scholarly journals Predictors for timely initiation of breastfeeding after birth in the hospitals of Nepal- a prospective observational study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Rejina Gurung ◽  
Avinash K. Sunny ◽  
Prajwal Paudel ◽  
Pratiksha Bhattarai ◽  
Omkar Basnet ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Public Hospitals ◽  
Obstetric Complication ◽  
Timely Initiation ◽  
Skin Contact ◽  
Cord Clamping ◽  
Skin To Skin ◽  
Timely Initiation Of Breastfeeding ◽  
Initiation Of Breastfeeding

Abstract Background Timely initiation of breastfeeding can reduce neonatal morbidities and mortality. We aimed to study predictors for timely initiation of breastfeeding (within 1 h of birth) among neonates born in hospitals of Nepal. Method A prospective observational study was conducted in four public hospitals between July and October 2018. All women admitted in the hospital for childbirth and who consented were included in the study. An independent researchers observed whether the neonates were placed in skin-to-skin contact, delay cord clamping and timely initiation of breastfeeding. Sociodemographic variables, obstetric and neonate information were extracted from the maternity register. We analysed predictors for timely initiation of breastfeeding with Pearson chi-square test and multivariate logistic regression. Results Among the 6488 woman-infant pair observed, breastfeeding was timely initiated in 49.5% neonates. The timely initiation of breastfeeding was found to be higher among neonates who were placed skin-to-skin contact (34.9% vs 19.9%, p - value < 0.001). The timely initiation of breastfeeding was higher if the cord clamping was delayed than early cord clamped neonates (44.5% vs 35.3%, p - value < 0.001). In multivariate analysis, a mother with no obstetric complication during admission had 57% higher odds of timely initiation of breastfeeding (aOR 1.57; 95% CI 1.33, 1.86). Multiparity was associated with less timely initiation of breastfeeding (aOR 1.56; 95% CI 1.35, 1.82). Similarly, there was more common practice of timely initiation of breastfeeding among low birthweight neonates (aOR 1.46; 95% CI 1.21, 1.76). Neonates who were placed skin-to-skin contact with mother had more than two-fold higher odds of timely breastfeeding (aOR 2.52; 95% CI 2.19, 2.89). Likewise, neonates who had their cord intact for 3 min had 37% higher odds of timely breastfeeding (aOR 1.37; 95% CI 1.21, 1.55). Conclusions The rate of timely initiation of breastfeeding practice is low in the health facilities of Nepal. Multiparity, no obstetric complication at admission, neonates placed in skin-to-skin contact and delay cord clamping were strong predictors for timely initiation of breastfeeding. Quality improvement intervention can improve skin-to-skin contact, delayed cord clamping and timely initiation of breastfeeding.

scholarly journals Assessment of timely initiation of breastfeeding and associated factors among mothers who have infants less than six months of age in Gunchire Town, Snnpr, Ethiopia 2019

2019 ◽  
Author(s):  
Ephrem Yohannes Roga ◽  
Tsegaye Tesfaye Hailu ◽  
Tadesse Gebreegziabher Kahsay
Keyword(s):  
Antenatal Care ◽  
Associated Factors ◽  
Institutional Delivery ◽  
Breast Disease ◽  
Timely Initiation ◽  
Skin Contact ◽  
Care Visit ◽  
Skin To Skin ◽  
Timely Initiation Of Breastfeeding ◽  
Initiation Of Breastfeeding

Abstract Background: Timely initiation of breastfeeding is defined as the initiation of breastfeeding within one hour after childbirth. Despite breastfeeding has benefit for both mothers and infants, globally breastfeeding within one hour of life in the world was less than half. In least developed countries (53%), Eastern and southern Africa (60%), Ethiopia (73%) of infant breastfed within one hour. The aim of this study was to assess timely initiation of breastfeeding and associated factors among mothers who have infant less than six months of age in Gunchire town, Ethiopia. Methods : The study was conducted from May 6 to 20, 2019 by using face to face interview of structured questionnaire. Community based cross-sectional study was employed on 333 women. The study participants were selected by Simple random sampling techniques. The data were coded, entered, cleaned and analyzed by SPSS with windows version 21.0. Binary and multivariate logistic regression statistical model were used. Adjusted odds ratio with 95% CI will be computed to see the strength of association. Results: In this study the magnitude of timely initiation of breastfeeding was 80.5%. Governmental employed mothers (AOR=2.914, 95%CI: 1.139, 7.46), Antenatal care visit (AOR=5.99, 95% CI:1.29, 27.81), Baby skin to skin contact (AOR=2.4, 95%CI:1.092, 5.34), Vaginal delivery (AOR=5.82 95%CI:1.68, 20.14) Institutional delivery (AOR=5.5, 95CI%:1.66, 18.3), Good knowledge of breastfeeding (AOR=4.02, 95%CI:1.04, 15.59) and Breast disease (AOR=0.24, CI95%: 0.08, 0.73) were significantly associated with timely initiation of breastfeeding. Conclusion: More than third quarter of the respondent mothers timely initiated breastfeeding. Being governmental employed, Antenatal care visit on current baby, skin to skin contact, vaginal delivery, institutional delivery, breast disease and knowledge of mothers about breastfeeding were significantly associated with timely initiation of breastfeeding. Recommendation: We would like to recommend Enamore woreda health office to provide information to give further education about breastfeeding. To Gunchire primary Hospital staffs work at maternal and child health clinic recommend them to provide appropriate services and stimulate the mothers to initiate breastfeeding, skin to skin contact enhancing within first hour of birth. Further study on timely initiation of breastfeeding at institution level is suggested. Key word: Timely, Breastfeeding

