Background: Irrespective of the place and mode of delivery, 'delayed' initiation of breastfeeding beyond the first hour of birth can negatively influence maternal and newborn health outcomes. In Bangladesh, 49% of newborns initiate breastfeeding after the first hour. The rate is higher among deliveries at a health facility (62%).
Objective: This study investigates the maternal, health service, infant, and household characteristics associated with delayed initiation of breastfeeding among health facility deliveries in Bangladesh.
Methods and Study Design: We used data from the 2014 Bangladesh Demographic and Health Survey. We included 1277 last-born children born at a health facility in the two years preceding the survey. 'Delayed' breastfeeding was defined using WHO recommendations as initiating after one hour of birth. We performed univariate and multivariable logistic regression to determine factors associated with delayed initiation.
Results: About three-fifth (n=785,62%) of the children born at a health facility delayed initiation of breastfeeding beyond one hour. After adjusting for potential confounders, we found delayed initiation to be common among women, who delivered by caesarean section (aOR:2.93; 95%CI:2.17-3.98), and who were exposed to media less than once a week (aOR:1.53; 95%C:1.07-2.19). Women with a higher body mass index had an increased likelihood of delaying initiation (aOR:1.05; 95%CI:1.01-1.11). Multiparous women were less likely to delay (aOR:0.71; 95%CI:0.53-0.96).
Conclusions: Delayed initiation following caesarean deliveries continues to be a challenge. Several other health facility and maternal factors also contribute to the delayed. Interventions to promote early breastfeeding should include strengthening the capacity of healthcare providers to encourage early initiation, especially for caesarean deliveries.