Clin Exp Pediatr > Accepted Articles
DOI:    [Accepted]
Published online October 18, 2021.
Early initiation of breastfeeding and factors associated with its delay among mothers at discharge from a single hospital
J. Jenifer Florence Mary1  , R. Sindhuri1  , A. ArulKumaran2, Amol R. Dongre1
1Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India
2Department of Pediatrics, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India
R. Sindhuri, Email:
Received: 3 February 2021   • Revised: 1 September 2021   • Accepted: 28 September 2021
According to the National Family Health Survey – 4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within one hour of delivery.
To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among them.
This was a hospital-based analytical cross-sectional study of 108 new mothers. After obtaining institutional review board approval and informed consent, we interviewed the new mothers on the day of discharge. Multivariate logistic regression was performed using SPSS version24.
The median breastfeeding initiation time was 90 min (interquartile range, 30–180 min). Overall, 43.5% of the mothers practiced EIBF, 77.4% practiced exclusive breastfeeding, and 43.5% were rooming in at discharge. Reasons for breastfeeding delays included extended recovery time from spinal anesthesia, maternal lassitude, and uncomfortable breastfeeding position due to post-cesarean pain. In the multivariate analysis, a birth weight less than 2500 g (adjusted odds ratio [aOR], 4.33; 95% confidence interval [CI], 1.12–16.82; p=0.03), cesarean section delivery (aOR, 4.68; 95% CI, 1.57–13.92; p=0.005), and mother’s poor knowledge of breastfeeding (aOR, 4.61; 95% CI, 1.44–14.72; p=0.010) were more likely to delay the initiation of breastfeeding.
EIBF was practiced by less than half of the new mothers as determined by the cesarean section, baby’s birth weight, and mothers’ awareness of breastfeeding. Thus, it is vital to improve breastfeeding and nutritional counseling among mothers during the antenatal period and improve healthcare professionals’ training to facilitate EIBF, even in circumstances such as cesarean section.
Key Words: Timely initiation of breastfeeding, Postnatal, Delayed breastfeeding initiation, Cesarean section

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