Determinants for delayed initiation of breastfeeding- A hospital based comparative study between primiparous and multiparous mothers

Abstract

Background: For the health and development of the newborn, initiation of lactation within hour of delivery is very crucial factor. Early milk secretion after the delivery is associated with various factors including parity of the mothers and early suckling by neonates. Aims and Objectives: To know and compare the time of initiation breast feeding and to identify and compare the determinants for delayed initiation of breast feeding between primiparous and multiparous mothers. Study Design: Hospital based longitudinal study. Setting: Obstetrics and Gynaecology department, tertiary care hospital, Gujarat, India. Materials and Methods: Total 150 women studied, out of which 75 were primiparous and 75 multiparous mothers. Socio-demographic variables, Obstetric and neonatal factors were compared between primi and multiparous women for delayed initiation of breast feeding by using pre-structured baseline questionnaire. Height, weight, Body mass index measurement and Haemoglobin estimation were done using standard procedure. Statistics: Data entry and analysis was done in software Epi info version 7.0. Statistical analysis was done by using binary logistic regression and Standard error of proportion. Results: None of the women from both groups (primiparous and multiparous) gave breast feeding early according to the “guidelines for infant and young child feeding, Government of India, 2004”. Present study showed positive effect of multiparity on early breast feeding initiation. Only 16% primiparous mothers had given first feed to newborn within 24 hours in comparison to multiparous mothers (50%). Odds (4.3) of having delayed breast initiation higher in nonworking primiparous than multiparous mothers. Difference in education of the mother in-laws had significant effect on the early initiation of the breast feeding as 94.67% mother in-laws of multiparous women were illiterate compared to 77.33% of primiparous mothers. Variables like history of previous abortion, previous neonatal deaths and caesarean delivery were significantly associated with delayed initiation of breast feeding in multiparous mothers compared to primiparous mothers. If in-laws of participants had expectation of male child and female child was born, it significantly delayed breastfeeding initiation more in primiparous mothers (55.35%) compared to multiparous mothers (35.29%). When asked the reason behind not initiating breast feeding early, all mothers of both group replied that it was due to lack of secretion of breast milk initially after delivery. Conclusion: Socio-demographic factors including lower education and expectation of male child by in- laws were more associated with delayed initiation breast feeding in primiparous mothers whereas obstetric problems were more associated with delayed initiation of breastfeeding in multiparous mothers.