scholarly journals Assessing the changes in childbirth care practices and neonatal outcomes in Western China: pre-comparison and post-comparison study on early essential newborn care interventions

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041829
Author(s):  
Wen Qu ◽  
Qing Yue ◽  
Yan Wang ◽  
Jin Liuxing Yang ◽  
Xi Jin ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Neonatal Mortality ◽  
Breast Feeding ◽  
Newborn Care ◽  
Western China ◽  
Comparison Study ◽  
Essential Newborn Care ◽  
Breastfeeding Rate ◽  
Care Practices ◽  
Childbirth Care

ObjectiveTo explore the changes in childbirth care practices and health outcomes of newborns after the introduction of early essential newborn care (EENC).DesignA pre-comparison and post-comparison study.SettingThe study was conducted in December 2016 and December 2018 in 18 counties in four western provinces of China.Participants46 hospitals that provide delivery services participated in the study.InterventionsEENC practices were introduced and implemented in the 46 hospitals.Outcome measuresThe changes of hospital indicators such as incidence of birth asphyxia and neonatal mortality were compared in 2016 and 2018. EENC coverage indicators, such as skin-to-skin (STS) contact, and time of first breast feeding were also compared before and after the intervention via interview with 524 randomly selected postpartum mothers (320 in 2016 and 204 in 2018).Results54 335 newborns were delivered in the pre-EENC period (2016) and 58 057 delivered in the post-EENC period (2018). According to hospital records, the proportion of newborns receiving immediate STS contact increased from 32.6% to 51.2% (Risk Ratio (RR)=1.57,95% CI 1.55 to 1.59) and the percentage of newborns receiving prolonged STS contact for more than 90 min increased from 8.1% to 26.8% (RR=3.31, 95% CI 3.21 to 3.41). No statistically significant changes were found in neonatal mortality, although slight decreases in birth asphyxiate and neonatal intensive care unit admission rates were detected. Among the mothers interviewed, the proportion of newborns receiving immediate STS contact increased from 34.6% to 80.0% (RR=2.31, 95% CI 1.69 to 3.17). The exclusive breastfeeding rate increased from 43% to 73.4% (RR=1.71, 95% CI 1.43 to 2.04). The average length of the first breast feeding increased from 15.8 min to 17.1 min.ConclusionsThe introduction of EENC has yielded significant improvements in newborn care services at the pilot hospitals, including enhanced maternal and newborn care practices, improved STS contact quality and early breastfeeding performance. Further studies are needed to evaluate the long-term impact of EENC on newborn health outcomes.

scholarly journals Early essential newborn care is associated with increased breastfeeding: a quasi-experiment study from Sichuan Province of western China

2020 ◽  
Author(s):  
Chenran Wang ◽  
Xiayun Li ◽  
Lin Zhang ◽  
Linman Wu ◽  
Ling Tan ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Newborn Care ◽  
Sichuan Province ◽  
Western China ◽  
Breastfeeding Initiation ◽  
Experiment Study ◽  
Essential Newborn Care ◽  
Breastfeeding Rate ◽  
First Time ◽  
Quasi Experiment Study

Abstract Background: Breastfeeding is critical to promote maternal and child health in a short and long term. China has set national targets to further improve the exclusive breastfeeding rate. We aimed to examine associations between the provision of Early Essential Newborn Care (EENC) and breastfeeding outcomes among full-term vaginally delivered neonates in the first six months of life.Methods: We conducted a quasi-experiment study in eight maternal and children’s hospitals in Mianyang City and Deyang City in Sichuan Province of western China. Four hospitals were randomly selected as the intervention group with the implementation of EENC while others as the control group receiving routine care. We assessed effects of EENC on breastfeeding initiation time, duration of first-time breastfeeding, and exclusive breastfeeding rates up to six months of age. Data in both groups were collected after delivery, at hospital discharge, 1 month, 3 months, and 6 months post birth in the baseline phase and post-EENC phase. Written consent was obtained from eligible mothers enrolled in this study. We performed univariate analyses to ascertain differences between the two groups, and difference in difference (DID) models to explore the net effects.Results: Of the 1349 enrolled mother and newborn pairs in our study, 1131 were followed up at 1 month of age, 1075 at 3 months, and 981 at 6 months. EENC was associated with earlier median time to initiate breastfeeding (25min vs. 33min, P<0.01), an increased chance of successful first-time breastfeeding (OR=5.534; 95% CI: 2.687-11.399), longer duration of skin to skin contact (SSC) (21.529 min; 95% CI: 18.171-24.887) and longer duration of the first breastfeed (4.157 min; 95% CI: 2.098-6.217), and an increased likelihood of being exclusively breastfed at discharge (74.5% vs. 55.0%, P<0.001), 3 months (OR=3.197; 95% CI: 1.008-10.144), and 6 months (OR=4.913; 95% CI: 1.709-14.130) of age.Conclusions: EENC enhances early and successful breastfeeding initiation, prolongs duration of the first breastfeed, and increases the rate of exclusive breastfeeding at six months of age. Our evidence suggests that nation wide scale up of EENC would increase the exclusive breastfeeding rate in the first six months of life.

