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Rossi E, Levasseur P, Clément M. "Mother's milk": Is there a social reversal in breastfeeding practices along with economic development? Soc Sci Med 2024; 345:116444. [PMID: 38044247 DOI: 10.1016/j.socscimed.2023.116444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 11/13/2023] [Accepted: 11/17/2023] [Indexed: 12/05/2023]
Abstract
Previous studies suggest that macro- and micro-level factors jointly influence breastfeeding (BF) practices, but empirical evidence on the dynamics of such interactions along with the process of a country's economic development remains limited. Based on 42 Demographic Health Surveys (DHS) conducted in 15 Asian countries with a large time window (1990-2017), we thus test the existence of a reversal in the association between household wealth and BF practices throughout the development process. Four BF indicators (early initiation of BF, exclusive BF, continued BF at one year and two years) are examined, along with a standardized asset-based household wealth index allowing for cross-wave and cross-country comparisons. To highlight the dynamics of the wealth-BF association, we carry out econometric estimations, including interaction terms between household wealth and the country's level of economic development (low, medium, and high) or time. Instrumental variable estimations are also performed to limit suspected endogeneity issues. Our results confirm a transition in the wealth gradient of exclusive BF and continued BF in Asian countries. More precisely, while these practices are pro-poor in the poorest countries of the sample, they progressively spread to wealthier households along with the level of economic development. For exclusive BF, this transition has resulted in a reversal of the wealth gradient at the end of the period (i.e., exclusive BF prevalence among the rich overpassing that of the poor). We fail, however, to observe this kind of transition for early initiation of BF, this practice remaining pro-poor, whatever the level of economic development. To sum up, our results provide robust evidence of a transition in the wealth gradient of some BF practices along with economic development and time, and thus largely echo the literature exploring the social reversal hypothesis in the case of non-communicable diseases.
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Ahmed S, Mahmud N, Farzana N, Parvin MI, Alauddin M. Early Initiation of Breastfeeding (EIBF) and Its Associated Factors Among Mothers With Infants Aged 0 to 6 Months in Jashore District, Bangladesh: A Cross-Sectional Study. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2023; 42:737-745. [PMID: 36630312 DOI: 10.1080/27697061.2022.2161663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/02/2022] [Accepted: 12/17/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Early initiation of breastfeeding (EIBF) is one of the most successful interventions for minimizing newborn morbidity and death. According to the database (Bangladesh Demographic Health Survey 2014), only around half of babies begin breastfeeding during the first hour of life in Bangladesh. The goal of this study was to determine the prevalence of EIBF in the Jashore area while also investigating its associated factors among mothers of infants aged 0 to 6 months in order to better understand the variables that impacted breastfeeding initiation. METHOD A cross-sectional study was conducted in the maternity wards of the 3 busiest hospitals in the Jashore district of Bangladesh from May to July 2019. Using random sampling, a total of 423 mother-infant pairs were chosen. Pearson chi-square test and bivariable and multivariable logistic regression statistical analysis were used to identify factors linked to EIBF. RESULTS The prevalence of EIBF was 46.3% (196/423). Mothers who had skin-to-skin contact after delivery (adjusted odds ratio [AOR], 2.25; 95% confidential interval [CI], 1.40-3.59), who did not deliver prelacteal food (AOR, 3.68; 95% CI, 1.65-8.21), and who provided colostrum (AOR, 5.89; 95% CI, 1.62-21.49) were more likely to begin breastfeeding within 1 hour than were their counterparts. CONCLUSIONS EIBF was found to be strongly linked with skin-to-skin contact after delivery, avoidance of prelacteal feeding, and colostrum feeding practice. As a result, we strongly urge public health officials and health care practitioners to encourage these feeding behaviors in order to increase EIBF.
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Affiliation(s)
- Suzon Ahmed
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Niaz Mahmud
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
- Food and Nutritional Sciences Program, North Carolina Agricultural and Technical State University, Greensboro, North Carolina, USA
| | - Nisat Farzana
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Mst Irin Parvin
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Md Alauddin
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
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Khanal V. Influence of breastfeeding education and support on predominant breastfeeding: Findings from a community-based prospective cohort study in Western Nepal. Health Sci Rep 2023; 6:e1548. [PMID: 37680209 PMCID: PMC10480414 DOI: 10.1002/hsr2.1548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023] Open
Abstract
Background and Aims Breastfeeding education and support have the potential to improve breastfeeding outcomes. However, there is a lack of research on the impact of breastfeeding education on predominant breastfeeding in Nepal and other South Asian countries. This study aimed to report the rate of predominant breastfeeding at the first, fourth, and sixth months of birth and examine the influence of breastfeeding promotion on predominant breastfeeding. Methods A community-based prospective cohort study was conducted in western Nepal. A total of 735 mother-infant pairs were recruited within 30 days of childbirth and followed up at the fourth and sixth months to collect data on infant feeding practices. Results The rate of predominant breastfeeding at first, fourth, and sixth months were 88.6% (N = 735), 78.2% (N = 715), and 26.3% (N = 711), respectively, showing a significant decline with infant age. Mothers who received support on breastfeeding skills (Adjusted Odds Ratio [AOR]: 2.55; 95% confidence interval [CI]: 1.73-3.75), those who received advice on keeping mother-infant together (AOR: 2.19; 95% CI: 1.14-4.22) and who had initiated breastfeeding within 1 h of childbirth (AOR: 2.55; 95% CI: 1.73-3.75), and who were educated, had higher likelihood of predominant breastfeeding at sixth month. Conclusion This study asserts a need for continuous and focused breastfeeding promotion programs to educate and support lactating mothers.
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Wasti SP, Shrestha A, Dhakal P, Gc VS. The prevalence of exclusive breastfeeding practice in the first six months of life and its associated factors in Nepal: A systematic review and meta-analysis. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 37:100863. [PMID: 37269619 DOI: 10.1016/j.srhc.2023.100863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 05/12/2023] [Accepted: 05/24/2023] [Indexed: 06/05/2023]
Abstract
Despite the global emphasis on breastfeeding, exclusive breastfeeding (EBF) in the first six months of life still lag behind the global recommendations in low- and middle-income countries, such as Nepal. This systematic review aims to determine the prevalence of EBF in the first six months of life and the associated factors determining EBF practices in Nepal. The databases PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, MIDIRS, DOAJ, and the NepJOL were searched for peer-reviewed literature published up to December 2021. The JBI quality appraisal checklist was used to assess the quality of studies. Analyses were performed by pooling together studies using the random-effect model, and the I2 test was used to assess the heterogeneity of the included studies. A total of 340 records were found, out of which 59 full-text were screened. Finally, 28 studies met the inclusion criteria and were selected for analysis. The pooled prevalence of EBF was 43 % (95 % confidence interval: 34-53). The odds ratio for the type of delivery was 1.59 (1.24-2.05), for ethnic minority groups 1.33 (1.02-1.75) and for first-birth order 1.89 (1.33-2.67). We found a lower prevalence of exclusive breastfeeding practice in Nepal compared to the national target. Multifaceted, effective, evidence-based interventions would encourage individuals in the exclusive breastfeeding journey. Incorporating the BEF counselling component into Nepal's existing maternal health counselling package may help promote exclusive breastfeeding practice. Further research to explore the reasons for the suboptimal level of EBF practice would help develop the targeted interventions pragmatically.
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Affiliation(s)
- Sharada P Wasti
- School of Human Sciences, University of Greenwich, London, UK
| | | | - Pushpa Dhakal
- National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Vijay S Gc
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK.
