Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America.
PLoS One. 2019 Jul 25;14(7):e0220224. doi: 10.1371/journal.pone.0220224. eCollection 2019.
Breastfeeding within one hour of birth is a critical component of newborn care and is estimated to avert 22% of neonatal mortality globally. Understanding the determinants of early initiation of breastfeeding (EIBF) is essential for designing targeted and effective breastfeeding promotion programmes. The aim of this study was to determine the prevalence and determinants of early initiation of breastfeeding among Bangladeshi women.
This paper analyses the data from the Bangladesh Demographic and Health Survey, 2014. Analysis was based on responses of women who had at least one live birth in the two years preceding the survey (n = 3,162) collected using a structured questionnaire. The primary outcome was breastfeeding initiation within one hour of birth ascertained by women's self-report. Explanatory variables included woman's age, education, religion, household wealth, place of residence and place of delivery, birth order, child's size, antenatal care (ANC), postnatal care (PNC) and skin-to-skin contact. Associations between variables were assessed by simple and multivariable logistic regressions.
Of the 3,162 recently delivered mothers, 51% initiated breastfeeding within one hour of delivery. Prevalence of EIBF varied significantly between different types of mode of delivery, among different geographical regions and among women who had PNC with their newborn. Women who had caesarean section (C-section) were less likely to initiate breastfeeding early after birth than women who had normal vaginal delivery (NVD) (AOR: 0.32, 95% CI 0.23 0.43; p value < 0.001). Women who had received PNC with their newborns within one hour of delivery were more likely to breastfeed their babies within one hour of birth compared to those who did not (AOR: 1.61, 95% CI 1.26 2.07; p value < 0.001). Mother's age, education, religion, household wealth index, place of residence and place of delivery, birth order, number of antenatal visits, child's size and skin-to-skin contact were not significantly associated with EIBF.
Findings from this study suggest that investing more effort in ensuring immediate PNC of mother-newborn pair can increase EIBF. Solutions should be explored to increase EIBF among mothers who undergo C-section as C-section is rising rapidly in Bangladesh. Further research is needed to explore the regional differences in the country, including specific cultural practices that influence EIBF.
产后一小时内进行母乳喂养是新生儿护理的关键组成部分，据估计，这可以避免全球 22%的新生儿死亡。了解早期母乳喂养启动（EIBF）的决定因素对于设计有针对性和有效的母乳喂养促进计划至关重要。本研究旨在确定孟加拉国妇女中早期母乳喂养启动的流行率和决定因素。
本文分析了 2014 年孟加拉国人口与健康调查的数据。分析基于在调查前两年内至少有一次活产的妇女的回答（n=3162），这些回答是使用结构化问卷收集的。主要结局是通过妇女自我报告确定的出生后一小时内开始母乳喂养。解释变量包括妇女的年龄、教育、宗教、家庭财富、居住地和分娩地点、分娩顺序、儿童大小、产前护理（ANC）、产后护理（PNC）和皮肤接触。通过简单和多变量逻辑回归评估变量之间的关联。
在 3162 名最近分娩的母亲中，有 51%在分娩后一小时内开始母乳喂养。EIBF 的流行率在不同类型的分娩方式、不同地理区域以及接受 PNC 的新母亲之间存在显著差异。与阴道分娩（NVD）相比，接受剖宫产（C -section）的妇女产后早期开始母乳喂养的可能性较小（AOR：0.32，95%CI 0.23 0.43；p 值<0.001）。与未接受者相比，在分娩后一小时内接受新生儿 PNC 的母亲更有可能在分娩后一小时内母乳喂养婴儿（AOR：1.61，95%CI 1.26 2.07；p 值<0.001）。母亲的年龄、教育、宗教、家庭财富指数、居住地和分娩地点、分娩顺序、产前检查次数、儿童大小和皮肤接触与 EIBF 无显著关联。
本研究结果表明，加大努力确保母婴立即接受产后护理可以增加 EIBF。应探索解决方案，以增加接受剖宫产的母亲的 EIBF，因为剖宫产在孟加拉国迅速增加。需要进一步研究以探索该国的区域差异，包括影响 EIBF 的特定文化习俗。