scholarly journals Timely initiation of breastfeeding and associated factors among mothers with vaginal and cesarean deliveries in public hospitals of Addis Ababa

2021 ◽  
Author(s):  
Adane Mekonnen ◽  
Zewdu Shewangizaw
Keyword(s):  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Associated Factors ◽  
Addis Ababa ◽  
Public Hospitals ◽  
Breastfeeding Initiation ◽  
Timely Initiation ◽  
Vaginal Deliveries ◽  
Timely Initiation Of Breastfeeding ◽  
Initiation Of Breastfeeding

Abstract Background WHO and UNICEF recommend breastfeeding to be initiated within the first hour of birth. It is possible to initiate breastfeeding within an hour of birth regardless of the method of delivery. Despite this, the practice of timely initiation of breastfeeding remains low in Ethiopia with both delivery modalities. Therefore, this study aims to compare timely initiation of breastfeeding and associated factors with cesarean and vaginal deliveries in public hospitals of Addis Ababa, 2021. Methods and materials: Comparative cross-sectional study was conducted from January 2021 to February 2021 in public hospitals of Addis Ababa. 322 mothers within three days of delivery at the postnatal ward of the respective public hospitals were selected. A multi-stage sampling method was employed with the final participants being recruited by systematic random sampling. Data was entered to Epi data Version 4.6 and analysis was performed by SPSS Version 26. A Binary and multivariate logistic regression statistical model was used. Adjusted odds ratio with 95% CI was computed to see the strength of association. Result Timely breastfeeding initiation was 79 (51.2%) and 123 (80%) for cesarean and vaginal deliveries. With a vaginal delivery, pre-lacteal feeding (AOR= 5.50, 95% CI:1.83-16.57) was significantly associated with timely initiation of breastfeeding. Multiparty (AOR= 2.14, 95% CI: 1.02-4.50), support from health care worker (AOR= 2.602, 95% CI: 1.16-5.82), and pre-lacteal feeding (AOR= 2.55, 95% CI: 1.13-5.75) were significantly associated with timely initiation of breastfeeding with cesarean delivery. Conclusion The rate of timely initiation of breastfeeding differs according to the mode of delivery. Cesarean delivery, as compared to vaginal delivery, was associated with a higher mean and median time for initiation of breastfeeding.

scholarly journals Coverage of the WHO’s four essential elements of newborn care and their association with neonatal survival in southern Nepal

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Emily Bryce ◽  
Luke C. Mullany ◽  
Subarna K. Khatry ◽  
James M. Tielsch ◽  
Steven C. LeClerq ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Newborn Care ◽  
Newborn Health ◽  
Essential Elements ◽  
Delayed Cord Clamping ◽  
Skin Contact ◽  
Cord Clamping ◽  
Risk Of Mortality ◽  
Skin To Skin ◽  
Initiation Of Breastfeeding

Abstract Background Despite recent improvements in child survival, neonatal mortality continues to decline at a slower rate and now represents 47% of under-five deaths globally. The World Health Organization developed core indicators to better monitor the quality of maternal and newborn health services. One such indicator for newborn health is “the proportion of newborns who received all four elements of essential care”. The four elements are immediate and thorough drying, skin to skin contact, delayed cord clamping, and early initiation of breastfeeding. Although there is existing evidence demonstrating an association with decreased neonatal mortality for each element individually, the cumulative impact has not yet been examined. Methods This analysis uses data from a randomized trial to examine the impact of sunflower versus mustard seed oil massage on neonatal mortality and morbidity in the Sarlahi district in Southern Nepal from 2010 to 2017. The proportion of newborn infants receiving an intervention was the exposure and neonatal mortality was the outcome in this analysis. Neonatal mortality was defined as a death between three hours and less than 28 days of age. Associations between neonatal mortality and the essential elements were estimated by Cox proportion hazards models. The hazard ratios and corresponding 95% confidence intervals were reported. Results 28,121 mother-infant pairs and 753 neonatal deaths were included. The percent receiving the individual elements ranged from 19.5% (skin to skin contact) to 68.2% (delayed cord clamping). The majority of infants received one or two of the elements of essential care, with less than 1% receiving all four. Skin to skin contact and early initiation of breastfeeding were associated with lower risk of neonatal mortality (aHR = 0.64 [0.51, 0.81] and aHR = 0.72 [0.60, 0.87], respectively). The risk of mortality declined as the number of elements received increased; receipt of one element compared to zero was associated with a nearly 50% reduction in risk of mortality and receipt of all four elements resulted in a 72% decrease in risk of mortality. Conclusions The receipt of one or more of the four essential elements of newborn care was associated with improved neonatal survival. The more elements of care received, the more survival improved.

