Impact of early infant feeding practices on mortality in low birth weight infants from rural Ghana

Edmond, Karen; Kirkwood, Betty; Tawiah, Charlotte; Owusu‐Agyei, Seth

doi:10.1038/jp.2008.19

Cited by 37 publications

(28 citation statements)

References 21 publications

(18 reference statements)

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“…Because early breastfeeding is associated with exclusive and total breastfeeding duration, and the latter with reduced morbidity and mortality, it is reasonable to expect that early breastfeeding will reduce these poor outcomes. However, only two observational studies conducted in Ghana and Nepal evaluated the effect of early breastfeeding on neonatal mortality, both showing that delayed initiation was associated with higher neonatal mortality [293,294]. A third study from Egypt also reported increased diarrhea incidence in the first six months of life among babies who were put to the breast three or more days after birth [295].…”

Section: Resultsmentioning

confidence: 99%

Global report on preterm birth and stillbirth (3 of 7): evidence for effectiveness of interventions

Barros

Bhutta

Batra

et al. 2010

BMC Pregnancy Childbirth

215

174

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IntroductionInterventions directed toward mothers before and during pregnancy and childbirth may help reduce preterm births and stillbirths. Survival of preterm newborns may also be improved with interventions given during these times or soon after birth. This comprehensive review assesses existing interventions for low- and middle-income countries (LMICs).MethodsApproximately 2,000 intervention studies were systematically evaluated through December 31, 2008. They addressed preterm birth or low birth weight; stillbirth or perinatal mortality; and management of preterm newborns. Out of 82 identified interventions, 49 were relevant to LMICs and had reasonable amounts of evidence, and therefore selected for in-depth reviews. Each was classified and assessed by the quality of available evidence and its potential to treat or prevent preterm birth and stillbirth. Impacts on other maternal, fetal, newborn or child health outcomes were also considered. Assessments were based on an adaptation of the Grades of Recommendation Assessment, Development and Evaluation criteria.ResultsMost interventions require additional research to improve the quality of evidence. Others had little evidence of benefit and should be discontinued. The following are supported by moderate- to high-quality evidence and strongly recommended for LMICs:• Two interventions prevent preterm births—smoking cessation and progesterone• Eight interventions prevent stillbirths—balanced protein energy supplementation, screening and treatment of syphilis, intermittant presumptive treatment for malaria during pregnancy, insecticide-treated mosquito nets, birth preparedness, emergency obstetric care, cesarean section for breech presentation, and elective induction for post-term delivery• Eleven interventions improve survival of preterm newborns—prophylactic steroids in preterm labor, antibiotics for PROM, vitamin K supplementation at delivery, case management of neonatal sepsis and pneumonia, delayed cord clamping, room air (vs. 100% oxygen) for resuscitation, hospital-based kangaroo mother care, early breastfeeding, thermal care, and surfactant therapy and application of continued distending pressure to the lungs for respiratory distress syndromeConclusionThe research paradigm for discovery science and intervention development must be balanced to address prevention as well as improve morbidity and mortality in all settings. This review also reveals significant gaps in current knowledge of interventions spanning the continuum of maternal and fetal outcomes, and the critical need to generate further high-quality evidence for promising interventions.

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Section: Resultsmentioning

confidence: 99%

Global report on preterm birth and stillbirth (3 of 7): evidence for effectiveness of interventions

Barros

Bhutta

Batra

et al. 2010

BMC Pregnancy Childbirth

215

174

View full text Add to dashboard Cite

show abstract

“…However, this finding should not be interpreted to mean that early initiation of breastfeeding is not important for child well‐being, as the neonatal and infant survival benefits of early initiation of breastfeeding are well established (Edmond et al . , , ; Mullany et al . ).…”

Section: Discussionmentioning

confidence: 99%

Determinants of child stunting in the Royal Kingdom of Bhutan: an in‐depth analysis of nationally representative data

