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Initiation of breastfeeding within one hour of birth and its determinants among normal vaginal deliveries at primary and secondary health facilities in Bangladesh: A case-observation study

Karim, Farhana, Billah, Sk. Masum, Chowdhury, Mohiuddin Ahsanul Kabir, Zaka, Nabila, Manu, Alexander ORCID:, Arifeen, Shams El and Khan, Abdullah Nurus Salam (2018) 'Initiation of breastfeeding within one hour of birth and its determinants among normal vaginal deliveries at primary and secondary health facilities in Bangladesh: A case-observation study'. PLoS ONE, Vol 13, Issue 8, e0202508.

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Background Initiation of breastfeeding within one hour of birth can avert 22% of newborn mortality. Several factors influence breastfeeding practice including mothers’ socio-demographic and obstetric characteristics, and factors related to time around child birth. This study explores breastfeeding initiation practices and associated influencing factors for initiating breastfeeding within one hour of birth in public health facilities of Bangladesh. Methods In this study, normal deliveries were observed in 15 public health facilities from 3 districts in Bangladesh. Study participants were selected by convenient sampling i.e. delivery cases attending health facilities during the study period were selected excluding caesarean section deliveries. Among 249 mothers, time of initiation of breastfeeding was observed and its association was measured with type of health facility, privacy in delivery room, presence of separate staff for newborn, spontaneous breathing, skin-to-skin contact and postnatal contact of mother or newborn with health care providers within one hour after delivery. Data was collected during August-September, 2016. Kruskal-Wallis test was used to measure equality of median duration of breastfeeding initiation time among two or more categories of independent variables. Series of simple logistic regressions were conducted followed by multiple logistic regression to identify the determinants for breastfeeding initiation within one hour. Results Among 249 mothers observed, 67% initiated breastfeeding within one hour of birth at health facilities and median time to initiate breastfeeding was 38 minutes (Inter-quartile range: 20–56 minutes). After controlling for maternal age as potential confounder, the odds of initiating breastfeeding within one hour of birth was significantly higher if mothers gave birth in district hospitals (AOR 3.5: 95% CI 1.5, 6.4), visual privacy was well-maintained in delivery room (AOR 2.6: 95% CI 1.2, 4.8), newborns cried spontaneously (AOR 4.9: 95% CI 3.4, 17.2), were put to skin-to-skin contact with mothers (AOR 3.4: 95% CI 1.9, 10.4) or were examined by health care providers in the facilities (AOR 2.4: 95% CI 1.3, 12.9). Conclusions In health facilities, initiation of breastfeeding within one hour is associated with some critical practices and events around the time of birth. With the global push toward facility-based deliveries, it is very important to identify those key factors, within the landscape of maternal and newborn care, which significantly enable health care providers and parents to engage in the evidence-based newborn care activities including early initiation of breastfeeding that will, in turn, reduce global rates of newborn mortality.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WQ Obstetrics > Childbirth. Prenatal Care > WQ 152 Natural childbirth
WS Pediatrics > By Age Groups > WS 420 Newborn infants. Neonatology
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):
SWORD Depositor: JISC Pubrouter
Depositing User: Stacy Murtagh
Date Deposited: 17 Aug 2018 10:18
Last Modified: 17 Aug 2018 10:29


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