Breast feeding initiation time and its impact on diarrheal disease and pneumonia in West Africa

Abstract

Although breast feeding (BF) is protective against infectious disease amongst children, its timing initiation effect after birth is unknown, whether immediate (<1 h), hours (>1 to <24 h) or days (>24 h). The authors examined relationships between early initiation time of BF and the prevalence of pneumonia and diarrhea in infants and under 5 children adjusting for gender, previous sibling death, maternal educational level, place of delivery and birth weight. This study utilized secondary database analysis of the de-identified and publicly available Multiple Indicator Cluster Survey (MICS) 4 data for the period between 2009-2011. A cross-sectional study was conducted for children under 5 years, using the data from Nigeria (n=26018), Ghana (n=7586), Togo (n=4908) and Sierra Leone (n=8798). A total of 47310 children were recorded for the four countries in West Africa with a mean age and birth weight distribution of 1.72+or-2 (0.45) years and 2.17+or-2 (0.62) kg, respectively. 'Hours' breast fed infants were significantly more likely to be protected from diarrhea than 'days' breast fed with a crude OR of 0.74 (95% CI=0.68-0.80 P=0.0292). The estimated adjusted OR for 'hours' breast feeding in relation to protection against diarrhea as compared to 'days' is 0.81 (95% CI=0.72-0.92 P=0.0478). In this population representing infants and children less than 5 years of age from four countries within the West African sub-region, breast feeding within 24 h after birth showed a protective effect against diarrhea as compared to breast feeding which commenced days after birth even after all adjustments for confounding variables had been considered.