Impact of breastfeeding on mortality in sub-Saharan Africa: a systematic review, meta-analysis, and cost-evaluation

Pretorius, Cianté E.; Asare, Hannah; Genuneit, Jon; Kruger, Herculina S; Ricci, Cristian

doi:10.1007/s00431-020-03721-5

Cited by 12 publications

(10 citation statements)

References 43 publications

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“…9 In a meta-analysis from Sub-Saharan Africa, early initiation of breastfeeding in the first hour after birth was associated with a 70% decrease in mortality compared with delayed initiation of breastfeeding (relative risk [RR] = 0.3; 95% CI, 0.22-0.40). 10 In a meta-analysis of 18 studies predominantly from Latin America, South Asia, and Africa, infants who were exclusively breastfed up to 6 months had a 93% decrease in risk of death compared with those who were never breastfed (RR = 0.07; 95% CI, 0.03-0.16) and a 65% decrease in risk of death compared with those who were partially breastfed (RR = 0.35; 95% CI, 0.20-0.61). 11 These positive benefits extend beyond the period of early infancy.…”

Section: Overall Mortalitymentioning

confidence: 99%

Breastfeeding in a Global Context: Epidemiology, Impact, and Future Directions

North

Gao

Allen

et al. 2022

Clinical Therapeutics

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Section: Overall Mortalitymentioning

confidence: 99%

Breastfeeding in a Global Context: Epidemiology, Impact, and Future Directions

North

Gao

Allen

et al. 2022

Clinical Therapeutics

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“…Malnutrition-related causes of neonatal morbidity, mortality, and impaired child growth coupled with the consequential effects on socio-economic development remains a major public health concern especially in developing countries [1][2][3][4][5][6]. The risk of under five mortality when initiation of breastfeeding is delayed in sub-Saharan Africa (SSA) was estimated to be threefold higher compared to any kind of infant feeding as 55.3% of under-five mortality is attributable to delayed initiation of breastfeeding [1].…”

Section: Introductionmentioning

confidence: 99%

Mother and newborn skin-to-skin contact and timely initiation of breastfeeding in sub-Saharan Africa

et al. 2023

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Background Mother and newborn skin-to-skin contact (SSC) plays a key role in breastfeeding practices of mothers. In this study, we examined the association between mother and newborn SSC and timely initiation of breastfeeding in sub-Saharan Africa (SSA). Methods This cross-sectional study utilized nationally representative data from the Demographic and Health Surveys of 17 countries in SSA from 2015 to 2020. Multilevel binary logistic regression analysis was performed to examine the association between mother and newborn SSC and timely initiation of breastfeeding. The results are presented using adjusted odds ratios (aOR), with 95% confidence interval (CI). Results The pooled prevalences of mother and newborn SSC and timely initiation of breastfeeding were 45.68% (95% CI = 34.12–57.23) and 62.89% (95% CI = 55.67–70.11), respectively. Mothers who practiced newborn SSC were more likely to practice timely initiation of breastfeeding compared to those who did not practice SSC [aOR = 1.68, 95% CI = 1.58, 1.78] and this persisted after controlling for all the covariates [aOR = 1.38, 95% CI = 1.29, 1.47]. At the country level, mother and newborn SSC increased the odds of timely initiation of breastfeeding in Angola [aOR = 1.99, 95% CI = 1.44, 2.76], Cameroon [aOR = 1.43, 95% CI = 1.02, 1.99], Ethiopia [aOR = 1.62, 95% CI = 1.16, 2.28], Guinea [aOR = 1.69, 95% CI = 1.10, 2.60], Liberia [aOR = 2.03, 95% CI = 1.33, 3.12], Malawi [aOR = 1.47, 95% CI = 1.02, 2.12], Mali [aOR = 1.42, 95% CI = 1.10, 1.84], Sierra Leone [aOR = 1.87, 95% CI = 1.23, 2.83], South Africa [aOR = 2.59, 95% CI = 1.41, 4.76], Tanzania [aOR = 1.60, 95% CI = 1.27, 2.01], Uganda [aOR = 1.43, 95% CI = 1.02, 1.99], Zambia [aOR = 1.86, 95% CI = 1.50, 2.30], and Zimbabwe [aOR = 1.65, 95% CI = 1.24, 2.21]. Conclusion The prevalence of SCC was relatively low but timely initiation of breastfeeding was high. Mother and newborn SSC is a strong predictor of timely initiation of breastfeeding in SSA. To enhance timely initiation of breastfeeding after birth, this study recommends that more child and maternal healthcare interventions focused on improving mother and newborn SSC should be implemented.