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Kumar R, Amir-Ud-Din R, Ahmed J, Asim M, Rashid F, Khan SA, Ali S, Pongpanich S. Correlates of early initiation of breast feeding and prelacteal feeding: a cross-sectional study in Sindh province of Pakistan. BMJ Open 2023; 13:e069902. [PMID: 36725095 PMCID: PMC9896234 DOI: 10.1136/bmjopen-2022-069902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES The objective of this study was to determine the prevalence and correlates of early initiation of breast feeding and prelacteal feeding in highly disadvantaged districts in Pakistan. DESIGN This cross-sectional study design. SETTINGS This study was carried out in twelve districts of the Sindh province of Pakistan. PARTICIPANTS A total of 4800 mothers with children under 2 years, selected through a multistage random sampling method. DATA ANALYSIS Bivariate association, survival analysis (Kaplan-Meier and Cox proportional hazard techniques), multivariate linear regression and the ordinary least square model were used. RESULTS The results show that the prevalence of early initiation of breast feeding was 68% and prelacteal feeding was 32%. Adequate treatment, proper guidance at antenatal care visits, postpartum health check, normal birth with skilled birth attendants, institutional birth, skin-to-skin contact at birth and birth size were all associated with early breastfeeding initiation (p<0.001). The odds of early initiation of breast feeding after birth are higher if the respondents received proper guidance (OR 2.05; 95% CI 1.02 to 4.11) or made skin-to-skin contact (OR 10.65; 95% CI 6.82 to 16.65). Bivariate association between the prelacteal feeding and a set of correlates suggests that all variables under study were significantly associated with the outcome variable of interest at a 95% or higher significance level. The factors which significantly reduced the odds of prelacteal feeding were adequate treatment (OR 0.29; 95% CI 0.23 to 0.37) and postpartum health check (OR 0.65; 95% CI 0.53 to 0.80). CONCLUSION Sudy concludes that the correlates like adequate treatment of mothers during labour, postpartum health check-up, normal birth with skilled birth attendants, institutional births and skin-to-skin contact between mother and the baby determine the early initiation of breast feeding and prelecteal feeding. Early initiation of breast feeding needs to be encouraged, and communities must be educated against the use of prelacteal feeding.
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Affiliation(s)
- Ramesh Kumar
- Health Systems & Policy Department, Health Services Academy, Islamabad, Pakistan
- College of Public Health Sciences, Chulalongkorn University College of Public Health Sciences, Bangkok, Thailand
| | - Rafi Amir-Ud-Din
- Economics Department, COMSATS Institute of Information Technology - Lahore Campus, Lahore, Punjab, Pakistan
| | - Jamil Ahmed
- Commnuity Health and Family Medicine Department, Arabian Gulf University, Manama, Bahrain
| | - Muhammad Asim
- Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Fozia Rashid
- Health Systems & Policy Department, Health Services Academy, Islamabad, Pakistan
- Gynecology and Obestetrics, Begum Jan Hospital, Islamabad, Pakistan
| | - Shahzad Ali Khan
- Health Systems & Policy Department, Health Services Academy, Islamabad, Pakistan
| | - Shaukat Ali
- Climate Change Impact Studies Centre, Ministry of Climate Change, Islamabad, Pakistan
| | - Sathirakorn Pongpanich
- College of Public Health Sciences, Chulalongkorn University College of Public Health Sciences, Bangkok, Thailand
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Hollow BL, Bulsara MK, Pant PD, Wallace HJ. Antenatal and perinatal service delivery associations with breastfeeding outcomes in Nepal: Analysis of the 2016 Nepal Demographic and Health Survey. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001824. [PMID: 37068091 PMCID: PMC10109470 DOI: 10.1371/journal.pgph.0001824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 03/21/2023] [Indexed: 04/18/2023]
Abstract
Infant and Young Child Feeding (IYCF) breastfeeding guidelines of the World Health Organization (WHO) have been promoted in Nepal since the early 1990s. This study investigated whether antenatal and perinatal service delivery in Nepal are associated with early initiation of breastfeeding and age-appropriate feeding practice (exclusive breastfeeding to six months; introduction of complementary foods at six months with continued breastfeeding to two years). Data from the 2016 Nepal Demographic and Health Survey (NDHS) were analysed using multivariable logistic regression. The unit of analysis was an interviewed woman and her last-born child aged 0-23 months. We examined number of antenatal visits, place and type of delivery, infant-mother skin-to-skin contact post-delivery, and breastfeeding observation and counselling by a healthcare provider within two days post-delivery. Of 1938 mother-infant dyads, 1073 (55.4%) commenced breastfeeding within one hour of delivery and 1665 (85.9%) were engaged in age-appropriate feeding. Breastfeeding within one hour of delivery was associated with infants delivered vaginally (aOR: 4.76, 95% CI: 2.96-7.65), infant-mother skin-to-skin contact post-delivery (aOR:2.10, 95% CI: 1.63-2.72) and observation of breastfeeding by a healthcare provider within two days post-delivery (aOR: 1.58, 95% CI: 1.20-2.08). Age-appropriate feeding was lowest amongst mothers with infants aged 4-5 months (40.8%) compared to those with infants aged 0-1 month (aOR: 0.158, 95% CI: 0.083-0.302). Antenatal and perinatal service delivery were not significantly associated with age-appropriate feeding. Further promotion of infant-mother skin-to-skin contact post-delivery (including after caesarean delivery) and observation of early breastfeeding may increase the rate of breastfeeding within one hour of delivery. Promotion of exclusive breastfeeding in antenatal and perinatal services and additional postnatal support should be considered to increase exclusive breastfeeding of infants to six months. These improvements may be achieved through enhanced implementation of the Baby Friendly Hospitals Initiative and effective training and sufficient practice for skilled birth attendants.
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Affiliation(s)
| | - Max K Bulsara
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Australia
| | | | - Hilary Jane Wallace
- School of Medicine, The University of Notre Dame Australia, Fremantle, Australia
- School of Population and Global Health, The University of Western Australia, Crawley, Australia
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Atchan M, Graham K, Hartney N, Martis R, Kearney L, Davey K, Daellenbach R, Hall H, Sweet L. Either 'a blessing in disguise', or 'I couldn't get help,': Australian and Aotearoa NZ women's experiences of early infant feeding during COVID-19. Women Birth 2022; 36:e305-e313. [PMID: 36443218 PMCID: PMC9699799 DOI: 10.1016/j.wombi.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND To manage the COVID-19 pandemic, public health restrictions and a rapid pivot to telehealth occurred. Peripartum services were significantly affected by a strained infrastructure. Decreased face to face access to health services and support affected maternal experiences and confidence internationally, yet little was reported with the Australian and Aotearoa New Zealand context. AIM To explore the early parenting and infant feeding experiences of new mothers from Australia and Aotearoa New Zealand in the context of a pandemic. METHODS An interpretive qualitative approach and thematic analysis obtained an in-depth understanding of the experiences of 27 mothers who gave birth during the first wave of the COVID-19 pandemic in 2020. FINDINGS Australian and Aotearoa New Zealand women reported similar experiences, which varied contextually. Restrictions and requirements impacted favourably and unfavourably. Many women found the peace and space of social distancing an unexpected benefit and were proud of their achievements, whilst others shared feelings of isolation and distress. Some women felt they instinctively did what they needed to do. Experiences correlated with differing levels of self-efficacy. DISCUSSION While many women relished the freedom from social obligations when faced with feeding challenges, there was general dissatisfaction with the level of support available. Care was fragmented, and health care needs were unmet, impacting feeding and parenting decisions and mental health. CONCLUSION Access to timely and appropriate professional support is an important factor in establishing breastfeeding and developing parenting confidence, particularly in the context of a pandemic and should be a health policy priority.