scholarly journals Early essential newborn care is associated with increased breastfeeding: a quasi-experimental study from Sichuan Province of Western China

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Chen-ran Wang ◽  
Xia-yun Li ◽  
Lin Zhang ◽  
Lin-man Wu ◽  
Ling Tan ◽  
...  
Keyword(s):  
Experimental Study ◽  
Exclusive Breastfeeding ◽  
Newborn Care ◽  
Sichuan Province ◽  
Western China ◽  
Breastfeeding Initiation ◽  
Essential Newborn Care ◽  
Breastfeeding Rate ◽  
Quasi Experimental ◽  
First Time

Abstract Background Breastfeeding is critical to promote maternal and child health. China has set national targets to further improve the exclusive breastfeeding rate. We aimed to examine associations between the provision of early essential newborn care (EENC) and breastfeeding outcomes among full term vaginally delivered neonates in the first 6 months of life. Methods We conducted a quasi-experimental study in eight maternal and children’s hospitals in Mianyang City and Deyang City in Sichuan Province of western China. Four hospitals were randomly selected as the intervention group with the implementation of EENC while others as the control group receiving routine care. We assessed effects of EENC on breastfeeding initiation time, duration of first-time breastfeeding, and exclusive breastfeeding rates up to 6 months of age. Data were collected after delivery, at hospital discharge, 1 month, 3 months, and 6 months post birth in the baseline phase from May to June 2017 and post-EENC phase from October to December 2017. We performed univariate analyses to ascertain differences between the two groups, and difference in difference (DID) models to explore the net effects. Results Of the 1349 enrolled mother and newborn pairs in our study, 1131 (83.9%) were followed up at 1 month of age, 1075 (79.7%) at 3 months, and 981 (72.7%) at 6 months. EENC was associated with earlier median time to initiate breastfeeding (25 min vs. 33 min, P <  0.01), an increased chance of successful first-time breastfeeding (OR 5.53; 95% CI 2.69, 11.40), longer duration of skin to skin contact (SSC) (21.53 min; 95% CI 18.17, 24.89) and longer duration of the first breastfeed (4.16 min; 95% CI 2.10, 6.22), and an increased likelihood of being exclusively breastfed at discharge (74.5% vs. 55.0%, P <  0.001), 3 months (OR 3.20; 95% CI 1.01, 10.15), and 6 months (OR 4.91; 95% CI 1.71, 14.13) of age. Conclusions EENC enhances breastfeeding initiation and increases exclusive breastfeeding at 6 months of age. Our evidence suggests that nationwide scale up of EENC would increase the exclusive breastfeeding rate in the first 6 months of life.

scholarly journals Community And Individual Factors Associated With Maternal And Neonatal Care Practices In Low Resource Settings. A Case Of Zimbabwe

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
E. Chiwawa ◽  
M. Mhlanga ◽  
A. Munodawafa ◽  
F. Mukora-Mutseyekwa
Keyword(s):  
Neonatal Mortality ◽  
Health Facility ◽  
Breast Feeding ◽  
Newborn Care ◽  
Neonatal Care ◽  
Care Seeking ◽  
District Health ◽  
Live Births ◽  
Factors Associated ◽  
Care Practices

