Initiation of breastfeeding among mothers attending a regional referral hospital in central uganda: a cross-sectional study.

BACKGROUND

Breastfeeding initiation within the first hour of birth is beneficial in reducing the risk of maternal and neonatal mortality. However, a significant proportion of mothers delay initiating breastfeeding within an hour of birth, but the association with age has not been rigorously studied. We examined the association between maternal age and delayed initiation of breastfeeding in a large urban referral hospital in central Uganda.

METHODS

This analytic cross-sectional study was conducted at the Entebbe Regional Referral Hospital in Central Uganda. Data were collected using a researcher-administered questionnaire between October 1, 2019, and December 20, 2019. Delayed initiation of breastfeeding was the primary outcome, defined as putting the newborn to the breast after one hour of birth. The primary exposure was maternal age categorized as 15-24, 25-34, and 35-45 years. We performed a modified Poisson regression analysis to determine the independent association between maternal age and delayed initiation of breastfeeding, adjusting for other confounders. We stated the findings as an adjusted prevalence ratio (aPR) and 95% confidence interval (CI).

RESULTS

We studied 384 participants with a mean age of 27.5 ± 5.5 years. Of the 384 participants studied, 275 (71.6%) had delayed initiating breastfeeding, with the majority aged 15-24 years. In a multivariable analysis, delayed initiation of breastfeeding was significantly associated with maternal age groups of 15-24 years (aPR 1.28, 95% CI 1.01,1.63) and 25-34 years (aPR 1.28, 95% CI 1.01-1.60) compared to the reference group of 35-45 years. Additionally, delivery through cesarean section compared to spontaneous vaginal delivery was associated with delayed initiation of breastfeeding (aPR 1.93, 95% CI 1.49-2.49).

CONCLUSION

Delayed initiation of breastfeeding is common and is associated with maternal age (15-24 and 25-34 years) as well as delivery through cesarean section. Routine health education and staff mentoring are needed to enhance early initiation of breastfeeding to prevent maternal and neonatal morbidity and mortality.