Volume 7, Issue 1, January 2019, Page: 8-15
Socio-Economic Differences in Early Initiation of Breastfeeding Among Children in a Ugandan Cross-Sectional Study
Ratib Mawa, Department of Public Health, Faculty of Health Sciences, Victoria University Kampala, Uganda
Caroline Kambugu Nabasirye, Department of Nursing and Midwifery, Faculty of Health Sciences, Lira University, Lira, Uganda
Margaret Chota, Department of Public Health, Faculty of Health Sciences, Victoria University Kampala, Uganda
Stephen Lawoko, Department of Public Health, Faculty of Health Sciences, Victoria University Kampala, Uganda
Tracy Leigh Schumacher, Department of Rural Health, Faculty of Health and Medicine University of Newcastle, Newcastle, Australia
Krishna Nand Sharma, Department of Public Health, Faculty of Health Sciences, Victoria University Kampala, Uganda
Received: Mar. 28, 2019;       Accepted: May 5, 2019;       Published: May 23, 2019
DOI: 10.11648/j.jfns.20190701.12      View  31      Downloads  9
Abstract
Early initiation of breastfeeding reduces neonatal and maternal morbidity and mortality, enhances mother-infant dyad bonding and maternal optimal breastfeeding practices. Studies on socio-economic inequalities in early initiation of breastfeeding are sparse in Uganda. This study therefore aimed to examine the association between socio-economic status and early initiation of breastfeeding among 5504 children aged 0-23 months in a country-wide population based cross-sectional study. Early initiation of breastfeeding defined as initiation of breastfeeding within an hour of birth was the outcome of interest. Proxy measures of socio-economic status (maternal occupation and household wealth index) were the exposure variable of interest. Bivariate analysis was conducted to determine the distribution of the prevalence of early initiation of breastfeeding by infant-mother dyad characteristics. Multivariate binary logistic regression models adjusted for relevant confounders were fitted to examine the association between socio-economic status and early initiation of breastfeeding. The results showed an overall prevalence early initiation of breastfeeding of 67.8% among Ugandan children. Children whose mothers self-reported their occupation as farmers and skilled manual workers had lower odds of early initiation of breastfeeding compared to those whose mothers were doing professional/technical/managerial work; OR: 0.69 (0.51 - 0.95) and 0.70 (0.49 - 0.99) respectively. On the other hand, children that lived in the poorest and poorer households had lower odds of early initiation of breastfeeding OR: 0.46 (0.32-0.67) and 0.64 (0.43-0.94) respectively. In conclusion, we found individual and household socio-economic inequality in EIB among children less than two years of age. Targeting interventions for promotion of EIB to less affluent mother-child dyads and households might be important in increasing optimal breastfeeding practices.
Keywords
Children, Breastfeeding, Socio-Economic Status, Uganda, Africa
To cite this article
Ratib Mawa, Caroline Kambugu Nabasirye, Margaret Chota, Stephen Lawoko, Tracy Leigh Schumacher, Krishna Nand Sharma, Socio-Economic Differences in Early Initiation of Breastfeeding Among Children in a Ugandan Cross-Sectional Study, Journal of Food and Nutrition Sciences. Vol. 7, No. 1, 2019, pp. 8-15. doi: 10.11648/j.jfns.20190701.12
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Lassi, Z. S, et al, Interventions to improve neonatal health and later survival: an overview of systematic reviews. EBioMedicine, 2015. 2 (8): p. 985-1000.
[2]
Fawzi, W. W, Timing of initiation, patterns of breastfeeding, and infant survival: prospective analysis of pooled data from three randomised trials. 2016.
[3]
Debes, A. K, et al, Time to initiation of breastfeeding and neonatal mortality and morbidity: a systematic review. BMC public health, 2013. 13 (3): p. S19.
[4]
Rollins, N. C, et al, Why invest, and what it will take to improve breastfeeding practices? The Lancet, 2016. 387 (10017): p. 491-504.
[5]
Victora, C. G, et al, Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet, 2016. 387 (10017): p. 475-490.
[6]
Group, N. S, Timing of initiation, patterns of breastfeeding, and infant survival: prospective analysis of pooled data from three randomised trials. The Lancet Global Health, 2016. 4 (4): p. e266-e275.
[7]
Brandtzaeg, P, Mucosal immunity: integration between mother and the breast-fed infant. Vaccine, 2003. 21 (24): p. 3382-3388.
[8]
Much, D, et al, Lactation is associated with altered metabolomic signatures in women with gestational diabetes. Diabetologia, 2016. 59 (10): p. 2193-2202.
[9]
Hansen, K, Breastfeeding: a smart investment in people and in economies. The Lancet, 2016. 387 (10017): p. 416.
[10]
Debes, A. K, et al, Time to initiation of breastfeeding and neonatal mortality and morbidity: a systematic review. 2013. 13 (3): p. S19.
[11]
Bhutta, Z. A, et al, Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? 2014. 384 (9940): p. 347-370.
[12]
Victora, C. G, et al, Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. 2016. 387 (10017): p. 475-490.
[13]
Rollins, N. and T. Doherty, Improving breastfeeding practices at scale. The Lancet Global Health, 2019. 7 (3): p. e292-e293.
[14]
Chowdhury, R, et al, Breastfeeding and maternal health outcomes: a systematic review and meta‐analysis. 2015. 104: p. 96-113.