Neonatal mortality has been increasing in Zimbabwe from 20/1,000 live births between 2000 and 2004 to 29 /1,000 live births between 2010 and 2014.Suboptimal newborn care practices are the predisposing factors to neonatal mortality. In Manicaland Province, care seeking behaviours for fever which is the main symptom of majority of infections in children and knowledge levels of danger signs that should cause the mother to take a child immediately to a health facility remains unacceptably lower than the national averages. A cross sectional descriptive and analytic design was carried out to explore the factors associated with the practice of the recommended newborn care practices by women of child bearing age in Mutare District. Health facilities were purposively sampled and participants were systematically sampled. Structured interviews were used to collect data which was analysed in Epi-Info version 7.2. Descriptive and multivariate analysis was performed on data collected from 349 participants. Practice of the five assessed recommended newborn care practices was high. Exclusive breast feeding (62%), early initiation of Breast feeding (74%), good code care (73%), care seeking for neonatal illness within 24hrs of onset of fever (82%) and keeping baby warm was at 58%. Statistically significant independent factors associated with the recommended newborn care practices were post-natal stay for more than 72 hours at the clinic (AOR=0.56; 95%CI: 0.12-0.87, p=0.000), and delivery at the health facility (AOR=0.43; 95%CI: 0.21-0.77; p=0.000). Cultural practices that impact negatively on neonatal care in Mutare district include; asking for permission to seek treatment for the child when ill, feeding the baby immediately after delivery and applying substances and mixed traditional herbs on the cord stump of the newborn. Improving newborn care outcomes require approaches addressing demand and supply factors to reach communities with correct information on good newborn care.

scholarly journals Neonatal Survival and Determinants of Mortality in Aroresa District, Southern Ethiopia: a Prospective cohort study

2019 ◽  
Author(s):  
Alaka Adiso Limaso ◽  
Mesay Hailu Dangisso ◽  
Desalegn Tsegaw Hibstu
Keyword(s):  
Risk Factors ◽  
Neonatal Mortality ◽  
Breast Feeding ◽  
Newborn Care ◽  
Public Health Problem ◽  
Southern Ethiopia ◽  
Essential Newborn Care ◽  
Exclusive Breast Feeding ◽  
Under Five ◽  
Pregnant Mothers

Abstract Background: The first day, week and month of life are the most critical period for the survival of children. In Ethiopia, despite a significant reduction in under-five mortality during the last fifteen years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia. Methods: A community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan–Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates’ survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P-value less than 0.05 were considered as significant. Result: The overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR=3.643; 95% CI, 1.36-9.77), male neonates (AHR=2.71; 95% CI, 1.03-7.09), mother’s perception of baby’s size (AHR=3.46; 95% CI, 1.119-10.704), neonates who had initiated exclusive breast feeding (EBF) after one hour (AHR=3.572; 95% CI, 1.255-10.165) and mothers who had no postnatal care (AHR=3.07; 95% CI, 1.16-8.12). Conclusion: Neonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.

scholarly journals Early essential newborn care is associated with increased breastfeeding: a quasi-experimental study from Sichuan Province of western China

2020 ◽  
Author(s):  
Chenran Wang ◽  
Xiayun Li ◽  
Lin Zhang ◽  
Linman Wu ◽  
Ling Tan ◽  
...  
Keyword(s):  
Experimental Study ◽  
Exclusive Breastfeeding ◽  
Newborn Care ◽  
Sichuan Province ◽  
Western China ◽  
Breastfeeding Initiation ◽  
Essential Newborn Care ◽  
Breastfeeding Rate ◽  
Quasi Experimental ◽  
First Time

