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

Archana Patel, Sherri Bucher, Yamini Pusdekar, Fabian Esamai, Nancy F. Krebs, Shivaprasad S. Goudar, Elwyn Chomba, Ana Garces, Omrana Pasha, Sarah Saleem, Bhalachandra S. Kodkany, Edward A. Liechty, Bhala Kodkany, Richard J. Derman, Waldemar A. Carlo, K. Michael Hambidge, Robert L. Goldenberg, Fernando Althabe, Mabel Berrueta, Janet L. MooreElizabeth M. McClure, Marion Koso-Thomas, Patricia L. Hibberd

Research output: Contribution to journalReview article

29 Citations (Scopus)

Abstract

Background: Early initiation of breastfeeding after birth and exclusive breastfeeding through six months of age confers many health benefits for infants; both are crucial high impact, low-cost interventions. However, determining accurate global rates of these crucial activities has been challenging. We use population-based data to describe: (1) rates of early initiation of breastfeeding (defined as within 1 hour of birth) and of exclusive breastfeeding at 42 days post-partum; and (2) factors associated with failure to initiate early breastfeeding and exclusive breastfeeding at 42 days post-partum. Methods: Prospectively collected data from women and their live-born infants enrolled in the Global Network's Maternal and Newborn Health Registry between January 1, 2010-December 31, 2013 included women-infant dyads in 106 geographic areas (clusters) at 7 research sites in 6 countries (Kenya, Zambia, India [2 sites], Pakistan, Argentina and Guatemala). Rates and risk factors for failure to initiate early breastfeeding were investigated for the entire cohort and rates and risk factors for failure to maintain exclusive breastfeeding was assessed in a sub-sample studied at 42 days post-partum. Result: A total of 255,495 live-born women-infant dyads were included in the study. Rates and determinants for the exclusive breastfeeding sub-study at 42 days post-partum were assessed from among a sub-sample of 105,563 subjects. Although there was heterogeneity by site, and early initiation of breastfeeding after delivery was high, the Pakistan site had the lowest rates of early initiation of breastfeeding. The Pakistan site also had the highest rate of lack of exclusive breastfeeding at 42 days post-partum. Across all regions, factors associated with failure to initiate early breastfeeding included nulliparity, caesarean section, low birth weight, resuscitation with bag and mask, and failure to place baby on the mother's chest after delivery. Factors associated with failure to achieve exclusive breastfeeding at 42 days varied across the sites. The only factor significant in all sites was multiple gestation. Conclusions: In this large, prospective, population-based, observational study, rates of both early initiation of breastfeeding and exclusive breastfeeding at 42 days post-partum were high, except in Pakistan. Factors associated with these key breastfeeding indicators should assist with more effective strategies to scale-up these crucial public health interventions.

Original languageEnglish (US)
Article numberS10
JournalReproductive Health
Volume12
Issue number2
DOIs
StatePublished - Jun 8 2015

Fingerprint

Breast Feeding
Cohort Studies
Prospective Studies
Pakistan
Parturition
Guatemala
Zambia
Kenya
Argentina
Low Birth Weight Infant
Insurance Benefits
Masks
Parity
Resuscitation
Cesarean Section
Population
Observational Studies
Registries

Keywords

  • Early initiation of breastfeeding
  • Exclusive breastfeeding
  • Global health
  • Neonatal mortality
  • Newborn

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

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. / Patel, Archana; Bucher, Sherri; Pusdekar, Yamini; Esamai, Fabian; Krebs, Nancy F.; Goudar, Shivaprasad S.; Chomba, Elwyn; Garces, Ana; Pasha, Omrana; Saleem, Sarah; Kodkany, Bhalachandra S.; Liechty, Edward A.; Kodkany, Bhala; Derman, Richard J.; Carlo, Waldemar A.; Michael Hambidge, K.; Goldenberg, Robert L.; Althabe, Fernando; Berrueta, Mabel; Moore, Janet L.; McClure, Elizabeth M.; Koso-Thomas, Marion; Hibberd, Patricia L.

In: Reproductive Health, Vol. 12, No. 2, S10, 08.06.2015.

Research output: Contribution to journalReview article

Patel, A, Bucher, S, Pusdekar, Y, Esamai, F, Krebs, NF, Goudar, SS, Chomba, E, Garces, A, Pasha, O, Saleem, S, Kodkany, BS, Liechty, EA, Kodkany, B, Derman, RJ, Carlo, WA, Michael Hambidge, K, Goldenberg, RL, Althabe, F, Berrueta, M, Moore, JL, McClure, EM, Koso-Thomas, M & Hibberd, PL 2015, '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', Reproductive Health, vol. 12, no. 2, S10. https://doi.org/10.1186/1742-4755-12-S2-S10
Patel, Archana ; Bucher, Sherri ; Pusdekar, Yamini ; Esamai, Fabian ; Krebs, Nancy F. ; Goudar, Shivaprasad S. ; Chomba, Elwyn ; Garces, Ana ; Pasha, Omrana ; Saleem, Sarah ; Kodkany, Bhalachandra S. ; Liechty, Edward A. ; Kodkany, Bhala ; Derman, Richard J. ; Carlo, Waldemar A. ; Michael Hambidge, K. ; Goldenberg, Robert L. ; Althabe, Fernando ; Berrueta, Mabel ; Moore, Janet L. ; McClure, Elizabeth M. ; Koso-Thomas, Marion ; Hibberd, Patricia L. / 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. In: Reproductive Health. 2015 ; Vol. 12, No. 2.
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T1 - Rates and determinants of early initiation of breastfeeding and exclusive breast feeding at 42 days postnatal in six low and middle-income countries

T2 - A prospective cohort study

AU - Patel, Archana

AU - Bucher, Sherri

AU - Pusdekar, Yamini

AU - Esamai, Fabian

AU - Krebs, Nancy F.

