Maternal and neonatal peripartum factors associated with late initiation of breast feeding in Bangladesh: a secondary analysis

Abhijeet Roy, Md Mokbul Hossain, Md Barkat Ullah, Malay Kanti Mridha, Abhijeet Roy, Md Mokbul Hossain, Md Barkat Ullah, Malay Kanti Mridha

Abstract

Objectives: Late initiation of breast feeding (LIBF) is associated with increased neonatal mortality and morbidity. This study aimed to assess the association between intrapartum, early postpartum and neonatal factors, and LIBF in Bangladesh.

Design, setting and participants: In this analysis, we used data from the mothers participating in a cluster-randomised controlled trial (Rang-Din Nutrition Study) conducted in rural northwest Bangladesh. Mothers (n=3594) were interviewed about the time of initiation of breast feeding, and peripartum maternal and neonatal complications within the first 72 hours of delivery. LIBF was defined as initiation of breast feeding 1 hour after birth. Factors associated with LIBF were identified by multivariable logistic regression analysis.

Main outcome measures: Prevalence and associated factors of LIBF.

Results: The prevalence of LIBF was 18.5%. Factors significantly associated with LIBF in multivariable logistic regression were assisted vaginal delivery (adjusted OR (AOR) 2.17, 95% CI 1.44 to 3.27); delivery by caesarean section (AOR 9.67, 95% CI 7.21 to 12.96); maternal health problems during childbirth (AOR 1.61, 95% CI 1.30 to 2.00); preterm newborns (AOR 1.39, 95% CI 1.09 to 1.78); newborns moved slowly immediately after birth (AOR 1.43, 95% CI 1.05 to 1.94); and sick newborns (AOR 1.60, 95% CI 1.12 to 2.29).

Conclusions: Findings from this study suggest that to reduce LIBF, peripartum maternal and neonatal complications should be prevented and treated.

Trial registration number: NCT01715038.

Keywords: community child health; epidemiology; nutrition.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