Abstract Background: Breastfeeding is critical to promote maternal and child health in a short and long term. China has set national targets to further improve the exclusive breastfeeding rate. We aimed to examine associations between the provision of early essential newborn care (EENC) and breastfeeding outcomes among full-term vaginally delivered neonates in the first six months of life. Methods: We conducted a quasi-experimental study in eight maternal and children’s hospitals in Mianyang City and Deyang City in Sichuan Province of western China. Four hospitals were randomly selected as the intervention group with the implementation of EENC while others as the control group receiving routine care. We assessed effects of EENC on breastfeeding initiation time, duration of first-time breastfeeding, and exclusive breastfeeding rates up to six months of age. Data in both groups were collected after delivery, at hospital discharge, 1 month, 3 months, and 6 months post birth in the baseline phase from May to June 2017 and post-EENC phase from October to December 2017. Written consent was obtained from eligible mothers enrolled in this study. We performed univariate analyses to ascertain differences between the two groups, and difference in difference (DID) models to explore the net effects. Results: Of the 1349 enrolled mother and newborn pairs in our study, 1131 (83.9%) were followed up at 1 month of age, 1075 (79.7%) at 3 months, and 981 (72.7%) at 6 months. EENC was associated with earlier median time to initiate breastfeeding (25min vs. 33min, P<0.01), an increased chance of successful first-time breastfeeding (OR=5.53; 95% CI: 2.69, 11.40), longer duration of skin to skin contact (SSC) (21.53 min; 95% CI: 18.17, 24.89) and longer duration of the first breastfeed (4.16 min; 95% CI: 2.10, 6.22), and an increased likelihood of being exclusively breastfed at discharge (74.5% vs. 55.0%, P<0.001), 3 months (OR=3.20; 95% CI: 1.01, 10.15), and 6 months (OR=4.91; 95% CI: 1.71, 14.13) of age. Conclusions: EENC enhances early and successful breastfeeding initiation, prolongs duration of the first breastfeed, and increases the rate of exclusive breastfeeding at six months of age. Our evidence suggests that nation wide scale up of EENC would increase the exclusive breastfeeding rate in the first six months of life.

scholarly journals Neonatal Survival and Determinants of Mortality in Aroresa District, Southern Ethiopia: a Prospective cohort study

2019 ◽  
Author(s):  
Alaka Adiso Limaso ◽  
Mesay Hailu Dangisso ◽  
Desalegn Tsegaw Hibstu
Keyword(s):  
Risk Factors ◽  
Neonatal Mortality ◽  
Breast Feeding ◽  
Newborn Care ◽  
Public Health Problem ◽  
Southern Ethiopia ◽  
Essential Newborn Care ◽  
Exclusive Breast Feeding ◽  
Under Five ◽  
Pregnant Mothers

Abstract Background: The first day, week and month of life are the most critical period for the survival of children. In Ethiopia, despite a significant reduction in under-five mortality during the last fifteen years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia. Methods: A community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan–Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates’ survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P-value less than 0.05 were considered as significant. Result: The overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR=3.643; 95% CI, 1.36-9.77), male neonates (AHR=2.71; 95% CI, 1.03-7.09), mother’s perception of being small baby’s size (AHR=3.46; 95% CI, 1.119-10.704), neonates who had initiated exclusive breast feeding (EBF) after one hour (AHR=3.572; 95% CI, 1.255-10.165) and mothers who had no postnatal care (AHR=3.07; 95% CI, 1.16-8.12). Conclusion: Neonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.

scholarly journals Neonatal Survival and Determinants of Mortality in Aroresa District, Southern Ethiopia: a Prospective cohort study

2019 ◽  
Author(s):  
Alaka Adiso Limaso ◽  
Mesay Hailu Dangisso ◽  
Desalegn Tsegaw Hibstu
Keyword(s):  
Risk Factors ◽  
Neonatal Mortality ◽  
Breast Feeding ◽  
Newborn Care ◽  
Public Health Problem ◽  
Southern Ethiopia ◽  
Essential Newborn Care ◽  
Exclusive Breast Feeding ◽  
Under Five ◽  
Pregnant Mothers

Abstract Background: The first day, week and month of life are the most critical period for the survival of children. In Ethiopia, despite a significant reduction in under-five mortality during the last fifteen years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia. Methods: A community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan–Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates’ survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P-value less than 0.05 were considered as significant. Result: The overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR=3.643; 95% CI, 1.36-9.77), male neonates (AHR=2.71; 95% CI, 1.03-7.09), mother’s perception of baby’s size (AHR=3.46; 95% CI, 1.119-10.704), neonates who had initiated exclusive breast feeding (EBF) after one hour (AHR=3.572; 95% CI, 1.255-10.165) and mothers who had no postnatal care (AHR=3.07; 95% CI, 1.16-8.12). Conclusion: Neonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.