scholarly journals Impact of cesarean section on timely initiation of breastfeeding in Ethiopia: a systematic review and meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Temesgen Getaneh ◽  
Ayenew Negesse ◽  
Getenet Dessie ◽  
Melaku Desta ◽  
Habtamu Temesgen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cesarean Section ◽  
Health Professionals ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Timely Initiation ◽  
Skin Contact ◽  
The Impact ◽  
Timely Initiation Of Breastfeeding ◽  
Initiation Of Breastfeeding

Abstract Background Timely initiation of breastfeeding is feeding of breast milk within one hour of birth, however, three in five babies were not breastfed in the first hour of birth globally. There is evidence that cesarean section is the major constraint for this low prevalence, but the impact of cesarean section on timely initiation of breastfeeding in Ethiopia is limited. Therefore, this meta-analysis aimed to provide evidence for policy makers, health professionals and program implementers. Methods This systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. Electronic bibliographic databases such as PubMed/Medline, EMBASE, PsycINFO, CINHAL, Scopus, Google Scholar, Science Direct and Cochrane Library were used to search relevant studies and was conducted up to February 2021. Random effects model meta-analysis was applied to estimate the pooled impact of cesarean section on timely initiation of breastfeeding with 95% confidence intervals (CI). I2 statistical test and, funnel plot and Egger’s test were used to check heterogeneity and publication bias across included studies respectively. Results According to meta-analysis of 17 studies, the pooled estimate of timely initiation of breastfeeding among women who had cesarean section in Ethiopia was 40.1% (95% CI 33.29, 46.92). The meta-analysis of 29,919 study participants showed that cesarean section was associated with a 79% lower odds of timely initiation of breastfeeding compared with vaginal birth (OR 0.21; 95% CI 0.16, 0.28). Conclusions In Ethiopia, almost only one-third of mothers who gave birth by cesarean section initiate breastfeeding within one hour of birth, much lower than the pooled prevalence among general population. Special health promotion, intervention and healthcare provider support during immediate or early skin to skin contact, and having focused breastfeeding guidelines for post-operative patient and trained health professionals should be considered for mothers who give birth through cesarean section.

scholarly journals Immediate newborn care and breastfeeding: EN-BIRTH multi-country validation study

2021 ◽  
Vol 21 (S1) ◽  
Author(s):  
Tazeen Tahsina ◽  
◽  
Aniqa Tasnim Hossain ◽  
Harriet Ruysen ◽  
Ahmed Ehsanur Rahman ◽  
...  
Keyword(s):  
Newborn Care ◽  
Health Indicators ◽  
Newborn Health ◽  
Public Hospitals ◽  
Maternal And Newborn Health ◽  
Delayed Cord Clamping ◽  
Cord Clamping ◽  
Improve Measurement ◽  
Immediate Newborn Care ◽  
Skin To Skin

Abstract Background Immediate newborn care (INC) practices, notably early initiation of breastfeeding (EIBF), are fundamental for newborn health. However, coverage tracking currently relies on household survey data in many settings. “Every Newborn Birth Indicators Research Tracking in Hospitals” (EN-BIRTH) was an observational study validating selected maternal and newborn health indicators. This paper reports results for EIBF. Methods The EN-BIRTH study was conducted in five public hospitals in Bangladesh, Nepal, and Tanzania, from July 2017 to July 2018. Clinical observers collected tablet-based, time-stamped data on EIBF and INC practices (skin-to-skin within 1 h of birth, drying, and delayed cord clamping). To assess validity of EIBF measurement, we compared observation as gold standard to register records and women’s exit-interview survey reports. Percent agreement was used to assess agreement between EIBF and INC practices. Kaplan Meier survival curves showed timing. Qualitative interviews were conducted to explore barriers/enablers to register recording. Results Coverage of EIBF among 7802 newborns observed for ≥1 h was low (10.9, 95% CI 3.8–21.0). Survey-reported (53.2, 95% CI 39.4–66.8) and register-recorded results (85.9, 95% CI 58.1–99.6) overestimated coverage compared to observed levels across all hospitals. Registers did not capture other INC practices apart from breastfeeding. Agreement of EIBF with other INC practices was high for skin-to-skin (69.5–93.9%) at four sites, but fair/poor for delayed cord-clamping (47.3–73.5%) and drying (7.3–29.0%). EIBF and skin-to-skin were the most delayed and EIBF rarely happened after caesarean section (0.5–3.6%). Qualitative findings suggested that focusing on accuracy, as well as completeness, contributes to higher quality with register reporting. Conclusions Our study highlights the importance of tracking EIBF despite measurement challenges and found low coverage levels, particularly after caesarean births. Both survey-reported and register-recorded data over-estimated coverage. EIBF had a strong agreement with skin-to-skin but is not a simple tracer for other INC indicators. Other INC practices are challenging to measure in surveys, not included in registers, and are likely to require special studies or audits. Continued focus on EIBF is crucial to inform efforts to improve provider practices and increase coverage. Investment and innovation are required to improve measurement.

