J Glob Health. 2023 May 12;13:04036. doi: 10.7189/jogh.13.04036.
Early initiation of breastfeeding (EIBF) plays an important role in reducing neonatal and infant mortality. Sub-Saharan African countries have high rates of neonatal and infant mortality, as well as a low prevalence of EIBF. By conducting a scoping review, we aimed to determine the gaps and current understandings of EIBF in Sub-Saharan Africa.
We conducted this scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) reporting guidelines, focusing on primary studies published from 2008 to 2021. We reviewed their titles and abstracts against the eligibility criteria, selecting the relevant ones to this study's criteria for a further full-text review.
The identified determinants can be categorized into household, maternal, and health service characteristics. Regarding health service characteristics, many studies reported that cesarean section was strongly associated with the delayed initiation of breastfeeding. Institutional delivery and delivery by skilled birth attendants were also reported to be associated with the early initiation of breastfeeding. Others pointed out that place of residence and wealth index as two household characteristics that were strongly associated with EIBF, as well as maternal characteristics such as older maternal age and higher education status.
We found that only eleven studies on the early initiation of breastfeeding have been conducted in Central and West Africa. Household, maternal, and health service factors have been reported to be associated with the early initiation of breastfeeding across many countries. More studies are needed to fill the current geographic gaps and investigate determinants that have not been examined. Future research should also cover interventions that have been effective in improving EIBF for women after caesarean sections in sub-Saharan Africa. Interventions that promote institutional delivery and deliveries by skilled attendants have the potential to improve the practice.
早期启动母乳喂养（EIBF）对于降低新生儿和婴儿死亡率起着重要作用。撒哈拉以南非洲国家的新生儿和婴儿死亡率较高，而 EIBF 的普及率较低。通过进行范围综述，我们旨在确定撒哈拉以南非洲 EIBF 的差距和当前认识。
我们按照系统评价和荟萃分析扩展的首选报告项目（PRISMA-ScR）报告指南进行了这项范围综述，重点关注 2008 年至 2021 年期间发表的原始研究。我们根据资格标准审查了这些研究的标题和摘要，选择了与本研究标准相关的研究进行全文审查。
确定的决定因素可以分为家庭、产妇和卫生服务特征。关于卫生服务特征，许多研究报告称剖宫产与母乳喂养的延迟启动密切相关。机构分娩和由熟练助产士分娩也与早期启动母乳喂养有关。还有人指出，居住地和财富指数是与 EIBF 密切相关的两个家庭特征，以及产妇特征，如母亲年龄较大和教育程度较高。
我们发现，只有 11 项关于早期启动母乳喂养的研究是在中非和西非进行的。许多国家报告称，家庭、产妇和卫生服务因素与早期启动母乳喂养有关。需要进行更多的研究来填补当前的地理差距，并调查尚未研究的决定因素。未来的研究还应涵盖在撒哈拉以南非洲地区已被证明能有效改善剖宫产妇女 EIBF 的干预措施。促进机构分娩和由熟练助产士分娩的干预措施有可能改善这一做法。
