Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Int Breastfeed J. 2021 Jan 22;16(1):14. doi: 10.1186/s13006-021-00360-w.
Irrespective of the place and mode of delivery, 'delayed' initiation of breastfeeding beyond the first hour of birth can negatively influence maternal and newborn health outcomes. In Bangladesh, 49% of newborns initiate breastfeeding after the first hour. The rate is higher among deliveries at a health facility (62%). This study investigates the maternal, health service, infant, and household characteristics associated with delayed initiation of breastfeeding among health facility deliveries in Bangladesh.
We used data from the 2014 Bangladesh Demographic and Health Survey. We included 1277 last-born children born at a health facility in the 2 years preceding the survey. 'Delayed' breastfeeding was defined using WHO recommendations as initiating after 1 h of birth. We performed univariate and multivariable logistic regression to determine factors associated with delayed initiation.
About three-fifth (n = 785, 62%) of the children born at a health facility delayed initiation of breastfeeding beyond 1 h. After adjusting for potential confounders, we found delayed initiation to be common among women, who delivered by caesarean section (adjusted Odds Ratio (aOR): 2.93; 95% CI 2.17, 3.98), and who were exposed to media less than once a week (aOR: 1.53; 95% CI 1.07, 2.19). Women with a higher body mass index had an increased likelihood of delaying initiation (aOR: 1.05; 95% CI 1.01, 1.11). Multiparous women were less likely to delay (aOR: 0.71; 95% CI 0.53, 0.96).
Delayed initiation of breastfeeding following caesarean deliveries continues to be a challenge, but several other health facility and maternal factors also contributed to delayed initiation. Interventions to promote early breastfeeding should include strengthening the capacity of healthcare providers to encourage early initiation, especially for caesarean deliveries.
无论分娩地点和方式如何，出生后 1 小时后“延迟”开始母乳喂养都会对母婴健康产生负面影响。在孟加拉国，49%的新生儿在出生后 1 小时内开始母乳喂养。在医疗机构分娩的比例更高（62%）。本研究调查了孟加拉国医疗机构分娩时与延迟开始母乳喂养相关的产妇、卫生服务、婴儿和家庭特征。
我们使用了 2014 年孟加拉国人口与健康调查的数据。我们纳入了调查前 2 年内在医疗机构出生的 1277 名最后出生的儿童。“延迟”母乳喂养是指按照世卫组织的建议在出生后 1 小时后开始。我们进行了单变量和多变量逻辑回归分析，以确定与延迟开始母乳喂养相关的因素。
约五分之三（n=785，62%）在医疗机构出生的儿童在 1 小时后才开始延迟母乳喂养。在调整了潜在混杂因素后，我们发现剖宫产分娩（调整后的优势比（aOR）：2.93；95%置信区间（CI）2.17，3.98）和每周接触媒体少于一次（aOR：1.53；95% CI 1.07，2.19）的妇女中，延迟开始母乳喂养较为常见。身体质量指数较高的妇女更有可能延迟开始母乳喂养（aOR：1.05；95% CI 1.01，1.11）。多产妇不太可能延迟（aOR：0.71；95% CI 0.53，0.96）。
剖宫产分娩后延迟开始母乳喂养仍然是一个挑战，但其他一些医疗机构和产妇因素也导致了延迟开始。促进早期母乳喂养的干预措施应包括加强医疗保健提供者的能力，鼓励尽早开始母乳喂养，特别是对于剖宫产分娩。
