Early feeding practices and associated factors in Sudan: a cross-sectional analysis from multiple Indicator cluster survey

Abstract

Background: In efforts to reduce neonatal mortality, the World Health Organization (WHO) has included breastfeeding among its recommended packages of interventions. Early initiation of breastfeeding and avoidance of prelacteal feeding are key contributors to optimal feeding practices. This study aims to assess the prevalence and associated factors of early breastfeeding practices in Sudan. Methods: This study utilises the cross-sectional nationally-representative Sudan Multiple Indicator Cluster Survey (MICS) conducted in 2014. The sample includes women who had a live birth in the two years before the survey and their self-report on early breastfeeding practices, namely early initiation and prelacteal feeding. Percentages of these early breastfeeding practices indicators were estimated accounting for the complex survey design. Multivariable logistic regression analyses were used to examine the factors associated with these outcomes. Results: Of 5622 mothers, 69% initiated breastfeeding within one hour of birth, 72% avoided prelacteal feeding in the first three days after birth, and 51% met the criteria for both (i.e. practised optimal early feeding practice). Optimal early feeding varied across regions of Sudan. Birth by caesarean section (Adjusted Odds Ratio [AOR] 0.34; 95% CI 0.25, 0.47) and at a health facility (AOR 0.75; 95% CI 0.60, 0.94) were negatively associated with optimal early feeding practice. Mothers with secondary education (AOR 1.62; 95% CI 1.30, 2.02), those who desired their pregnancy at the time (AOR 1.31; 95% CI 1.08, 1.60), those who were assisted by a skilled birth attendant at birth (AOR 1.48; 95% CI 1.19, 1.83), and those who gave birth to female infants (AOR 1.16; 95% CI 1.02, 1.33) had higher odds of use optimal early feeding practice. Similarly, the odds of optimal early feeding increased with parity and maternal age. Conclusions: Only half of Sudanese mothers practised optimal early feeding practice, with important differences between regions in the country. Early feeding practices in Sudan are associated with various maternal, child and community level factors. The findings suggest the need to develop breastfeeding promotion programs with consideration of regional variations and healthcare system interventions.

Prelacteal feeding among infants within the first week of birth in eastern Uganda: evidence from a health facility-based cross-sectional study

“…Our study shows that prelacteal feeding is less likely among mothers who had spontaneous vaginal delivery compared to those who had a cesarean section delivery. Our finding is consistent with the results of previous studies [ 8 , 26 , 27 ]. The plausible biological explanation is that as a baby breastfeeds, the nipple is stimulated, and this causes the release of oxytocin into the maternal bloodstream resulting in the contraction of the uterine muscles.…”

RETRACTED ARTICLE: Prevalence and predictors of timely initiation of breastfeeding in Ghana: an analysis of 2017–2018 multiple indicator cluster survey

“…It has been predicted by Duodu et al that Ghana may meet its target of timely initiation of breastfeeding by 2044 [ 17 ]. The prevalence of timely initiation of breastfeeding in Ghana is also substantially lower than that reported in countries such as Ethiopia (74.3%), Malawi (76.9%), Sudan (69%), Rwanda (81.5%), and Mozambique (77.7%) [ 11 , 24 , 27 , 28 ]. The differences in prevalence of timely initiation of breastfeeding across countries might be attributed to differences in socio-cultural context, economy and health inequalities [ 11 ].…”

Neonatal Jaundice and Autism: Precautionary Principle Invocation Overdue

“…Later access to less appropriate care means that the safety advantages of supplemental feeding relative to starvation are likely more marked for neonates in lower-resourced settings compared to their wealthy, Western counterparts. This may help explain why widespread prelacteal feeding, seen by some of its practitioners as helping new mothers rest and newborns stay nourished to promote health and breastfeeding success, has a long history of diverse traditions and continues today, along with more limited wetnursing and co-nursing practices, in many low- and middle-income countries [ 43 - 56 ] and most foraging societies [ 58 ]. Such supplementary feeding is the target of extensive public health attention aiming to stop it.…”

“…This created intergenerational knowledge gaps about safe breastfeeding. Well-meaning reformers then brought breastfeeding back with a new, historically anomalous emphasis on exclusivity, and in the absence of the pre-existing safety infrastructure - wetnursing [ 37 - 41 ], co-nursing [ 42 ], and prelacteal feeding [ 43 - 56 ] - that had protected neonates from common breastfeeding insufficiencies in all prior advanced civilizations. This safety infrastructure persisted in most of the non-Western world, including among the vast majority of foraging societies documented in the Human Relations Area Files (HRAF); in most societies in the HRAF and Standard Cross-Cultural Sample, mothers initiate breastfeeding at least a day and up to a week postpartum [ 57 , 58 ].…”