Prevalence and determinants of initiation of breastfeeding within one hour of birth: An analysis of the Bangladesh Demographic and Health Survey, 2014

Abstract

Background

Breastfeeding within one hour of birth is a critical component of newborn care and is esti- mated to avert 22% of neonatal mortality globally. Understanding the determinants of early

initiation of breastfeeding (EIBF) is essential for designing targeted and effective breastfeed- ing promotion programmes. The aim of this study was to determine the prevalence and

determinants of early initiation of breastfeeding among Bangladeshi women. Methods This paper analyses the data from the Bangladesh Demographic and Health Survey, 2014. Analysis was based on responses of women who had at least one live birth in the two years preceding the survey (n = 3,162) collected using a structured questionnaire. The primary

outcome was breastfeeding initiation within one hour of birth ascertained by women’s self- report. Explanatory variables included woman’s age, education, religion, household wealth,

place of residence and place of delivery, birth order, child’s size, antenatal care (ANC), post- natal care (PNC) and skin-to-skin contact. Associations between variables were assessed

by simple and multivariable logistic regressions. Results Of the 3,162 recently delivered mothers, 51% initiated breastfeeding within one hour of delivery. Prevalence of EIBF varied significantly between different types of mode of delivery, among different geographical regions and among women who had PNC with their newborn. Women who had caesarean section (C-section) were less likely to initiate breastfeeding early after birth than women who had normal vaginal delivery (NVD) (AOR: 0.32, 95% CI 0.23 0.43; p value < 0.001). Women who had received PNC with their newborns within one hour of delivery were more likely to breastfeed their babies within one hour of birth compared

to those who did not (AOR: 1.61, 95% CI 1.26 2.07; p value < 0.001). Mother’s age, educa- tion, religion, household wealth index, place of residence and place of delivery, birth order,

number of antenatal visits, child’s size and skin-to-skin contact were not significantly associ- ated with EIBF.

Conclusions Findings from this study suggest that investing more effort in ensuring immediate PNC of mother-newborn pair can increase EIBF. Solutions should be explored to increase EIBF among mothers who undergo C-section as C-section is rising rapidly in Bangladesh. Further

research is needed to explore the regional differences in the country, including specific cul- tural practices that influence EIBF.