Predictors of early initiation of breastfeeding in women who birth in government hospitals in Sri Lanka: an assessment across socio-demographic and clinical measures

Abstract

Introduction Early initiation of breastfeeding can be predicted by socio-demographic and clinical characteristics of birthing women, and health care support for breastfeeding. However, the relative influence of many of these characteristics on early initiation of breastfeeding has not been established in Sri Lanka. Therefore, we aimed to identify predictors of early initiation of breastfeeding across a wide range of socio-demographic and clinical characteristics. Methods A cross-sectional survey was conducted with women who had a live baby across four government hospitals in Sri Lanka. Women who were 12 hours post-birth and still admitted to the hospital were invited to participate. Data were collected by eliciting quantitative data through participant interviews and extracting additional information from their medical records. Contribution of socio-demographic and clinical characteristics to explaining variations in early initiation of breastfeeding was estimated using binary logistic regression analysis with simultaneous adjustment. Results The response rate was 83.8%, with 302 women participating. The proportion of women who initiated breastfeeding within one hour of birth was 64.5% (n=195). Women were more likely to initiate breastfeeding within one hour of birth if their body mass index was < 18.5 kg/m2 (OR: 4.17; 95% CI: 1.23-14.05), and less likely if they gave birth by elective caesarean section (OR: 0.27; 95% CI: 0.14-0.51), were administered antibiotics (OR: 0.4; 95% CI: 1.05-4.73) and had a baby with respiratory distress (OR: 0.08, 95% CI: 0.01-0.57). Conclusion Current intrapartum care practices associated with elective caesarean and antibiotic administration, and immediate care of babies with respiratory distress, should be critically reviewed for understanding the mechanisms underlying their negative impact on breastfeeding initiation in Sri Lanka.