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Affiliation(s)
- Marjorie Atchan
- School of Nursing, Midwifery and Public Health, University of Canberra, Locked Bag 1, Canberra, ACT 2617 Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia,Corresponding author at: School of Nursing, Midwifery and Public Health, University of Canberra, Locked Bag 1, Canberra, ACT 2617, Australia
| | - Kristen Graham
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Nicki Hartney
- Deakin University, School of Nursing and Midwifery, 1 Gheringhap St., Geelong, Vic. 3227 Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Ruth Martis
- Liggins Institute, The University of Auckland, Aotearoa, New Zealand,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Lauren Kearney
- The University of Queensland, School of Nursing, Midwifery & Social Work, Brisbane, QLD 4072 Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Kym Davey
- School of Nursing and Midwifery, Monash University, Peninsula campus, McMahons Rd, Frankston, VIC 3199 Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Rea Daellenbach
- Department of Health Practice, Ara Institute of Canterbury, New Zealand,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Helen Hall
- Institute of Health and Wellbeing, Federation University, Mt Helen Campus, Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Linda Sweet
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia,Institute of Health and Wellbeing, Federation University, Mt Helen Campus, Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
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Zavala-Soto JO, Hernandez-Rivero L, Tapia-Fonllem C. Pro-lactation cesarean section: Immediate skin-to-skin contact and its influence on prolonged breastfeeding. FRONTIERS IN SOCIOLOGY 2022; 7:908811. [PMID: 36237277 PMCID: PMC9551215 DOI: 10.3389/fsoc.2022.908811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/26/2022] [Indexed: 06/16/2023]
Abstract
Mexico has a high rate of cesarean sections and one of the lowest prevalences of exclusive breastfeeding in all of Latin America. There are known factors that can compensate for the disadvantages and drawbacks of cesarean delivery over breastfeeding. In terms of studying the variations of breastfeeding experiences, this work specifically concentrates on exploring different changes in the technique of cesarean section, related to immediate Skin-to-Skin Contact for women with high and low risk pregnancies, which may in turn influence Maternal Satisfaction and the choice of Prolonged Breastfeeding. A convenience sample of (n = 150) women who underwent cesarean section in a private hospital in Mexico between the years 2015-2020 participated in this study, the participants answered a structured interview protocol designed for the specific purposes of this study. The analysis was guided grounded theory. The majority of these participants (n = 121, 82.3%) were in labor before entering a cesarean section. The most common indications for cesarean section were those of active-phase arrest and regarding maternal complications, previous cesarean sections (n = 59) and hypertensive complications (n = 15) were the most frequent. For fetal complications, non-cephalic fetal positions (n = 12) were reported as the most common. Despite the different conditions of their cesarean sections, almost all the women experienced Skin-to-Skin Contact during the cesarean section. Almost all of them managed to breastfeed for more than 6 months and many of them breastfed their babies for up to 2 years. The main factors associated to prolonged breastfeeding and satisfaction were higher education degrees, immediate skin-to-skin contact during surgery and counseling on breastfeeding after the baby was born. Our findings highlight the importance of considering adjustments during and after a cesarean section, making it more focused on women and toward better probabilities of achieving prolonged breastfeeding in Mexican women. This being a first step for future studies of direct interventions in the breastfeeding process, such as the management of skin-to-skin contact and professional support after birth for guided breastfeeding.
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Affiliation(s)
- José Octavio Zavala-Soto
- Programs of Master and Doctorate in Social Sciences, University of Sonora, Hermosillo, Mexico
- Obstetrics Department of the San José Hospital of Hermosillo, Hermosillo, Sonora, Mexico
| | | | - César Tapia-Fonllem
- Programs of Master and Doctorate in Social Sciences, University of Sonora, Hermosillo, Mexico
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Dulal S, Prost A, Karki S, Merom D, Shrestha BP, Bhandari B, Manandhar DS, Osrin D, Costello A, Saville NM. Feeding, caregiving practices, and developmental delay among children under five in lowland Nepal: a community-based cross-sectional survey. BMC Public Health 2022; 22:1721. [PMID: 36088374 PMCID: PMC9464411 DOI: 10.1186/s12889-022-13776-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 07/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Nurturing care, including adequate nutrition, responsive caregiving and early learning, is critical to early childhood development. In Nepal, national surveys highlight inequity in feeding and caregiving practices for young children. Our objective was to describe infant and young child feeding (IYCF) and cognitive and socio-emotional caregiving practices among caregivers of children under five in Dhanusha district, Nepal, and to explore socio-demographic and economic factors associated with these practices. Methods We did a cross-sectional analysis of a subset of data from the MIRA Dhanusha cluster randomised controlled trial, including mother-child dyads (N = 1360), sampled when children were median age 46 days and a follow-up survey of the same mother-child dyads (N = 1352) when children were median age 38 months. We used World Health Organization IYCF indicators and questions from the Multiple Indicator Cluster Survey-4 tool to obtain information on IYCF and cognitive and socio-emotional caregiving practices. Using multivariable logistic regression models, potential explanatory household, parental and child-level variables were tested to determine their independent associations with IYCF and caregiving indicators. Results The prevalence of feeding indicators varied. IYCF indicators, including ever breastfed (99%), exclusive breastfeeding (24-hour recall) (89%), and vegetable/fruit consumption (69%) were common. Problem areas were early initiation of breastfeeding (16%), colostrum feeding (67%), no pre-lacteal feeding (53%), timely introduction of complementary feeding (56%), minimum dietary diversity (49%) and animal-source food consumption (23%). Amongst caregiving indicators, access to 3+ children’s books (7%), early stimulation and responsive caregiving (11%), and participation in early childhood education (27%) were of particular concern, while 64% had access to 2+ toys and 71% received adequate care. According to the Early Child Development Index score, only 38% of children were developmentally on track. Younger children from poor households, whose mothers were young, had not received antenatal visits and delivered at home were at higher risk of poor IYCF and caregiving practices. Conclusions Suboptimal caregiving practices, inappropriate early breastfeeding practices, delayed introduction of complementary foods, inadequate dietary diversity and low animal-source food consumption are challenges in lowland Nepal. We call for urgent integrated nutrition and caregiving interventions, especially as interventions for child development are lacking in Nepal. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13776-8.
