Magnitude and factors associated with delayed initiation of breastfeeding among mothers who deliver in Mulago hospital, Uganda.

Abstract

Background: Breastfeeding as a determinant of infant health and nutrition saves up to 1.5 million infant lives annually. Though breastfeeding is mostly universal in sub-Saharan Africa, early initiation of breastfeeding is rarely practiced. Objective: To determine magnitude and factors associated with delayed initiation of breastfeeding among mother-infant pairs who deliver in Mulago hospital. Methods: We carried out a descriptive cross sectional study, where 665 mother-infant pairs were interviewed within 24 hours following delivery; with additional qualitative data collected using focus group discussions to understand reasons for delaying initiation. The data was analysed by identification and coding of themes. Results: In this study, 31.4% mothers delayed initiation of breastfeeding. This was associated with maternal HIV positive status (AOR 2.3; 95% CI 1.3-4.2), inadequate prenatal guidance, (AOR 3.6; 95% CI 1.9-6.8), inadequate professional assistance to initiate breastfeeding (AOR 1.8; 95% CI 1.2-2.8) and caesarean section delivery (AOR 8.6; 95% CI 4.7-16.0). Other reasons were perceived lack of breast milk, need of rest for both mother and baby after labor, and negative cultural beliefs. Uganda. Afri Health Sci. 2015;15(4):1130-5. http://dx.doi.org/10.4314/ahs.v15i4.11

Factors associated with delayed initiation of breastfeeding: a survey in Northern Uganda

“…This association has also been observed in other studies done in Uganda, Nigeria and Vietnam [12,26,35]. The practice of separating the newborn from the mother immediately after caesarean delivery could partly explain this delay [36].…”

“…Another community survey done in Eastern Uganda showed that only 51% of mothers initiated breastfeeding immediately after birth [24]. This proportion is, however, different from another study done at the national referral hospital, which found a much higher proportion of almost 70%, of mothers initiating breastfeeding early [12]. The difference could be explained by the policies at the national referral hospital or differences in the populations studied.…”

“…The practice of separating the newborn from the mother immediately after caesarean delivery could partly explain this delay [36]. In addition, encouraging women to initiate breastfeeding early after caesarean section is uncommon [12,36,37]. Fatigue and post caesarean pain may also contribute to this delay [12].…”

“…The prevalence of mothers who delay initiation of breastfeeding is high both in Uganda [12] and the world at large [6] with only about half of mothers worldwide practicing early initiation of breastfeeding [6]. Factors associated with delayed initiation of breastfeeding include maternal-infant factors (such as absence of breast milk, HIV status of the parent and perinatal morbidity), cultural factors (such as colostrum discarding), and social factors (such as rural residence and place of delivery) among others [12–14].…”

“…Factors associated with delayed initiation of breastfeeding include maternal-infant factors (such as absence of breast milk, HIV status of the parent and perinatal morbidity), cultural factors (such as colostrum discarding), and social factors (such as rural residence and place of delivery) among others [12–14]. However, breastfeeding initiation practices have been found to vary across ethnic lines and geographical locations [15].…”