Aguayo¹,

Badgaiyan²,

Paintal³

2014

Maternal & Child Nutrition

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Stunting is associated with poor survival and development in children. Our analysis identifies the factors most significantly associated with child stunting in Bhutan using a nationally representative sample of 2085 children 0–23 months old. We find that 27.5% of children were stunted and almost half (42.6%) of the stunted children were severely stunted. Children's mean height-for-age z-score deteriorated significantly with age (from −0.23 in infants 0–5 months old to −1.60 in children 18–23 months old) and levels of severe stunting were significantly higher among boys. Multivariate regression analysis indicates that children from the Eastern/Western regions had a 64% higher odds of being stunted than children from the Central region (OR 1.64; 95% CI 1.29–2.07); similarly, children from the two lower wealth quintiles had 37% higher odds of being stunted than children from the two upper wealth quintiles (OR 1.37; 95% CI 1.00–1.87). Children whose mothers received three or fewer antenatal care visits during the last pregnancy had a 31% higher odds of being stunted (OR 1.31; 95% CI 1.01–1.69) while children whose mothers did not receive antenatal care from a doctor, nurse or midwife had a 51% higher odds of being stunted (OR 1.51; 95% CI 1.18–1.92). Recommended complementary feeding practices tended to be associated with lower odds of stunting, particularly in the first year of life. Specifically, children who were not fed complementary foods at 6–8 months had about threefold higher odds of being severely stunted than children who were fed complementary foods (OR 2.73; 95% CI 1.06–7.02).

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“…We know that exclusive breast feeding has a protective effect on overall mortality and morbidity from pneumonia and gastrointestinal infection, so it is important that we target these specific issues much more for mothers in these settings. [27][28][29][30][31][32] Despite health workers reporting their counselling of mothers on supporting their LBW baby (breast feeding, keeping the babies warm and recognition of illness), they also blamed mothers for lack of adherence to their advice. This is likely to be shaped in part by poor education and traditional beliefs, but our findings show challenges faced by caregivers are compounded by a general lack of support for mothers who have high expectations placed on them from health workers and communities.…”

Section: Lack Of Resourcesmentioning

confidence: 99%

Understanding the challenges to caring for low birthweight babies in rural southern Malawi: a qualitative study exploring caregiver and health worker perceptions and experiences

et al. 2017

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BackgroundLow birthweight (LBW) babies account for >80% of neonatal mortality in sub-Saharan Africa and South Asia and those who survive the neonatal period are still at risk of detrimental outcomes. LBW is a major public health problem in Malawi and strongly contributes to the country’s high neonatal mortality rate. We aimed to get a better understanding of the care of LBW babies in rural Malawi in order to inform action to improve their outcomes.MethodsQualitative methods were used to identify challenges faced by caregivers and health workers within communities and at the rural facility level. We conducted 33 in-depth interviews (18 with caregivers; 15 with health workers) and 4 focus group discussions with caregivers. Interviews were recorded, transcribed and translated. Thematic analysis was used to index the data into themes and develop a robust analytical framework.ResultsCaregivers referred to LBW babies as weak, with poor health, stunted growth, developmental problems and lack of intelligence. Poor nutrition of the mother and illnesses during pregnancy were perceived to be important causes of LBW. Discrimination and stigma were described as a major challenge faced by carers of LBW babies. Problems related to feeding and the high burden of care were seen as another major challenge. Health workers described a lack of resources in health facilities, lack of adherence to counselling provided to carers and difficulties with continuity of care and follow-up in the community.ConclusionThis study highlights that care of LBW babies in rural Malawi is compromised both at community and rural facility level with poverty and existing community perceptions constituting the main challenges. To make progress in reducing neonatal mortality and promoting better outcomes, we must develop integrated community-based care packages, improve care at facility level and strengthen the links between them.

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Impact of early infant feeding practices on mortality in low birth weight infants from rural Ghana

Cited by 37 publications

References 21 publications

Global report on preterm birth and stillbirth (3 of 7): evidence for effectiveness of interventions

Global report on preterm birth and stillbirth (3 of 7): evidence for effectiveness of interventions

Determinants of child stunting in the Royal Kingdom of Bhutan: an in‐depth analysis of nationally representative data

Understanding the challenges to caring for low birthweight babies in rural southern Malawi: a qualitative study exploring caregiver and health worker perceptions and experiences

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