actors Associated With the Initiation of Breastfeeding Within One Hour of Delivery at Kenyatta National Hospital

Abstract

Background: The World Health Organization (WHO) recommends that Neonates be breastfed immediately after birth to reduce neonatal mortality, stimulate milk production, and reduce the incidence of postpartum hemorrhage. Understanding the factors of EIBF is necessary to trigger facility staff and health policymakers to implement high impact EIBF interventions. However, the assessment of EIBF has often been as a report by mothers or as an intent to breastfeed without actual evidence of EIBF. The use of LATCH (latch, audible swallow, type of nipple, comfort, hold) Tool eliminates systematic differences occurring due to reporting biases by postpartum mothers on whether they practiced breastfeeding or not. Study Objective: To determine the factors associated with the establishment of breastfeeding within one hour of delivery at Kenyatta National Hospital (KNH). Methodology: This was a facility-based cross-sectional study of 108 women who delivered at 34 weeks or above in KNH. The LATCH tool offered a standardized method of assessment of breastfeeding to minimize observer bias. Participants were scored with this tool. A score of 5 and above denotes success, while below 5 denotes no success. The rate of EIBF, maternal, and neonatal characteristics was described using frequency distribution. Chi-square (χ2) test or Fisher's exact test p-value was used for comparison of LATCH scale items in single and married women appropriately. Stepwise mmultivariable logistic regression was used to investigate the factors independently associated with EIBF. Results: The mean age of participants was 26.57 years [standard deviation (SD), ± 5.79], and a range of 18–51 years. Six in ten (63.9%) were married, 3.3% – single, 0.9% – divorced, 1.9% – widowed, 16.7% – primary education, 51.9% – secondary education, and 31.5% – post-secondary education and 68% were unemployed. Of the 108 mother-infant dyads, 63 (58.3%) achieved successful LATCH. After controlling for other factors, the odds of establishing breastfeeding within one hour of childbirth were lower if the mother had a salaried job than being unemployed [adjusted odds ratio (aOR): 0.07, 95% CI: 0.01–0.89, p- value = 0.027]. Infants who were born through spontaneous vertex/vaginal delivery (SVD) had seven-fold higher odds of establishing breastfeeding within one hour than those who had a caesarean section (aOR: 7.14, 95% CI: 2.33–21.9; p-value < 0.001). Conclusion: Breastfeeding in the first hour after delivery was 58.3% but was still below the WHO recommendation that all mothers should practice EIBF. The use of a standardized tool xii (LATCH) will enable systematic assessment of breastfeeding and can be incorporated into the patient file as part of the postpartum assessment.