ENF was strongly associated with delayed initiation of breastfeeding, even after adjusting for other related factors and stratifying on the neonate’s ability to suckle normally after birth. More research is needed to understand the impact of these findings on optimal breastfeeding in this setting. It is possible that ENF feeding and the ability to breastfeed immediately after birth are interrelated in their respective associations to suboptimal breastfeeding initiation. This study in a large population representative of other populations in rural South Asia, demonstrates significantly longer times to breastfeeding initiation than previously appreciated, with a possible important role of ENF feeding.Trial registrationThe randomized controlled trial on which this analysis is based, “Impact of Maternal Vitamin A or Beta-Carotene Supplementation on Maternal and Infant Mortality in Bangladesh”, was registered with ClinicalTrials.gov as trial number ID GHS-A-00-03-00019-00 and identifier NCT00198822. The identifier was first received September 12, 2005 (retrospectively registered). The first participant was enrolled in August 2001.Electronic supplementary materialThe online version of this article (doi:10.1186/s13...

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Section: Discussionsupporting

confidence: 57%

Early newborn ritual foods correlate with delayed breastfeeding initiation in rural Bangladesh

et al. 2016

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“…This district is located in the south-western plain areas (Terai) of Nepal bordering India in the south. The methodology of this study has been described previously [31, 32] but briefly 735 mother-infant pairs (rural 378, urban 357) were randomly recruited from 15 rural and 12 urban locations. Mothers were recruited from their communities within 30 days of giving birth and followed up during the fourth (90–120 days) and sixth months (150–180 days) (Fig.…”

Section: Methodsmentioning

confidence: 99%

Implications of methodological differences in measuring the rates of exclusive breastfeeding in Nepal: findings from literature review and cohort study

Khanal

Lee

Jordan

et al. 2016

BMC Pregnancy Childbirth

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BackgroundCorrect measurement and continuous monitoring of exclusive breastfeeding are essential to promote exclusive breastfeeding. Measuring exclusive breastfeeding is a complex issue as rates can vary according to the definition, measurement period, questions asked, and infant’s age. This article reviewed the methodology of reporting exclusive breastfeeding in Nepal, and compared exclusive breastfeeding rates using data from a cohort study undertaken in western Nepal.MethodsA literature review was first conducted on studies published during 2000–2014. In our cohort study, 735 mother-infant pairs were recruited within the first month postpartum and followed up during the fourth and sixth months.ResultsThe majority of studies in Nepal, including national surveys, used the World Health Organization (WHO) recommended definition (only breastmilk with the exception of medicine and vitamin syrup), and the most common measurement period was a 24-h recall. Our data demonstrated that the exclusive breastfeeding rate during the sixth month was 8.9% using the recall-since-birth method but was 18.7% using the 24-h recall method. Substantial differences in rates were also found during the first (66.3% vs 83.9%) and fourth months (39.2% vs 61.1%).ConclusionWe found that recent studies reporting exclusive breastfeeding in Nepal varied considerably in methodology. The most commonly used measurement, the 24-h recall, leads to over-estimation of the prevalence of exclusive breastfeeding when compared to the recall-since-birth method. A common standard of reporting exclusive breastfeeding is clearly needed for evidence-based decision making.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1180-9) contains supplementary material, which is available to authorized users.

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“…1 There are very few studies examining the role of awareness of world health organization's breastfeeding recommendation in determining mothers breastfeeding decisions and practice. 2 As a result, the impact of promoting the recommendation on rates of breastfeeding is less clear.…”

Section: Introductionmentioning

confidence: 99%

Knowledge and factors affecting initiation of breast feeding in post-natal mothers in a tertiary care center

et al. 2018

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Background: The study was planned to evaluate awareness of breast feeding among mother, institutional quality indicators of early breast feeding. The objective was to know factors causing delay in breast feeding initiation, to assess knowledge, cultural practices, and quality indicators of hospital regarding breast feeding initiative.Methods: The observational study was conducted over a period of 3months from July 2017-Sept 2017 in a tertiary care centre of India. 118 postnatal mothers were interviewed for time of first breast feeding (dependent variable or outcome), and independent variables age, education , religion, parity, occupation of mother, antenatal visits, prelacteal feeds, customs of not breast feeding, duration of labour, mode of delivery, sedation, pain after delivery, baby over mother abdomen after birth, institutional quality indicators-knowledge of breast feeding given by doctor /nurses, relatives, self reading, mothers with correct attachment and position of baby during breast feeding and separation of mother and baby post delivery.Results: Mean time of initiation of breast feeding was 1340.262min after birth. Prelacteal feeds, lack of education, cesarean deliveries, parity of mother, sedation, anesthesia during cesarean and lack of counselling by staff nurses were found to have early increased time of initiation of breast feeding.Conclusions: Great lacuna in knowledge, attitude and practice of early breast feeding of mother.

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Factors associated with Early Initiation of Breastfeeding in Western Nepal

Cited by 86 publications

References 27 publications

Early newborn ritual foods correlate with delayed breastfeeding initiation in rural Bangladesh

Early newborn ritual foods correlate with delayed breastfeeding initiation in rural Bangladesh

Implications of methodological differences in measuring the rates of exclusive breastfeeding in Nepal: findings from literature review and cohort study

Knowledge and factors affecting initiation of breast feeding in post-natal mothers in a tertiary care center

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