scholarly journals Fostering the practice of rooming-in in newborn care

2013 ◽  
Vol 3 (2) ◽  
pp. 177-178
Author(s):  
Saurabh R. Shrivastava ◽  
Prateek S. Shrivastava ◽  
Jegadeesh Ramasamy
Keyword(s):  
Institutional Delivery ◽  
Newborn Care ◽  
Cost Effective ◽  
Timely Initiation ◽  
Cost Effective Approach ◽  
Health Related ◽  
And Child Health ◽  
Timely Initiation Of Breastfeeding ◽  
Initiation Of Breastfeeding ◽  
Universal Application

Practice of rooming-in meant that baby and mother stayed together in the same room day and night in the hospital, right from the time of delivery till the time of discharge. Adoption of rooming-in offers multiple benefits to the newborn, mother, and mother-child as a unit. It is a cost-effective approach wherefewer instruments are required and spares additional manpower. Rooming-in endeavors the opportunity to contribute signifi cantly in the child’s growth, development and survival by assisting in timely initiation of breastfeeding. To ensure universal application of rooming-in in hospitals, a comprehensive and technically sound strategy should be formulated and implemented with active participation of healthcare professionals. Measures such as advocating institutional delivery through outreach awareness activities; adoption of baby-friendly hospital initiative; inculcating a sense of ownership among health professionals, can be strategically enforced for better maternal and child health related outcomes.

scholarly journals Barriers and facilitators to breastfeeding during the immediate and one month postpartum periods, among Mexican women: a mixed methods approach

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Sonia Hernández-Cordero ◽  
Ana Lilia Lozada-Tequeanes ◽  
Ana Cecilia Fernández-Gaxiola ◽  
Teresa Shamah-Levy ◽  
Matthias Sachse ◽  
...  
Keyword(s):  
Infant Formula ◽  
Exclusive Breastfeeding ◽  
Mexican Women ◽  
Timely Initiation ◽  
Private Hospitals ◽  
Public And Private ◽  
Public And Private Hospitals ◽  
Hospital Practices ◽  
Timely Initiation Of Breastfeeding ◽  
Initiation Of Breastfeeding

Abstract Background Evidence suggests that inadequate hospital practices, as well as sociocultural and community factors have detrimental effects on timely initiation as the first breastfeed within first hour after birth, and exclusive breastfeeding. The purpose of the study was to examine the factors that influence timely initiation of breastfeeding and exclusive breastfeeding at birth and 1 month postpartum in Mexican women delivering in public and private hospitals. Methods Mixed methods were conducted between May and July 2017, including surveys (n = 543) and semi-structured interviews (n = 60) in the immediate (7 h) and intermediate (30 days) postpartum periods. Participants were women aged 15–49 years, in public and private hospitals, of urban and rural municipalities of Chihuahua and Puebla, Mexico. Results Timely initiation was reported by 49.4% of mothers, and 34.7% reported that their children received infant formula at the hospital. Only 44.8% of women reported exclusive breastfeeding at 1 month postpartum. Timely initiation of breastfeeding was higher in women with vaginal delivery (62.1 vs 35.5%; p < 0.05) and those who received information during pregnancy (OR 1.07; p = 0.018). Exclusive breastfeeding at 1 month postpartum was related to older maternal age (OR 1.05; p < 0.001) and the fact that the mothers had received more information about breastfeeding during pregnancy (OR 1.13; p = 0.0001). Infant formula use was less associated with timely initiation (OR 0.46; p = 0.001). Participants in qualitative data identified the emotional, physical and economic benefits of breastfeeding, however, the perception about insufficient production of human milk, and the belief that infant formula is recommended, persists. Conclusions Modification of hospital practices, such as decreasing the number of cesarean and the use of infant formula, as well as the support of the initiation and continuation of exclusive breastfeeding by health personnel and family members, could help increase breastfeeding practices in Mexican women.

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