scholarly journals Neonatal Survival and Determinants of Mortality in Aroresa District, Southern Ethiopia: a Prospective cohort study

2019 ◽  
Author(s):  
Alaka Adiso Limaso ◽  
Mesay Hailu Dangisso ◽  
Desalegn Tsegaw Hibstu
Keyword(s):  
Risk Factors ◽  
Neonatal Mortality ◽  
Breast Feeding ◽  
Newborn Care ◽  
Public Health Problem ◽  
Southern Ethiopia ◽  
Essential Newborn Care ◽  
Exclusive Breast Feeding ◽  
Under Five ◽  
Pregnant Mothers

Abstract Background: The first day, week and month of life are the most critical period for the survival of children. In Ethiopia, despite a significant reduction in under-five mortality during the last fifteen years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia. Methods: A community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan–Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates’ survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P-value less than 0.05 were considered as significant. Result: The overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR=3.643; 95% CI, 1.36-9.77), male neonates (AHR=2.71; 95% CI, 1.03-7.09), mother’s perception of baby’s size (AHR=3.46; 95% CI, 1.119-10.704), neonates who had initiated exclusive breast feeding (EBF) after one hour (AHR=3.572; 95% CI, 1.255-10.165) and mothers who had no postnatal care (AHR=3.07; 95% CI, 1.16-8.12). Conclusion: Neonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.

scholarly journals Early essential newborn care is associated with increased breastfeeding: a quasi-experimental study from Sichuan Province of Western China

2020 ◽  
Author(s):  
Chenran Wang ◽  
Xiayun Li ◽  
Lin Zhang ◽  
Linman Wu ◽  
Ling Tan ◽  
...  
Keyword(s):  
Experimental Study ◽  
Exclusive Breastfeeding ◽  
Newborn Care ◽  
Sichuan Province ◽  
Western China ◽  
Breastfeeding Initiation ◽  
Essential Newborn Care ◽  
Breastfeeding Rate ◽  
Quasi Experimental ◽  
First Time

Abstract Background: Breastfeeding is critical to promote maternal and child health in a short and long term. China has set national targets to further improve the exclusive breastfeeding rate. We aimed to examine associations between the provision of early essential newborn care (EENC) and breastfeeding outcomes among full-term vaginally delivered neonates in the first six months of life.Methods: We conducted a quasi-experimental study in eight maternal and children’s hospitals in Mianyang City and Deyang City in Sichuan Province of western China. Four hospitals were randomly selected as the intervention group with the implementation of EENC while others as the control group receiving routine care. We assessed effects of EENC on breastfeeding initiation time, duration of first-time breastfeeding, and exclusive breastfeeding rates up to six months of age. Data in both groups were collected after delivery, at hospital discharge, 1 month, 3 months, and 6 months post birth in the baseline phase from May to June 2017 and post-EENC phase from October to December 2017. Written consent was obtained from eligible mothers enrolled in this study. We performed univariate analyses to ascertain differences between the two groups, and difference in difference (DID) models to explore the net effects.Results: Of the 1349 enrolled mother and newborn pairs in our study, 1131 (83.9%) were followed up at 1 month of age, 1075 (79.7%) at 3 months, and 981 (72.7%) at 6 months. EENC was associated with earlier median time to initiate breastfeeding (25min vs. 33min, P<0.01), an increased chance of successful first-time breastfeeding (OR=5.53; 95% CI: 2.69, 11.40), longer duration of skin to skin contact (SSC) (21.53 min; 95% CI: 18.17, 24.89) and longer duration of the first breastfeed (4.16 min; 95% CI: 2.10, 6.22), and an increased likelihood of being exclusively breastfed at discharge (74.5% vs. 55.0%, P<0.001), 3 months (OR=3.20; 95% CI: 1.01, 10.15), and 6 months (OR=4.91; 95% CI: 1.71, 14.13) of age.Conclusions: EENC enhances early and successful breastfeeding initiation, prolongs duration of the first breastfeed, and increases the rate of exclusive breastfeeding at six months of age. Our evidence suggests that nation wide scale up of EENC would increase the exclusive breastfeeding rate in the first six months of life.

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