[15]
Collective, G. B, UNICEF, and W. H. Organization, Global breastfeeding scorecard, 2017: Tracking progress for breastfeeding policies and programmes. World Health Organization, 2017.
[16]
UNICEF, W. a, Enabling women to breastfeed through better policies and programmes: Global breastfeeding scorecard 2018. 2018.
[17]
Issaka, A. I, K. E. Agho, and A. M. Renzaho, Prevalence of key breastfeeding indicators in 29 sub-Saharan African countries: a meta-analysis of demographic and health surveys (2010–2015). BMJ open, 2017. 7 (10): p. e014145.
[18]
ICF, U, of S. (UBOS) and. (2018). Uganda Demographic Health Survey 2016. Uganda Demographic and Health Survey 2016.
[19]
Collective, G. B. and UNICEF, Nurturing the health and wealth of nations: the investment case for breastfeeding. World Health Organization, 2017.
[20]
John, J. R, et al, Determinants of early initiation of breastfeeding in Ethiopia: a population-based study using the 2016 demographic and health survey data. BMC pregnancy and childbirth, 2019. 19 (1): p. 69.
[21]
Ogunlesi, T. A, Maternal socio-demographic factors influencing the initiation and exclusivity of breastfeeding in a Nigerian semi-urban setting. Maternal and child health journal, 2010. 14 (3): p. 459-465.
[22]
Acharya, P. and V. Khanal, The effect of mother’s educational status on early initiation of breastfeeding: further analysis of three consecutive Nepal Demographic and Health Surveys. BMC Public Health, 2015. 15 (1): p. 1069.
[23]
Wilkinson, R. G. and M. Marmot, Social determinants of health: the solid facts. 2003: World Health Organization.
[24]
Marmot, M, Social determinants of health inequalities. The lancet, 2005. 365 (9464): p. 1099-1104.
[25]
Sharma, I. K. and A. Byrne, Early initiation of breastfeeding: a systematic literature review of factors and barriers in South Asia. International breastfeeding journal, 2016. 11 (1): p. 17.
[26]
Kimani-Murage, E. W, et al, Factors affecting actualisation of the WHO breastfeeding recommendations in urban poor settings in K enya. Maternal & Child Nutrition, 2015. 11 (3): p. 314-332.
[27]
Gertz, B. and E. DeFranco, Predictors of breastfeeding non‐initiation in the NICU. Maternal & child nutrition, 2019: p. e12797.
[28]
Wagner, S, et al, Breastfeeding initiation and duration in France: The importance of intergenerational and previous maternal breastfeeding experiences—results from the nationwide ELFE study. Midwifery, 2019. 69: p. 67-75.
[29]
Yngve, A. and M. Sjöström, Breastfeeding determinants and a suggested framework for action in Europe. Public health nutrition, 2001. 4 (2b): p. 729-739.
[30]
Bbaale, E, Determinants of early initiation, exclusiveness, and duration of breastfeeding in Uganda. Journal of health, population, and nutrition, 2014. 32 (2): p. 249.
[31]
Kalisa, R, et al, Magnitude and factors associated with delayed initiation of breastfeeding among mothers who deliver in Mulago hospital, Uganda. African health sciences, 2015. 15 (4): p. 1130-1135.
[32]
Statistics, U. B. o. and ICF, Uganda Demographic and Health Survey 2016: Key Indicators Report. 2017, Uganda Bureau of Statistics (UBOS), and Rockville, MD: UBOS and ICF Kampala.
[33]
Organization, W. H, Indicators for assessing infant and young child feeding practices: part 2: measurement. 2010.
[34]
Uganda, M, Policy Guidelines on Infant and Young Child Feeding. January 2009. 2009.
[35]
Elias, P, Occupational Classification (ISCO-88). 1997.
[36]
Vyas, S, L. J. H. p. Kumaranayake, and planning, Constructing socio-economic status indices: how to use principal components analysis. 2006. 21 (6): p. 459-468.
[37]
ICF, U. J. U. D. and H. Survey, of S. (UBOS) and. (2018). Uganda Demographic Health Survey 2016.
[38]
Organization, W. H, Indicators for assessing infant and young child feeding practices: part 1: definitions: conclusions of a consensus meeting held 6-8 November 2007 in Washington DC, USA. 2008.
[39]
Organization, W. H, Indicators for assessing infant and young child feeding practices: conclusions of a consensus meeting held 6-8 November 2007 in Washington DC, USA. 2008: World Health Organization (WHO).
[40]
Ndirangu, M, et al, Trends and factors associated with early initiation of breastfeeding in Namibia: analysis of the Demographic and Health Surveys 2000–2013. 2018. 18 (1): p. 171.
[41]
Ndirangu, M, et al, Trends and factors associated with early initiation of breastfeeding in Namibia: analysis of the Demographic and Health Surveys 2000–2013. BMC pregnancy and childbirth, 2018. 18 (1): p. 171.
[42]
Berde, A. S. and S. S. Yalcin, Determinants of early initiation of breastfeeding in Nigeria: a population-based study using the 2013 demograhic and health survey data. BMC Pregnancy and Childbirth, 2016. 16 (1): p. 32.
[43]
Houweling, T. A, et al, Huge poor-rich inequalities in maternity care: an international comparative study of maternity and child care in developing countries. 2007. 85: p. 745-754.
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