Prevalence and Predictors of Delayed Initiation of Breastfeeding Among Postnatal Women at a Tertiary Hospital in Eastern Uganda: a Cross-Sectional Study

Abstract

BackgroundThe rates for the delayed initiation of breastfeeding in Uganda remain unacceptably high and reasons for this are not well understood. We aimed to determine the prevalence and predictors for the delayed initiation of breastfeeding in Eastern Uganda. MethodsThis study employed a cross-sectional study design. A total of 404 mother-infant pairs were enrolled onto the study between July and November, 2020 at Mbale regional referral hospital (MRRH). They were interviewed on socio-demographic related, infant-related, labour and delivery characteristics using a structured questionnaire. We estimated adjusted odds ratios using multivariable logistic regression models.Results. The rate of delayed initiation of breastfeeding was 70% (n=283/404, 95% CI: 65.3% – 74.4%). The factors that were associated with delayed initiation of breastfeeding were maternal charateristics including: being single (AOR=0.37; 95%CI: 0.19 – 0.74), receiving antenatal care for less than 3 times while pregnant (AOR=1.85, 95%CI: 1.07 – 3.19) undergoing a caesarean section (AOR= 2.07; 95%CI: 1.3 – 3.19) and having a difficult labour (AOR=2.05; 95%CI: 1.25 – 3.35). Infant characteristics included: having a health issue at birth (AOR=9.8; 95%CI: 2.94 – 32.98).Conclusions:The proportion of infants that do not achieve early initiation of breastfeeding in this setting remains high. Women at high risk of delaying the initiation of breastfeeding include those who: deliver by caesarean section, do not receive antenatal care and have labour difficulties. Infants at risk of not achieving early initiation of breastfeeding include those that have a health issue at birth. We recommend increased support for women who undergo caesarean section in the early initiation of breastfeeding. Breastfeeding support can be initiated in the recovery room after caesarean delivery or in the operating theatre. The importance of antenatal care attendance should be emphasized during health education classes.

Predictors of late initiation of breastfeeding practice in Ethiopia: a multilevel mixed-effects analysis of recent evidence from EDHS 2019

“…Late initiation of breastfeeding practice is significantly higher among mothers with no ANC visit than among those who have received ANC. This finding is supported by studies conducted in Uganda61 and Namibia 32. Mothers who attended ANC visits may have been informed about the importance of timely initiation of breast feeding for child health, leading them to start breast feeding at an earlier convenience.…”

Providing education from adolescence to promote exclusive breastfeeding: a retrospective study

“…Postcesarean section mothers experience two times more obstacles in exclusive breastfeeding than postvaginal delivery mothers. (13,(41)(42)(43) The proportion of breastfeeding initiation in post-cesarean section mothers ranges from 4.8% to 40.1%. (44,45) Generally, newborns are kept separate from the mothers after cesarean section; hence, early initiation of breastfeeding is delayed.…”