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

• Main Authors: 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
• Format: Article
• Language: English
• Published: Taylor & Francis Group 2017-01-01
• Series: Global Health Action
• Subjects: Nutrition; infant-feeding; post-conflict; breastmilk; neonatal
• Online Access: http://dx.doi.org/10.1080/16549716.2017.1410975
• ISSN: 1654-9716; 1654-9880

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 breastfeeding 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 breastfeeding 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.