AU - Goudar, Shivaprasad S.

AU - Chomba, Elwyn

AU - Garces, Ana

AU - Pasha, Omrana

AU - Saleem, Sarah

AU - Kodkany, Bhalachandra S.

AU - Liechty, Edward A.

AU - Kodkany, Bhala

AU - Derman, Richard J.

AU - Carlo, Waldemar A.

AU - Michael Hambidge, K.

AU - Goldenberg, Robert L.

AU - Althabe, Fernando

AU - Berrueta, Mabel

AU - Moore, Janet L.

AU - McClure, Elizabeth M.

AU - Koso-Thomas, Marion

AU - Hibberd, Patricia L.

PY - 2015/6/8

Y1 - 2015/6/8

N2 - Background: Early initiation of breastfeeding after birth and exclusive breastfeeding through six months of age confers many health benefits for infants; both are crucial high impact, low-cost interventions. However, determining accurate global rates of these crucial activities has been challenging. We use population-based data to describe: (1) rates of early initiation of breastfeeding (defined as within 1 hour of birth) and of exclusive breastfeeding at 42 days post-partum; and (2) factors associated with failure to initiate early breastfeeding and exclusive breastfeeding at 42 days post-partum. Methods: Prospectively collected data from women and their live-born infants enrolled in the Global Network's Maternal and Newborn Health Registry between January 1, 2010-December 31, 2013 included women-infant dyads in 106 geographic areas (clusters) at 7 research sites in 6 countries (Kenya, Zambia, India [2 sites], Pakistan, Argentina and Guatemala). Rates and risk factors for failure to initiate early breastfeeding were investigated for the entire cohort and rates and risk factors for failure to maintain exclusive breastfeeding was assessed in a sub-sample studied at 42 days post-partum. Result: A total of 255,495 live-born women-infant dyads were included in the study. Rates and determinants for the exclusive breastfeeding sub-study at 42 days post-partum were assessed from among a sub-sample of 105,563 subjects. Although there was heterogeneity by site, and early initiation of breastfeeding after delivery was high, the Pakistan site had the lowest rates of early initiation of breastfeeding. The Pakistan site also had the highest rate of lack of exclusive breastfeeding at 42 days post-partum. Across all regions, factors associated with failure to initiate early breastfeeding included nulliparity, caesarean section, low birth weight, resuscitation with bag and mask, and failure to place baby on the mother's chest after delivery. Factors associated with failure to achieve exclusive breastfeeding at 42 days varied across the sites. The only factor significant in all sites was multiple gestation. Conclusions: In this large, prospective, population-based, observational study, rates of both early initiation of breastfeeding and exclusive breastfeeding at 42 days post-partum were high, except in Pakistan. Factors associated with these key breastfeeding indicators should assist with more effective strategies to scale-up these crucial public health interventions.

AB - Background: Early initiation of breastfeeding after birth and exclusive breastfeeding through six months of age confers many health benefits for infants; both are crucial high impact, low-cost interventions. However, determining accurate global rates of these crucial activities has been challenging. We use population-based data to describe: (1) rates of early initiation of breastfeeding (defined as within 1 hour of birth) and of exclusive breastfeeding at 42 days post-partum; and (2) factors associated with failure to initiate early breastfeeding and exclusive breastfeeding at 42 days post-partum. Methods: Prospectively collected data from women and their live-born infants enrolled in the Global Network's Maternal and Newborn Health Registry between January 1, 2010-December 31, 2013 included women-infant dyads in 106 geographic areas (clusters) at 7 research sites in 6 countries (Kenya, Zambia, India [2 sites], Pakistan, Argentina and Guatemala). Rates and risk factors for failure to initiate early breastfeeding were investigated for the entire cohort and rates and risk factors for failure to maintain exclusive breastfeeding was assessed in a sub-sample studied at 42 days post-partum. Result: A total of 255,495 live-born women-infant dyads were included in the study. Rates and determinants for the exclusive breastfeeding sub-study at 42 days post-partum were assessed from among a sub-sample of 105,563 subjects. Although there was heterogeneity by site, and early initiation of breastfeeding after delivery was high, the Pakistan site had the lowest rates of early initiation of breastfeeding. The Pakistan site also had the highest rate of lack of exclusive breastfeeding at 42 days post-partum. Across all regions, factors associated with failure to initiate early breastfeeding included nulliparity, caesarean section, low birth weight, resuscitation with bag and mask, and failure to place baby on the mother's chest after delivery. Factors associated with failure to achieve exclusive breastfeeding at 42 days varied across the sites. The only factor significant in all sites was multiple gestation. Conclusions: In this large, prospective, population-based, observational study, rates of both early initiation of breastfeeding and exclusive breastfeeding at 42 days post-partum were high, except in Pakistan. Factors associated with these key breastfeeding indicators should assist with more effective strategies to scale-up these crucial public health interventions.

KW - Early initiation of breastfeeding

KW - Exclusive breastfeeding

KW - Global health

KW - Neonatal mortality

KW - Newborn

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