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Birhan TY, Alene M, Seretew WS, Taddese AA. Magnitude and determinants of breastfeeding initiation within one hour among reproductive women in Sub-Saharan Africa; evidence from demographic and health survey data: a multilevel study. BMC Public Health 2022; 22:1062. [PMID: 35624450 PMCID: PMC9145512 DOI: 10.1186/s12889-022-13114-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 03/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background Early initiation of breastfeeding is one of the most simple and essential intervention for child development and survival in the world. World Health Organization recommended to begin breast milk with one hour after delivery. The objective of this study was to determine the magnitude of early initiation of breastfeeding in Sub-Saharan Africa using DHS data set. Methods This study was carried out within 32 Sub-Saharan African countries from 2010–2020, a pooled study of early initiation of breastfeeding was performed. For assessing model fitness and contrast, intra-class correlation coefficient, median odds ratio, proportional change in variance, and deviance were used. In order to identify possible covariates associated with early initiation of breastfeeding in the study area, the multilevel multivariable logistic regression model was adapted. Adjusted Odds Ratio was used with 95% confidence interval to declare major breastfeeding factors. Result The pooled prevalence of early initiation of breastfeeding in Sub-Saharan Africa countries was 57% (95% CI; 56%—61%), the highest prevalence rate of early initiation of breastfeeding was found in Malawi while the lowest prevalence was found in Congo Brazzaville (24%). In multilevel multivariable logistic regression model; wealth index (AOR = 1.20; 95% CI 1.16 – 1.26), place of delivery (AOR = 1.97; 95% CI 1.89 – 2.05), skin-to-skin contact (AOR = 1.51; 95% CI 1.47 – 1.57), mode of delivery (AOR = 0.27; 95% CI 0.25 – 0.29), media exposure (AOR = 1.36; 95% CI 1.31 – 1.41) were significantly correlated with early initiation of breastfeeding in Sub-Saharan Africa. Conclusion The magnitude of early initiation of breastfeeding rate was low in Sub-Saharan Africa. Covariates significantly associated with early initiation of breastfeeding was wealth index, place of delivery, mode of delivery, women educational status, and media exposure. Structural improvements are required for women with caesarean births to achieve optimal breastfeeding practice in Sub-Saharan Africa.
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Affiliation(s)
- Tilahun Yemanu Birhan
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Muluneh Alene
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Wullo Sisay Seretew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Asefa Adimasu Taddese
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Factors Influencing Early Initiation of Breastfeeding in Healthy Term Newborns: A Cross-Sectional Study at a Tertiary Care Center in South India. Neonatal Netw 2022; 41:129-136. [PMID: 35644358 DOI: 10.1891/11-t-738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Despite well-known benefits, rates of exclusive breastfeeding and early initiation of breastfeeding are very low. This study was conducted to identify most important and easily modifiable barriers to Early Initiation of Breast Feeding (EIBF).Methods: This hospital-based cross-sectional study was conducted from January 2018 to December 2018. Data on factors which could impact EIBF was collected by interviewing with mothers using semi-structured questionnaire.Results: Only 306 (33.7 percent) of the total 908 mother-neonate dyads enrolled received breastfeeding within 1 hour of birth. Factors affecting EIBF included: delivery by lower segment cesarean section (LSCS), lack of prenatal advice on breastfeeding, use of prelacteal feeds, and maternal illness.Conclusion: Rates of EIBF were very low in present setting. Counseling during antenatal visits on the importance of EIBF, and having adequate staff to support initiation of BF, may improve the EIBF.
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Adhikari N, Acharya K, Upadhya DP, Pathak S, Pokharel S, Pradhan PMS. Infant and young child feeding practices and its associated factors among mothers of under two years children in a western hilly region of Nepal. PLoS One 2021; 16:e0261301. [PMID: 34914802 PMCID: PMC8675745 DOI: 10.1371/journal.pone.0261301] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 11/30/2021] [Indexed: 11/18/2022] Open
Abstract
Infant and young child feeding is a key area to improve child survival and promote healthy growth and development. Nepal government has developed and implemented different programs to improve infant and young child feeding practice. However, the practice remains poor and is a major cause of malnutrition in Nepal. This study aims to identify infant and young child feeding practices and its associated factors among mothers of children aged less than two years in western hilly region of Nepal. A descriptive cross-sectional study was carried out among 360 mothers of under two years' children in Syangja district. A semi structural questionnaire was used. Data was entered in EpiData and analyzed using IBM SPSS version 21. Descriptive statistics were used to report the feeding practices and other independent variables. Bivariate and multivariate logistic regression model was used to establish the factors associated with infant and young child feeding practices. The prevalence of breastfeeding, timely initiation of breastfeeding, exclusive breastfeeding, timely initiation of complementary feeding, minimum dietary diversity, minimum meal frequency and minimum acceptable diet (MAD) were 95.6%, 69.2%, 47.6%, 53.3%, 61.5%, 67.3% and 49.9% respectively. Normal delivery (AOR 6.1, 95% CI 1.2-31.3) and higher maternal autonomy (AOR 5.2, 95% CI 1.8-14.6) were significantly associated with exclusive breastfeeding. Similarly, crop production and food security (AOR 3.8, 95% CI 1.9-7.7), maternal knowledge on MAD (AOR 2.5, 95% CI 1.0-6.2) and maternal autonomy (AOR 4.2, 95% CI 2.1-8.4) were significantly associated with minimum acceptable diet. Factors such as maternal education, maternal health services utilization, maternal knowledge, and maternal autonomy were associated with infant and young child feeding practices, which warrants further attention to these factors to reduce malnutrition.
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Affiliation(s)
- Nabin Adhikari
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal
| | | | - Dipak Prasad Upadhya
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal
| | - Sumita Pathak
- Nursing Department, Kathmandu Model Hospital, Kathmandu, Nepal
| | - Sachin Pokharel
- La-Grandee International College, Pokhara University, Kaski, Nepal
| | - Pranil Man Singh Pradhan
- Department of Community Medicine, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal
- Nepalese Society of Community Medicine, Lalitpur, Nepal
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Ghosh P, Rohatgi P, Bose K. Determinants of time-trends in exclusivity and continuation of breastfeeding in India: An investigation from the National Family Health Survey. Soc Sci Med 2021; 292:114604. [PMID: 34864276 DOI: 10.1016/j.socscimed.2021.114604] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 09/06/2021] [Accepted: 11/23/2021] [Indexed: 11/28/2022]
Abstract
Breastfeeding is an essential key factor for reducing child mortality and the risk of disease. Therefore, to ensure health and wellbeing for all (Sustainable Development Goal 03), and to reduce inequalities in child health status (SDG 10), understanding the determinants of breastfeeding is essential. Our research aims to investigate determinants of different breastfeeding practices from 2005-06 (NFHS-3) to 2015-16 (NFHS-4), and changes in different breastfeeding practices among various demographic, social, religious, and economic groups during this decade. We have used a multivariate binary logistic regression model to estimate significant determinants of different breastfeeding practices. The results show an 8.4% hike in Exclusive Breastfeeding (EBF), along with a 3.3% and 1% drop in the Continuation of Breastfeeding (CBF) up to one and two years respectively during this decade in India. Significant variation has been found in EBF, CBF1 and CBF2 among various categories of child's birth interval, place of residence, social groups, economic communities, and geographic regions. Maternal nutritional status and anemia levels had significant influence on CBF1 and CBF2, and gender of the children on EBF and CBF2 from 2005-06 to 2015-16. There was no significant variation in CBF1 and CBF2 among children born in different birth orders, whereas EBF was significantly less among higher birth orders children. A dramatic improvement in EBF was found among first birth ordered children, teenage and/or highly educated mother, rich families, and in north India, and CBF2 was significantly raised only among higher educated mothers. The estimation of determinants throughout the decade is essential for improving government policies related to supporting and encouraging breastfeeding. The study suggests more initiatives and investment for the promotion, support and improvement of CBF for one and two years, and reduction of inequality among various demographic and socio-economic groups and geographic regions.
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Affiliation(s)
- Pritam Ghosh
- Department of Geography, University of Calcutta, 35, Ballygunge Circular Road, Kolkata 700019, West Bengal, India; Department of Geography, Ramsaday College, Amta, Howrah 711401, West Bengal, India.
| | - Pratima Rohatgi
- Department of Geography, University of Calcutta, 35, Ballygunge Circular Road, Kolkata 700019, West Bengal, India.
| | - Kaushik Bose
- Department of Anthropology, Vidyasagar University, Midnapore, West Bengal, India.