References

    1. World Health Organization . Early initiation of breastfeeding to promote exclusive breastfeeding [Internet]. Available: [Accessed 07 Sep 2020].
    1. Victora CG, Bahl R, Barros AJD, et al. . Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet 2016;387:475–90. 10.1016/S0140-6736(15)01024-7
    1. Thapa BR. Health factors in colostrum. Indian J Pediatr 2005;72:579–81. 10.1007/BF02724182
    1. Sobhy SI, Mohame NA. The effect of early initiation of breast feeding on the amount of vaginal blood loss during the fourth stage of labor. J Egypt Public Health Assoc 2004;79:1.
    1. Smith ER, Hurt L, Chowdhury R, et al. . Delayed breastfeeding initiation and infant survival: a systematic review and meta-analysis. PLoS One 2017;12:e0180722. 10.1371/journal.pone.0180722
    1. UNICEF W. Capture the Moment—Early initiation of breastfeeding: the best start for every newborn. New York: UNICEF, 2018.
    1. Liu L, Oza S, Hogan D, et al. . Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the sustainable development goals. Lancet 2016;388:3027–35. 10.1016/S0140-6736(16)31593-8
    1. Resource Centre . Surviving the First Day: State of the world’s mothers 2013 [Internet], 2013. Available: [Accessed 09 Dec 2020].
    1. National Institute of Population Research and Training MEaFWD . Bangladesh Demographic and Health Survey (BDHS) 2017-18: Key Indicators Report [Internet. Bangladesh: Ministry of Health and Family Welfare D, 2019.
    1. Sharma IK, Byrne A. Early initiation of breastfeeding: a systematic literature review of factors and barriers in South Asia. Int Breastfeed J 2016;11:17. 10.1186/s13006-016-0076-7
    1. Alzaheb RA. A review of the factors associated with the timely initiation of breastfeeding and exclusive breastfeeding in the middle East. Clin Med Insights Pediatr 2017;11:1179556517748912. 10.1177/1179556517748912
    1. Mugadza G, Zvinavashe M, Gumbo FZ, et al. . Early breastfeeding initiation and incidence of neonatal sepsis in Chipinge district Zimbabwe. Int J Contemp Pediatrics 2018;5:1. 10.18203/2349-3291.ijcp20175564
    1. Edmond KM, Zandoh C, Quigley MA, et al. . Delayed breastfeeding initiation increases risk of neonatal mortality. Pediatrics 2006;117:e380–6. 10.1542/peds.2005-1496
    1. NEOVITA Study Group . Timing of initiation, patterns of breastfeeding, and infant survival: prospective analysis of pooled data from three randomised trials. Lancet Glob Health 2016;4:e266–75. 10.1016/S2214-109X(16)00040-1
    1. Bangladesh Breastfeeding Foundation . Baby-Friendly Hospital Initiative (BFHI) [Internet], 2020. Available: [Accessed 15 Oct 2020].
    1. Bangladesh achieves the highest level of breastfeeding and the greatest increase in complementary feeding [Internet]. Available: [Accessed 10 Feb 2021].
    1. Islam MA, Mamun A, Hossain MM, et al. . Prevalence and factors associated with early initiation of breastfeeding among Bangladeshi mothers: a nationwide cross-sectional study. PLoS One 2019;14:e0215733. 10.1371/journal.pone.0215733
    1. Karim F, Khan ANS, Tasnim F, et al. . Prevalence and determinants of initiation of breastfeeding within one hour of birth: an analysis of the Bangladesh demographic and health survey, 2014. PLoS One 2019;14:e0220224. 10.1371/journal.pone.0220224
    1. Gedefaw G, Goedert MH, Abebe E, et al. . Effect of cesarean section on initiation of breast feeding: findings from 2016 Ethiopian demographic and health survey. PLoS One 2020;15:e0244229. 10.1371/journal.pone.0244229
    1. Oakley LL, Henderson J, Redshaw M, et al. . The role of support and other factors in early breastfeeding cessation: an analysis of data from a maternity survey in England. BMC Pregnancy Childbirth 2014;14:88. 10.1186/1471-2393-14-88
    1. Matias SL, Nommsen-Rivers LA, Creed-Kanashiro H, et al. . Risk factors for early lactation problems among Peruvian primiparous mothers. Matern Child Nutr 2010;6:120–33. 10.1111/j.1740-8709.2009.00195.x
    1. Patel A, Bucher S, Pusdekar Y, et al. . Rates and determinants of early initiation of breastfeeding and exclusive breast feeding at 42 days postnatal in six low and middle-income countries: a prospective cohort study. Reprod Health 2015;12 Suppl 2:S10. 10.1186/1742-4755-12-S2-S10
    1. Patel A, Banerjee A, Kaletwad A. Factors associated with prelacteal feeding and timely initiation of breastfeeding in hospital-delivered infants in India. J Hum Lact 2013;29:572–8. 10.1177/0890334412474718
    1. Mridha MK, Matias SL, Chaparro CM, et al. . Lipid-Based nutrient supplements for pregnant women reduce newborn stunting in a cluster-randomized controlled effectiveness trial in Bangladesh. Am J Clin Nutr 2016;103:236–49. 10.3945/ajcn.115.111336
