Background: Despite well-known benefits, rates of exclusive breastfeeding and early initiation of breastfeeding are very low. This study was conducted to identify most important and easily modifiable barriers to Early Initiation of Breast Feeding (EIBF).Methods: This hospital-based cross-sectional study was conducted from January 2018 to December 2018. Data on factors which could impact EIBF was collected by interviewing with mothers using semi-structured questionnaire.Results: Only 306 (33.7 percent) of the total 908 mother–neonate dyads enrolled received breastfeeding within 1 hour of birth. Factors affecting EIBF included: delivery by lower segment cesarean section (LSCS), lack of prenatal advice on breastfeeding, use of prelacteal feeds, and maternal illness.Conclusion: Rates of EIBF were very low in present setting. Counseling during antenatal visits on the importance of EIBF, and having adequate staff to support initiation of BF, may improve the EIBF.
IntroductionPneumonia continues to be the leading cause of morbidity and mortality in children younger than five years. The World Health Organization (WHO) recommends intravenous antibiotics for five days for severe pneumonia. However, the optimum duration of parenteral antibiotic therapy for pneumonia is not practicable and feasible in poor and resource-constrained settings like India. Given the current Indian scenario wherein childhood pneumonia is extremely prevalent, we attempted to undertake this study to compare the duration of antibiotic therapy in severe cases of community-acquired pneumonia (CAP). MethodsA prospective observational study was carried out on 225 cases of severe and very severe CAP patients at a tertiary care center. The study group included children between two months to five years of age. The participants were subjected to antibiotic therapy (parenteral) plus supportive care. The selection of antibiotics was empirical and according to the WHO acute respiratory infection control program. Hematological parameters including blood hemoglobin, C-reactive protein, erythrocyte sedimentation rate (ESR), and total leukocyte count, and radiological evaluation were performed on all the participants. Cases were followed up for the duration of clinical response. ResultsOut of the 225 cases, 25 patients did not respond to antibiotics and were categorized as the treatment failure group. Of the remaining 200 cases, 104 (52%) showed clinical response within three days (3.0±0.016), and 96 showed a response in four to seven days (4.4±0.064). The mean duration of antibiotic therapy among shortcourse versus long-course treatment was statistically significant (p<0.0001). The majority of patients developed leukocytosis, neutrophilia, and elevated ESR. ConclusionShort-course parenteral antibiotics therapy was equally effective as long-course therapy in severe pneumonia. However, very severe pneumonia patients required a longer course of parenteral antibiotics therapy. Very severe pneumonia was significantly associated with high mortality and treatment failure.
Background Low birth weight (LBW) is at the forefront of 100 core health issues that are used as indicators to assess the global nutrition monitoring framework as reported by the World Health Organization (WHO). Several factors could contribute to LBW, which essentially include intrauterine growth retardation and premature delivery/birth. Moreover, LBW predisposes neonates to several developmental disturbances including both physical and mental disorders. Given that LBW is more common in poor and developing countries, there is not much reliable data that could be used to formulate strategies for controlling this problem. This study, therefore, attempts to assess the prevalence of LBW among newborn babies and its associated maternal risk factors. Methods This hospital-based cross-sectional study was carried out between June 2016 and May 2017 (one year) and included 327 LBW babies. A predefined and prevalidated questionnaire was used to obtain data for the study. The data collected included age, religion, parity, birth spacing, pre-pregnancy weight, weight gain during pregnancy, height, mother’s education, occupation, family income, socioeconomic status, obstetric history, previous history of stillbirths and abortions, and history of any LBW baby. Results The prevalence of LBW was noted to be 36.33%. The occurrence of LBW babies was predominant among mothers who were aged <19 years (62.26%) and >35 years (57.14%). Grand multipara women showed the highest rates (53.70%) of LBW babies. Additionally, LBW was predominantly noticed among newborns (46.66%) with a birth spacing of <18 months, those born to mothers with pre-pregnancy weight of <40 Kg (94.04%), mothers with a height of <145 cm (83.46%), mothers who gained <7 kg during the pregnancy (82.20%), illiterate mothers (43.75%), and mothers who were agricultural workers (63.76%). Other maternal factors that could predispose to LBW included lower monthly income (66.25%), low socioeconomic status (52.90%), less number of antenatal visits (59.65%), low blood hemoglobin (100%), history of strenuous physical activities (48.66%), smoking and/or tobacco chewing habit (91.42%), alcoholism (66.66%), lack of iron and folic acid supplementation during pregnancy (64.58%), history of stillbirths (51.51%), and mothers suffering from chronic hypertension, preeclampsia, and eclampsia (47.61%), and tuberculosis (75%). Religion-wise, Muslim mothers revealed the highest prevalence (48.57%) of LBW, followed by Hindus (37.71%) and Christians (20%). The mother’s age, pre-pregnancy weight, weight gain during pregnancy, height of the mother, hemoglobin concentration, weight of the baby, and length of the newborn (p≤0.05) could influence the health of the newborn. However, maternal infections, previous bad obstetrics history, presence of systemic illnesses, and protein and calorie supplementation (p≥0.05) had no significant impact on birth weight. Conclusions The results showed that multiple factors are respo...
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