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Determinant of Mother's Health Promotional Measures Practice of Infant with Age 6-12 Months in a Tertiary Hospital of Nepal. Adv Prev Med 2021; 2021:6647230. [PMID: 34221515 PMCID: PMC8211523 DOI: 10.1155/2021/6647230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 05/22/2021] [Accepted: 05/28/2021] [Indexed: 11/30/2022] Open
Abstract
Background Promotion of health is vital for the optimal growth and development of every infant. Globally, many infants died due to common problems such as diarrhoea and respiratory infection; most of these problems are related to inadequate breast feeding, improper complimentary feeding, lack of immunization, and home accident. Infant and child health status depends upon mothers' knowledge and practice regarding health promotional measures. This study aimed to determine practice and its determinants regarding health promotional measures of infant with 6–12 months age amongst the mothers attending Pediatrics Outpatient Department of Universal College of Medical Science and Teaching Hospital, Bhairahawa, Rupandehi, Nepal. Methods Hospital-based cross-sectional study was conducted in Universal College of Medical Science, Bhairahawa, Rupandehi, Nepal, among 414 mothers attending pediatrics outpatient department from September 2019–March 2020. Purposive sampling technique was used to select mothers of infants aged 6–12 months. Bivariate analysis was used primarily to assess the association between dependent and independent variables. Variables which were associated in bivariate analysis with p < 0.05 were entered into a multivariable logistic regression model to identify associated factors of health promotional measures. The goodness of fit of multivariate logistic regression was checked by Nagelkerke R square and variation inflation factor. Results The mean age and family size was 25.89 ± 4.81 years and 5.94 ± 2.48, respectively. A total of 71.5% mothers have good practice of health promotional measures. Mothers from Dalit caste (adjusted odds ratio = 0.04, confidence interval: 0.005–0.30), mothers with below school leaving certificate education (AOR = 0.08, CI: 0.02–0.27), fathers engaged in nonagricultural work (AOR = 7.21, CI: 2.59–20.11), birth space of index child greater than 2 years (AOR = 12.88, CI: 3.49–47.58), and family monthly income greater than 20000 Nepalese rupees (AOR = 3.29, CI: 1.16–13.32 were significantly associated with good practice of health promotional measures. Conclusions More than one-fourth of the mothers have poor practice of health promotional measures. Ethnicity, mothers' education, fathers' occupation, birth space of index child, and family monthly income were found to be independent determinants of practice of health promotion measures. Thus, policy makers should provide specific education regarding health promotional measures to both parents.
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Legesse Liben M, Adem R, Yimer NB. The effect of antenatal care on colostrum avoidance in pastoralists: The case of Afar, Northeast Ethiopia. Glob Pediatr Health 2021; 8:2333794X211013764. [PMID: 34017907 PMCID: PMC8114240 DOI: 10.1177/2333794x211013764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022] Open
Abstract
Breastfeeding is sufficient for infants in the first 6 months of life and is important to maintain maternal health. Evidences revealed that neonatal mortality is higher among children who received colostrum as compared to those who are deprived of colostrum. Therefore, this study aimed to assess the factors associated with colostrum avoidance practice among pastoralists in Afar Regional State, Northeast Ethiopia. A community-based cross-sectional study was conducted on 1188 mother-child pairs in Afar Regional State in June 2016. Univariable and multivariable logistic regression analyses were carried out to identify the predictors of colostrum avoidance. Statistical significance was declared at P-value <.05. About 40% of children deprived of colostrum. Mothers aged 20 to 34 years (AOR: 1.79; 95% CI: 1.18, 2.73), not attending antenatal checkup (AOR: 1.82; 95% CI: 1.64, 2.85), receiving prelacteal feeding (AOR: 2.21; CI: 1.88, 3.93) and late initiation of breastfeeding (AOR: 2.71; 95% CI: 2.02, 3.65) were positively associated with colostrum avoidance. Nearly 4 in 10 children deprived of colostrum. Therefore, promoting antenatal care and strengthening service-based counseling on proper newborn feeding practices will be important to improve colostrum feeding.
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Affiliation(s)
| | - Reem Adem
- Afar Regional Health Bureau, Afar, Ethiopia
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Birhan TY, Seretew WS, Alene M. Trends and determinants of breastfeeding within one hour in Ethiopia, further analysis of Ethiopian Demographic and Health Survey: multivariate decomposition analysis. Ital J Pediatr 2021; 47:77. [PMID: 33771215 PMCID: PMC8004466 DOI: 10.1186/s13052-021-01032-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/19/2021] [Indexed: 11/24/2022] Open
Abstract
Background Despite the substantial efforts to improve timely/early initiation of breastfeeding, avoidance of colostrum, and delayed initiation of breastfeeding remains a big challenge in developing countries. Therefore, this study aimed to analyze the trends of early breastfeeding rate over time based on the Ethiopian Demographic and Health Survey (EDHS). Methods Secondary data analysis was conducted based on the Ethiopian Demographic Health Surveys (EDHSs) conducted in 2005, 2011, and 2016. A total weighted sample of 9, 111, 10,106, and 8564 in 2005, 2011, and 2016 respectively were included for analysis. Trend and Logistic based decomposition analysis technique was used for analyzing the trends of early breastfeeding initiation over time and factors contributing to the change in early breastfeeding initiation rate. STATA 15 was employed for data management and analyses. All analyses presented in this paper were weighted for the sampling probabilities and non-response. Result Among children age less than 5 years the rate of early breastfeeding initiation rate overtime was increased from 70.5% in 2005 to 72.7% in 2016. The highest rate of improvement was seen in the second phase of the study (2011–2016) while it shows a decline in the first phase (2005–2011) from 70.5 to 55.1%. The decomposition analysis indicated that about half of the overall change in early breastfeeding initiation rate was due to the difference in women’s composition. Particularly, an increase in health facility delivery and vaginal delivery was a significant predictor of the increasing rate of early breastfeeding initiation over the surveys. Conclusion Early initiation of breastfeeding slightly increasing over the last 10 years in Ethiopia. Half of the overall increase in the early initiation of breastfeeding was due to the change in compositional characteristics of women over 10 years in Ethiopia. Change in the composition of women according to health facility delivery and vaginal delivery were the major source of the increase in early breastfeeding initiation over time. Public interventions including promoting health facility delivery of women for further improvements of early breastfeeding initiation should be needed.
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Affiliation(s)
- Tilahun Yemanu Birhan
- Department of Epidemiology and Biostatistics, Institute of public health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Wullo Sisay Seretew
- Department of Epidemiology and Biostatistics, Institute of public health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Muluneh Alene
- Department of Public Health, College of Health Science, DebreMarkos University, Debre Markos, Ethiopia
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Teshale AB, Worku MG, Tesema GA. Spatial distribution and determinants of the change in pre-lacteal feeding practice over time in Ethiopia: A spatial and multivariate decomposition analysis. PLoS One 2021; 16:e0244574. [PMID: 33444391 PMCID: PMC7808656 DOI: 10.1371/journal.pone.0244574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 12/11/2020] [Indexed: 11/18/2022] Open
Abstract
Background Pre-lacteal feeding persists in low and middle-income countries as deep-rooted nutritional malpractice. It imposes significant negative consequences on neonatal health, including increased risk of illness and mortality. Different studies revealed that pre-lacteal feeding practice is decreased over time. Even though different studies are done on the prevalence and determinants of pre-lacteal feeding practice, up to our knowledge, the spatial distribution and the determinants of the change in pre-lacteal feeding practice over time are not researched. Objective To assess the spatial distribution and determinants of the change in pre-lacteal feeding practice over time in Ethiopia. Methods We used the Ethiopian demographic and health surveys (EDHSs) data. For this study, a total weighted sample of 14672 (5789 from EDHS 2005, 4510 from EDHS 2011, and 4373 from EDHS 2016) reproductive-age women who gave birth within two years preceding the respective surveys and whoever breastfeed were used. The logit-based multivariate decomposition analysis was used to identify factors that contributed to the decrease in pre-lacteal feeding practice over the last 10 years (from 2005 to 2016). Using the 2016 EDHS data, we also conducted a spatial analysis by using ArcGIS version 10.3 and SaTScan version 9.6 software to explore the spatial distribution and hotspot clusters of pre-lacteal feeding practice. Result Pre-lacteal feeding practice was decreased from 29% [95% Confidence interval (CI): 27.63–29.96%] in 2005 to 8% [95% CI: 7.72–8.83%] in 2016 with annual rate of reduction of 7.2%. The overall decomposition analysis showed that about 20.31% of the overall decrease in pre-lacteal feeding practice over the last 10 years was attributable to the difference in composition of women (endowment) across the surveys, while, the remaining 79.39% of the overall decrease was explained by the difference in the effect of characteristics (coefficient) across the surveys. In the endowment component, the difference in composition of residence, perception of distance from the health facility, maternal educational level, wealth status, occupation, ANC visit, place of delivery, the timing of breastfeeding initiation, and wanted last-child/pregnancy were found to be significant contributing factors for the decrease in pre-lacteal feeding practice. After controlling for the role of compositional changes, the difference in the effect of distance from the health facility, wealth status, occupation, antenatal care (ANC) visit, and wanted last-child/pregnancy across the surveys were significantly contributed to the observed decrease in pre-lacteal feeding practice. Regarding the spatial distribution, pre-lacteal feeding practice was non-random in Ethiopia in which the primary and secondary clusters’ of pre-lacteal feeding identified in Somalia and the Afar region respectively. Conclusion Pre-lacteal feeding practice has shown a significant decline over the 10-year period. Program interventions considering women with poor maternal health service utilization such as ANC visits, women with poor socioeconomic status, women with an unintended pregnancy, and women from remote areas especially at border areas such as Somali and Afar could decrease pre-lacteal feeding practice in Ethiopia.
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Affiliation(s)
- Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, University of Gondar, College of Medicine and Health Science, School of Medicine, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Seidu AA, Ameyaw EK, Ahinkorah BO, Bonsu F. Determinants of early initiation of breastfeeding in Ghana: a population-based cross-sectional study using the 2014 Demographic and Health Survey data. BMC Pregnancy Childbirth 2020; 20:632. [PMID: 33076852 PMCID: PMC7574209 DOI: 10.1186/s12884-020-03308-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 10/02/2020] [Indexed: 11/12/2022] Open
Abstract
Background The World Health Organisation (WHO) recommends that breastfeeding should be initiated within the first hour of delivery followed by exclusive breastfeeding up to 6 months. This study examined the determinants of early initiation of breastfeeding in Ghana using data from the 2014 Ghana Demographic and Health Survey. Methods A sample size of 4219 was used for the study. Descriptive statistics was conducted to ascertain the proportion of children who had early initiation of breastfeeding after which binary logistic regression analysis was carried out. Results were presented using frequencies, percentages, unadjusted and adjusted odds ratios. Statistical significance was pegged at p<0.05. Results Children of first birth order [AOR = 0.71, CI = 0.61–0.84], those who were delivered by non-professionals [AOR = 0.51, CI = 0.30–0.88] and those whose mothers were Traditionalists [AOR = 0.65, CI = 0.46–0.92] and Mole-Dagbanis [AOR = 0.69, CI = 0.54–0.89] were less likely to go through early initiation of breastfeeding compared to those of 2–4 birth order, those who were delivered by health professionals, those whose mothers were Christians and Akan, respectively. Conversely, children born to mothers who read newspaper/magazine at least once a week were more likely to go through early initiation of breastfeeding, compared to those who never read newspaper/magazine [AOR = 1.40, CI = 1.01–1.95]. Children born to mothers who watched television less than once a week were more likely to go through early initiation of breastfeeding compared to those who watched television at least once a week [AOR = 1.40, CI = 1.01–1.95]. Finally, women from the Northern [AOR = 2.40, CI = [1.77–3.26] and Upper East regions [AOR = 2.57, CI = [1.86–3.56] practiced early initiation of breastfeeding compared to those from the Ashanti region. Conclusions Empowering healthcare providers to be consistent in early breastfeeding initiation advocacy and effective community engagement on the need to embrace and practice early initiation of breastfeeding can improve the situation.
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Affiliation(s)
- Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Freda Bonsu
- Asutifi South District Health Directorate, Hwidiem, Ghana
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Gebretsadik GG, Tkuwab H, Berhe K, Mulugeta A, Mohammed H, Gebremariam A. Early initiation of breastfeeding, colostrum avoidance, and their associated factors among mothers with under one year old children in rural pastoralist communities of Afar, Northeast Ethiopia: a cross sectional study. BMC Pregnancy Childbirth 2020; 20:448. [PMID: 32758166 PMCID: PMC7405449 DOI: 10.1186/s12884-020-03151-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 07/31/2020] [Indexed: 11/29/2022] Open
Abstract
Background Early initiation of breastfeeding (EIBF) is defined as initiation of breastfeeding within 1 h of birth. This is also the time colostrum is secreted with its potential benefits. Globally, two out of five under 5 children die in the first month of life, more than a third of which being on the first day. Neonatal mortality is still a major health problem in Ethiopia. EIBF and colostrum feeding are associated with decreased neonatal morbidity and mortality. With this study, we aim to determine the magnitude and factors associated with EIBF and colostrum avoidance. Methods A community based cross-sectional study was conducted from May to June 2016 on 390 mothers in Afar region. Bivariate logistic regression was used to identify the association between the independent and the outcome variables. Multivariable logistic regression was used to determine the independent predictors of EIBF and colostrum avoidance. The strength of the association was measured by odds ratio and 95% confidence interval, and p-value < 0.05 was considered statistically significant. Hosmer and Lemeshow test was used to test model goodness of fitness and multi-collinearity between independent variables was checked. Results About 248(63.6%) respondents initiated breastfeeding within 1 h of birth. Mothers whose delivery was attended by a health professional had 4.75 times higher odds (AOR 4.75; 95% CI 1.71, 13.19) of EIBF as compared to those who were attended by others. Trust on nurses to provide pregnancy care (AOR 5.59; 95% CI 1.05, 29.8) was significantly associated with EIBF. About 300(76.9%) respondents discarded colostrum. Mothers who had no discussion with TBA on child nutrition were 6.6 times (AOR 6.63; 95% CI 1.43, 30.63) more likely to avoid colostrum than their counterparts. Conclusion More than one-third of infants didn’t start breastfeeding within 1 h of birth and three-fourth of the mothers discarded colostrum. Therefore, it is important to develop and/or strengthen services/advice on EIBF including colostrum feeding. Promoting delivery by health professionals, discussion on child nutrition and building trust between mothers and health professionals can be important community interventions to encourage EIBF and colostrum feeding.