    1. Ullah MB, Mridha MK, Arnold CD, et al. . Newborn physical condition and breastfeeding behaviours: secondary outcomes of a cluster-randomized trial of prenatal lipid-based nutrient supplements in Bangladesh. Matern Child Nutr 2019;15:e12844. 10.1111/mcn.12844
    1. World Health Organization . Infant and young child feeding: a tool for assessing national practices, policies and programmes, 2003. Available: [Accessed 10 Sep 2020].
    1. National Institute of Population Research and Training MEaFWD . Bangladesh Demographic and Health Survey (BDHS) 2011 [Internet. Bangladesh: Ministry of Health and Family Welfare D, 2013.
    1. Betrán AP, Torloni MR, Zhang JJ, et al. . WHO statement on caesarean section rates. BJOG 2016;123:667–70. 10.1111/1471-0528.13526
    1. Rowe-Murray HJ, Fisher JRW. Baby friendly Hospital practices: cesarean section is a persistent barrier to early initiation of breastfeeding. Birth 2002;29:124–31. 10.1046/j.1523-536X.2002.00172.x
    1. Boccolini CS, Carvalho MLde, Oliveira MICde, et al. . [Factors that affect time between birth and first breastfeeding]. Cad Saude Publica 2008;24:2681–94. 10.1590/s0102-311x2008001100023
    1. Ekéus C, Högberg U, Norman M. Vacuum assisted birth and risk for cerebral complications in term newborn infants: a population-based cohort study. BMC Pregnancy Childbirth 2014;14:36. 10.1186/1471-2393-14-36
    1. Tully KP, Ball HL. Maternal accounts of their breast-feeding intent and early challenges after caesarean childbirth. Midwifery 2014;30:712–9. 10.1016/j.midw.2013.10.014
    1. Lau Y, Htun TP, Lim PI, Im Lim P, et al. . Maternal, infant characteristics, breastfeeding techniques, and initiation: structural equation modeling approaches. PLoS One 2015;10:e0142861. 10.1371/journal.pone.0142861
    1. Hobbs AJ, Mannion CA, McDonald SW, et al. . The impact of caesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. BMC Pregnancy Childbirth 2016;16:90. 10.1186/s12884-016-0876-1
    1. Takahashi K, Ganchimeg T, Ota E, et al. . Prevalence of early initiation of breastfeeding and determinants of delayed initiation of breastfeeding: secondary analysis of the who global survey. Sci Rep 2017;7:44868. 10.1038/srep44868
    1. World Health Organization . | WHO recommendations on postnatal care of the mother and newborn [Internet]. Available: [Accessed 07 Oct 2020].
    1. WHO recommendation on birth preparedness and complication readiness | RHL [Internet]. Available: [Accessed 10 Sep 2020].
    1. WHO U . Protecting, promoting and supporting Breastfeeding in facilities providing maternity and newborn services: the revised BABY-FRIENDLY HOSPITAL INITIATIVE [Internet], 2018. Available: [Accessed 10 Sep 2020].
    1. Niela-Vilén H, Melender H-L, Axelin A, et al. . Predictors of breastfeeding initiation and frequency for preterm infants in the NICU. J Obstet Gynecol Neonatal Nurs 2016;45:346–58. 10.1016/j.jogn.2016.01.006
    1. Vieira TO, Vieira GO, Giugliani ERJ, et al. . Determinants of breastfeeding initiation within the first hour of life in a Brazilian population: cross-sectional study. BMC Public Health 2010;10:760. 10.1186/1471-2458-10-760
    1. Walker M. Breastfeeding the late preterm infant. J Obstet Gynecol Neonatal Nurs 2008;37:692–701. 10.1111/j.1552-6909.2008.00293.x
    1. Kynø NM, Ravn IH, Lindemann R, et al. . Parents of preterm-born children; sources of stress and worry and experiences with an early intervention programme - a qualitative study. BMC Nurs 2013;12:28. 10.1186/1472-6955-12-28
    1. Franck LS, Cox S, Allen A, et al. . Parental concern and distress about infant pain. Arch Dis Child Fetal Neonatal Ed 2004;89:71F–5. 10.1136/fn.89.1.F71
    1. Golubnitschaja O, Yeghiazaryan K, Cebioglu M, et al. . Birth asphyxia as the major complication in newborns: moving towards improved individual outcomes by prediction, targeted prevention and tailored medical care. Epma J 2011;2:197–210. 10.1007/s13167-011-0087-9
    1. WHO . Guidelines on basic newborn resuscitation [Internet]. Available: [Accessed 10 Sep 2020].
    1. Kamath-Rayne BD, Josyula S, Rule ARL, et al. . Improvements in the delivery of resuscitation and newborn care after helping babies breathe training. J Perinatol 2017;37:1153–60. 10.1038/jp.2017.110
    1. Dickson KE, Simen-Kapeu A, Kinney MV, et al. . Every newborn: health-systems bottlenecks and strategies to accelerate scale-up in countries. Lancet 2014;384:438–54. 10.1016/S0140-6736(14)60582-1
    1. Rohde J, Cousens S, Chopra M, et al. . 30 years after Alma-Ata: has primary health care worked in countries? Lancet 2008;372:950–61. 10.1016/S0140-6736(08)61405-1
    1. Haines A, Sanders D, Lehmann U, et al. . Achieving child survival goals: potential contribution of community health workers. Lancet 2007;369:2121–31. 10.1016/S0140-6736(07)60325-0

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera