Prevalence of and factors associated with early initiation of breastfeeding in Bangladesh: a multilevel modelling

Abstract

Background Early initiation breastfeeding (EIBF) is a sign of good health for both the mother and the newborn baby. The objective of this study was to estimate the prevalence of EIBF among mothers in Bangladesh and to identify its associated factors. Methods The study used the most recent Bangladesh Demographic and Health Survey 2017–2018 data. A total of 4776 (weighted) respondents were included in the final analysis. The association between the outcome and the independent variables was determined using multilevel (mixed effects) logistic regression analysis. Results The overall weighted prevalence of EIBF among Bangladeshi mothers was 61.19% (confidence interval [CI] 59.80 to 62.56). The study shows that non-poor wealth status (adjusted odds ratio [AOR] 0.81 [95% CI 0.68 to 0.95]), institutional delivery (AOR 0.77 [95% CI 0.61 to 0.96]) and caesarean delivery (AOR 0.31 [95% CI 0.26 to 0.38]) were associated with the lower odds of EIBF. Mother's secondary education (AOR 1.34 [95% CI 1.01 to 1.83]), at least four antenatal care visits (AOR 1.36 [95% CI 1.04 to 1.53]), normal birthweight (AOR 1.42 [95% CI 1.09 to 1.85]) and placed on mother's chest and bare skin after birth (AOR 1.33 [95% CI 1.11 to 1.60]) were associated with higher odds of EIBF. Conclusion In order to enhance EIBF in Bangladesh, health professionals should emphasise skin-to-skin contact after delivery.

Inequalities in early initiation of breastfeeding in Bangladesh: an estimation of relative and absolute measures of inequality

“…Inequality in early initiation of breastfeeding among the wealth quintile was found significant over the survey period where the poorest subgroup was interestingly found advantageous with higher early initiation of breastfeeding among the poor compared to the rich in all survey waves except in 2004. This finding was in line with the study conducted in Bangladesh [ 4 ] and Ethiopia [ 20 ] and in contradiction with several other studies [ 9 , 15 , 31 ]. The contradictory result could be simply due to the better awareness of Bangladeshi women about early initiation of breastfeeding irrespective of their wealth status [ 4 ].…”

“…This finding was in line with the study conducted in Bangladesh [ 4 ] and Ethiopia [ 20 ] and in contradiction with several other studies [ 9 , 15 , 31 ]. The contradictory result could be simply due to the better awareness of Bangladeshi women about early initiation of breastfeeding irrespective of their wealth status [ 4 ]. It could also be explained by the fact that poor women mostly deliver at home by normal vaginal delivery, while delivery by cesarean-section is more prevalent among women from households with rich wealth status according to previous studies conducted in Bangladesh [ 7 , 32 , 33 ].…”

“…This might be due to the presence of an unequal increase in the prevalence of breastfeeding initiation among different subgroups [ 5 ]. The increasing trend in the initiation of breastfeeding within 1st hour of life could be due to the increase in the health-related knowledge of early initiation of breastfeeding, its importance in childhood development, and increased awareness among mothers [ 4 ]. Another plausible explanation can be the extensive effort of the government of Bangladesh and non-government organizations in creating awareness about the importance of early initiation of breastfeeding through advertisement in the mass media, and different campaigns providing counseling and community mobilization [ 30 ].…”

“…Early initiation of breastfeeding practice in South Asia is only 39%, which is the lowest among different regions around the globe [ 2 ]. Bangladesh, however, manifested better early initiation of breastfeeding practice ranging from 51.24 to 61.19% [ 3 , 4 ] but falling short of the WHO’s 100% early initiation of breastfeeding recommendation [ 5 ]. Breastfeeding is the universally accepted single best infant feeding practice source, providing numerous benefits to the newborn and mother pair.…”

“…There are disparities in early initiation of breastfeeding practice based on geographic region and other socioeconomic conditions. For instance, a recent study using BDHS 2017-18 data demonstrated that early initiation of breastfeeding is highly prevalent in Rangpur (66.57%) and Sylhet (66.13%) division due to its local norms and culture as well as the decreased cesarean delivery rates [ 4 ]. Numerous research has looked at the socioeconomic factors and other maternal and child-related factors that are associated with early initiation of breastfeeding in Bangladesh [ 7 , 8 ], and in other countries [ 9 – 11 ].…”