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Affiliation(s)
| | - Helen Tkuwab
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Kidanemaryam Berhe
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Afework Mulugeta
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Wu WJ, Tiwari A, Choudhury N, Basnett I, Bhatt R, Citrin D, Halliday S, Kunwar L, Maru D, Nirola I, Pandey S, Rayamazi HJ, Sapkota S, Saud S, Thapa A, Goldberg A, Maru S. Community-based postpartum contraceptive counselling in rural Nepal: a mixed-methods evaluation. Sex Reprod Health Matters 2020; 28:1765646. [PMID: 32546070 PMCID: PMC7887993 DOI: 10.1080/26410397.2020.1765646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Unmet need for postpartum contraception in rural Nepal remains high and expanding access to sexual and reproductive healthcare is essential to achieving universal healthcare. We evaluated the impact of an integrated intervention that employed community health workers aided by mobile technology to deliver patient-centred, home-based antenatal and postnatal counselling on postpartum modern contraceptive use. This was a pre–post-intervention study in seven village wards in a single municipality in rural Nepal. The primary outcome was modern contraceptive use among recently postpartum women. We performed a multivariable logistic regression to examine contraceptive use among postpartum women pre- and one-year post-intervention. We conducted qualitative interviews to explore the implementation process. There were 445 postpartum women in the pre-intervention group and 508 in the post-intervention group. Modern contraceptive use increased from 29% pre-intervention to 46% post-intervention (p < 0.0001). Adjusting for age, caste, and household expenditure, time since delivery and sex of child in the index pregnancy, postpartum women one-year post-intervention had twice the odds (OR 2.3; CI 1.7, 3.1; p < 0.0001) of using a modern contraceptive method as compared to pre-intervention. Factors at the individual, family, and systems level influenced women’s contraceptive decisions. The intervention contributed to increasing contraceptive use through knowledge transfer, demand generation, referrals to healthcare facilities, and follow-up. A community-based, patient-centred contraceptive counselling intervention supported by mobile technology and integrated into longitudinal care delivered by community health workers appears to be an effective strategy for improving uptake of modern contraception among postpartum women in rural Nepal.
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Affiliation(s)
- Wan-Ju Wu
- Assistant Professor, Possible, New York, NY, USA; Boston Medical Center, Department of Obstetrics and Gynecology, Boston, MA, USA; Boston University School of Medicine, Department of Obstetrics and Gynecology, Boston, MA, USA
| | - Aparna Tiwari
- Research Analyst, Nyaya Health Nepal, Kathmandu, Nepal
| | - Nandini Choudhury
- Delivery Science Analyst, Possible, New York, NY, USA; Icahn School of Medicine at Mount Sinai, Arnhold Institute for Global Health, New York, NY, USA
| | - Indira Basnett
- Health Advisor, Ministry of Health and Population, Nepal Health Sector Support Programme, Kathmandu, Nepal
| | - Rita Bhatt
- Community Health Nurse, Nyaya Health Nepal, Kathmandu, Nepal
| | - David Citrin
- Director of Evidence to Policy, Possible, New York, NY, USA; Departments of Global Health and Anthropology, Henry M Jackson School of International Studies, University of Washington, Seattle, WA, USA
| | - Scott Halliday
- Senior Implementation Research Manager, Possible, New York, NY, USA; Icahn School of Medicine at Mount Sinai, Arnhold Institute for Global Health, New York, NY, US; Department of Global Health, Henry M Jackson School of International Studies, University of Washington, Seattle, WA, USA
| | - Lal Kunwar
- Independent Consultant, Nyaya Health Nepal, Kathmandu, Nepal
| | - Duncan Maru
- Senior Advisor, Possible, New York, NY, USA; Icahn School of Medicine at Mount Sinai, Departments of Internal Medicine and Pediatrics, Arnhold Institute for Global Health, New York, NY, USA
| | - Isha Nirola
- Doctoral Candidate, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sachit Pandey
- Mobile Systems Engineer, Nyaya Health Nepal, Kathmandu, Nepal
| | | | - Sabitri Sapkota
- Director of Implementation Research, Nyaya Health Nepal, Kathmandu, Nepal
| | - Sita Saud
- Community Health Programme Associate , Nyaya Health Nepal, Kathmandu, Nepal
| | - Aradhana Thapa
- Director of Healthcare Design, Nyaya Health Nepal, Kathmandu, Nepal
| | - Alisa Goldberg
- Associate Professor, Brigham and Women's Hospital, Department of Obstetrics, Gynecology and Reproductive Biology, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Planned Parenthood League of Massachusetts, Boston, MA, USA
| | - Sheela Maru
- Assistant Professor, Possible, New York, NY, USA; Icahn School of Medicine at Mount Sinai, Department of Obstetrics, Gynecology, and Reproductive Science, Arnhold Institute for Global Health, New York, NY, USA
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Rana MM, Islam MR, Karim MR, Islam AZ, Haque MA, Shahiduzzaman M, Hossain MG. Knowledge and practices of exclusive breastfeeding among mothers in rural areas of Rajshahi district in Bangladesh: A community clinic based study. PLoS One 2020; 15:e0232027. [PMID: 32384096 PMCID: PMC7209213 DOI: 10.1371/journal.pone.0232027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 04/06/2020] [Indexed: 11/18/2022] Open
Abstract
Background World Health Organization (WHO) suggests that exclusive breastfeeding (EBF) is the best nutrition for the neonate. Still, it remains a big challenge to establish EBF not only in Bangladesh but also in any developing countries. Objective The aim of this study was to determine the level of knowledge and practices on EBF and its relationship between different socioeconomic and demographic factors among mothers having at least one child of aged 6–12 months in the rural area of Rajshahi District, Bangladesh. Methodology A community clinic (CC) based study has been conducted by using semi-structured questionnaire. A total of 513 mothers having at least one child aged 6–12 months from 32 different CC in the rural area of Rajshahi District, Bangladesh during September to December 2015. A composite index, chi-square test, and logistic regression model were utilized in this study. Results The prevalence of knowledge and practices on EBF were 34.5% and 27.9% among mothers having at least one child aged 6–12 months. From the analyses, mothers age of ≥21 years were (adjusted odds ratio (AOR) = 13.840, 95% CI: 7.394–25.904; p<0.001) times more likely to have knowledge on EBF and (AOR = 0.084, 95% CI: 0.050–0.143; p<0.05) times less likely to have practices of EBF compared to mother’s age ≤20 years. Service holders mothers were (AOR = 9.992, 95% CI: 4.485–22.260, p<0.05) times more likely to have practices than that of house wife. Home delivery mothers was (AOR = 0.208, 95% CI: 0.111–0.389; p<0.05) times less likely to have practices of EBF than that of the hospital delivery mothers. Those mothers monthly family income ≥10,000 Bangladeshi taka (BDT) currency was (AOR = 0.092, 95% CI: 0.050–0.168, p<0.05) times less likely to have practices of EBF compared to their counterparts. Conclusions This study was found poor knowledge and practices on EBF. This study suggested that education and EBF related intervention could play an important role to increase good knowledge and practices on EBF among mothers. Malnutrition will be decreased if EBF was widely established in Bangladesh.