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“…Different studies examining U5M previously showed that source of water [ 8 ], multiple births [ 6 , 7 ], region [ 9 , 10 ], age and sex of household head [ 1 ], maternal education status [ 11 , 12 ], place of delivery [ 9 , 10 , 13 ], maternal age [ 14 – 16 ], sex of the child [ 8 , 13 , 16 ], residence [ 17 , 18 ], family size [ 9 , 15 ], number of children under five [ 18 , 19 ], birth order [ 9 , 15 ], and breastfeeding status [ 18 , 20 ] have a significant association with under-five mortality.…”

Section: Introductionmentioning

confidence: 99%

Geographic variation and factors associated with under-five mortality in Ethiopia. A spatial and multilevel analysis of Ethiopian mini demographic and health survey 2019

Tessema

Mulat²,

Gebrehewet³

2022

PLoS ONE

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Background The distribution of under-five mortality (U5M) worldwide is uneven and the burden is higher in Sub-Saharan African countries, which account for more than 53% of the global under-five mortality. In Ethiopia, though U5M decreased substantially between 1990 and 2019, it remains excessively high and unevenly distributed. Therefore, this study aimed to assess geographic variation and factors associated with under-five mortality (U5M) in Ethiopia. Methods We sourced data from the most recent nationally representative 2019 Ethiopian Mini-Demographic and Health Survey for this study. A sample size of 5,695 total births was considered. Descriptive, analytical analysis and spatial analysis were conducted using STATA version 16. Both multilevel and spatial analyses were employed to ascertain the factors associated with U5M in Ethiopia. Results The U5M was 5.9% with a 95% CI 5.4% to 6.6%. Based on the multivariable multilevel logistic regression model results, the following characteristics were associated with under-five mortality: family size (AOR = 0.92, 95% CI: 0.84,0.99), number of under-five children in the family (AOR = 0.17, 95% CI: 0.14, 0.21), multiple birth (AOR = 14.4, 95% CI: 8.5, 24.3), children who were breastfed for less than 6 months (AOR = 5.04, 95% CI: 3.81, 6.67), people whose main roof is palm (AOR = 0.57, 95% CI: 0.34, 0.96), under-five children who are the sixth or more child to be born (AOR = 2.46, 95% CI: 1.49, 4.06), institutional delivery (AOR = 0.57, 95% CI: 0.41, 0.81), resident of Somali and Afar region (AOR = 3.46, 95% CI: 1.58, 7.55) and (AOR = 2.54, 95% CI: 1.10, 5.85), respectively. Spatial analysis revealed that hot spot areas of under-five mortality were located in the Dire Dawa and Somali regions. Conclusion Under-five mortality in Ethiopia is high and unacceptable when compared to the 2030 sustainable development target, which aims for 25 per 1000 live births. Breastfeeding for less than 6 months, twin births, institutional delivery and high-risk areas of under-five mortality (Somali and Dire Dawa) are modifiable risk factors. Therefore, maternal and community education on the advantages of breastfeeding and institutional delivery is highly recommended. Women who deliver twins should be given special attention. An effective strategy should be designed for intervention in under-five mortality hot spot areas such as Somali and Dire Dawa.

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Impact of breastfeeding on mortality in sub-Saharan Africa: a systematic review, meta-analysis, and cost-evaluation

Cited by 12 publications

References 43 publications

Breastfeeding in a Global Context: Epidemiology, Impact, and Future Directions

Breastfeeding in a Global Context: Epidemiology, Impact, and Future Directions

Mother and newborn skin-to-skin contact and timely initiation of breastfeeding in sub-Saharan Africa

Geographic variation and factors associated with under-five mortality in Ethiopia. A spatial and multilevel analysis of Ethiopian mini demographic and health survey 2019

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