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

Abstract

Background: Initiation of breastfeeding later than 1 hour after birth is associated with increased neonatal morbidity and mortality. Objective: To determine the prevalence and factors associated with delayed initiation of breastfeeding. Methods: We conducted a survey in 2016 of 930 children under the age of 2 years in Lira district, northern Uganda. Mothers of the children were interviewed and data was collected on mobile phones using Open Data Kit software (https://opendatakit.org). Multivariable logistic regression was used to determine factors associated with delayed initiation of breastfeeding. Results: Almost half [48.2%, 95% confidence interval (CI) (44.3–52.1)] of the mothers delayed initiation of breastfeeding. Factors significantly associated with delayed initiation of breast feeding in multivariable analysis included caesarean delivery [Adjusted Odds Ratio (AOR) 11.10 95% CI (3.73–33.04)], discarding initial breast milk [AOR 2.02 95% CI (1.41–2.88)], home delivery [AOR 1.43 95% CI (1.04–1.97)] and mother being responsible for initiating breastfeed ing as compared to a health worker or relative [AOR 1.73 95% CI (1.33–2.26)]. Mothers having a secondary education were less likely [AOR 0.54 95% CI (0.30–0.96)] to delay initiation of breastfeeding as compared to those with no education. Conclusion: About half the mothers delayed initiation of breastfeeding until after 1 hour after birth. Programs to promote, protect and support breastfeeding in this post conflict region are urgently needed.

Description

Breastfeeding initiation patterns vary across different con texts. This study was done in Lira district, situated in post conflict northern Uganda, to inform the conduct of a randomized controlled study. Our study showed that delayed initiation is common in this region associated with factors such as caesarean delivery, home delivery, lack of education and discarding of initial milk. This study also showed that importance of persons other than the mother in initiating breastfeeding.

Keywords

Nutrition, infant-feeding, post-conflict, breastmilk, neonatal

Citation

David Mukunya, James K Tumwine, Victoria Nankabirwa, Grace Ndeezi, Isaac Odongo, Josephine Tumuhamye, Justin Bruno Tongun, Samuel Kizito, Agnes Napyo, Vincentina Achora, Beatrice Odongkara & Thorkild Tylleskar (2017) Factors associated with delayed initiation of breastfeeding: a survey in Northern Uganda, Global Health Action, 10:1, 1410975, DOI: 10.1080/16549716.2017.1410975