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Affiliation(s)
- Md. Masud Rana
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Md. Rafiqul Islam
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
- * E-mail:
| | - Md. Reazul Karim
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Ahmed Zohirul Islam
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | | | - Md. Shahiduzzaman
- Department of Electrical and Electronic Engineering, Northern University, Dhaka, Bangladesh
| | - Md. Golam Hossain
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
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Dharel D, Dhungana R, Basnet S, Gautam S, Dhungana A, Dudani R, Bhattarai A. Breastfeeding practices within the first six months of age in mid-western and eastern regions of Nepal: a health facility-based cross-sectional study. BMC Pregnancy Childbirth 2020; 20:59. [PMID: 32000701 PMCID: PMC6990469 DOI: 10.1186/s12884-020-2754-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 01/20/2020] [Indexed: 11/20/2022] Open
Abstract
Background The World Health Organization recommends initiation of breastfeeding within 1 hour of birth and exclusive breastfeeding up to 6 months of age. Infant feeding practices, including suboptimal breastfeeding practices, are associated with stunting. Rate of stunting was highest in the Mid-western region and lowest in the Eastern region of Nepal. This study aimed to assess the breastfeeding practices in these two regions, as well as to identify factors associated with partial breastfeeding. Methods We conducted a health facility-based cross-sectional study in the Mid-western and Eastern regions of Nepal from December 2017 to May 2018. Investigators administered a pre-tested questionnaire among consecutive 574 mother-infant dyads at different levels of health facilities. We dichotomized the breastfeeding pattern to partial breastfeeding and full (exclusive or predominant) breastfeeding. We conducted multivariable logistic regression to identify factors associated with partial breastfeeding within 6 months of age. Results There were 574 infants included in the study, all of which received at least some breastfeeding. Only 23.2% of infants were exclusively breastfed until 6 months, with 28.2% predominantly breastfed and 48.6% partially breastfed. Partial breastfeeding rate was 52.3% in the Mid-western region and 44.4% in the Eastern region. Breastfeeding was initiated within an hour from birth in 67.2% of infants. One-quarter of infants were given pre-lacteal feed, honey being the commonest. Knowledge of the recommended duration of exclusive breastfeeding was inadequate in 16, and 65% of mothers reported breastfeeding problems in the first 6 months. Firstborn and low birth weight infants had a significantly higher rate of partial breastfeeding. Partial breastfeeding was also higher when infants were not breastfed within 1 hour from birth, mothers reported having breastfeeding-related problems or had inadequate knowledge of the duration of exclusive breastfeeding. Conclusion Nearly half of the infants were fully breastfed at 6 months of age in Nepal. The rate of partial breastfeeding was higher with inadequate knowledge on duration of exclusive breastfeeding or late initiation of breastfeeding or perceived breastfeeding problems. Hence, programs should address knowledge and practice gaps in breastfeeding practices, particularly among mothers of low birth weight and firstborn infants.
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Affiliation(s)
- Dinesh Dharel
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, 1403 29th Street NW, Calgary, AB, T2N 2T9, Canada. .,BP Koirala Institute of Health Sciences, Dharan, Nepal.
| | | | - Sushma Basnet
- Lifeline Hospital Institute of Health Sciences, Damak, Jhapa, Nepal
| | - Swotantra Gautam
- BP Koirala Institute of Health Sciences, Dharan, Nepal.,Population Health Research Institute (PHRI), Hamilton, Canada
| | | | - Rajesh Dudani
- John H Stroger Hospital of Cook Country, Chicago, USA
| | - Asmita Bhattarai
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Hanley-Cook G, Argaw A, Dahal P, Chitekwe S, Kolsteren P. Infant and young child feeding practices and child linear growth in Nepal: Regression-decomposition analysis of national survey data, 1996-2016. MATERNAL AND CHILD NUTRITION 2020; 18 Suppl 1:e12911. [PMID: 31922348 PMCID: PMC8770650 DOI: 10.1111/mcn.12911] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/09/2019] [Accepted: 10/17/2019] [Indexed: 11/30/2022]
Abstract
Suboptimal infant and young child feeding (IYCF) practices have profound implications on child survival, health, growth, and development. First, our study analysed trends in 18 IYCF indicators and height‐for‐age z‐score (HAZ) and stunting prevalence across Nepal's Family Health Survey 1996 and four rounds of Nepal Demographic and Health Surveys from 2001–2016. Second, we constructed multivariable regression models and decomposed the contribution of optimal IYCF practices on HAZ and stunting prevalence over the 1996–2016 period. Our findings indicate that most age‐appropriate IYCF practices and child linear growth outcomes improved over the past two decades. At present, according to the World Health Organization's tool for national assessment of IYCF practices, duration of breastfeeding is rated very good, early initiation of breastfeeding and exclusive breastfeeding (EBF) are rated good, whereas minimal bottle‐feeding and introduction of solid, semi‐solid or soft foods are rated fair. Our study also reports that a paucity of age‐appropriate IYCF practices—in particular complementary feeding—are significantly associated with increased HAZ and decreased probability of stunting (p < .05). Moreover, age‐appropriate IYCF practices—in isolation—made modest statistical contributions to the rapid and sustained reduction in age‐specific child linear growth faltering from 1996–2016. Nevertheless, our findings indicate that comprehensive multisectoral nutrition strategies—integrating and advocating optimal IYCF—are critical to further accelerate the progress against child linear growth faltering. Furthermore, specific focus is needed to improve IYCF practices that have shown no significant development over the past two decades in Nepal: EBF, minimum acceptable diet, and minimal bottle‐feeding.
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Affiliation(s)
- Giles Hanley-Cook
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Alemayehu Argaw
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium.,Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Pradiumna Dahal
- Nutrition Section, United Nations Children's Fund (UNICEF), Kathmandu, Nepal
| | - Stanley Chitekwe
- Nutrition Section, United Nations Children's Fund (UNICEF), Kathmandu, Nepal
| | - Patrick Kolsteren
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
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The effect of maternal health service utilization in early initiation of breastfeeding among Nepalese mothers. Int Breastfeed J 2019; 14:33. [PMID: 31384286 PMCID: PMC6668139 DOI: 10.1186/s13006-019-0228-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 07/22/2019] [Indexed: 11/10/2022] Open
Abstract
Background The World Health Organization (WHO) recommends early initiation of breastfeeding and exclusive breastfeeding for six months. Understanding the association of maternal health services and early initiation of breastfeeding might be useful on prioritizing the health services to promote early breastfeeding practices. The purpose of this study was to examine the association between utilization of maternal health services and early initiation of breastfeeding among Nepalese mothers. Methods Nationally representative data from the 2016 Nepal Demographic Health Survey (NDHS) was used to determine the association between early initiation of breastfeeding and variables related to maternal health services utilization. Association was measured by using Chi-square test followed by calculation of adjusted odds ratio (AOR) and 95% confidence intervals (CI) using multivariable logistic regression analysis. Results Out of 1,978 children, 55% were breastfed within an hour of birth. Early initiation of breastfeeding was associated among mothers who delivered at the health facilities (AOR 2.22; 95% CI 1.36, 3.60). Mothers who had a vaginal birth (AOR 6.70; 95% CI 4.30, 10.42) were significantly more likely to breastfeed within an hour of birth compared to mothers who had caesarean delivery. The odds of initiating early breastfeeding were higher among mothers from Province 5 (AOR 1.59; CI 1.02, 2.48), Province 6 (AOR 2.58; 95% CI 1.41,4.69) and Province 7 (AOR 2.30; CI 1.36, 3.87). Conclusions Health facility delivery and a vaginal delivery were strongly associated with early initiation of breastfeeding. It is vital to intensify maternal health service up to the community to aware pregnant women to utilize maternal health services to improve breastfeeding practices. Skilled Birth Attendant (SBA) training should include comprehensive breastfeeding counselling package to motivate mothers to initiate early breastfeeding especially for mothers having caesarean delivery.
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