From Delivery to First Feed: A Hospital-Based Cross-Sectional Study of Factors Associated With Early Initiation of Breastfeeding Among Mothers in Noakhali, Bangladesh.

Abstract

Background and aims: Early initiation of breastfeeding (EIBF) within the first hour of birth is vital for newborn survival and maternal health. Although national surveys indicate that EIBF remains suboptimal in Bangladesh, evidence on local variations and context-specific determinants is limited. In particular, no study had specifically examined EIBF and its associated factors among mothers in Noakhali, a coastal district with diverse socioeconomic and healthcare characteristics. Hence, this study aimed to assess the prevalence and determinants of EIBF among mothers in Noakhali, Bangladesh.

Methods: A cross-sectional study was conducted from November 2018 and June 2019 at Noakhali General Hospital, Bangladesh. A total of 397 consenting mothers with infants aged < 6 months were recruited using convenience sampling. Data were collected via interviewer-administered structured questionnaires.

Results: Around 45.3% of mothers initiated breastfeeding within the first hour. Early initiation of breastfeeding was significantly more likely among literate mothers (adjusted odds ratios [AOR] = 3.525, 95% confidence intervals [CI] = 1.371-9.064, p = 0.009), mothers with female infants (AOR = 3.205, 95% CI = 1.846-5.565, p < 0.001), those who received breastfeeding counseling during antenatal care (AOR = 3.737, 95% CI = 1.634-8.544, p = 0.002), and those who received postnatal care (AOR = 6.818, 95% CI = 3.305-14.064, p < 0.001). Early initiation was significantly less likely among mothers living in urban areas (AOR = 0.279, 95% CI = 0.129-0.605, p = 0.001), those who experienced maternal complications during pregnancy (AOR = 0.158, 95% CI = 0.050-0.500, p = 0.002), and those who delivered by cesarean section (AOR = 0.197, 95% CI = 0.100-0.385, p < 0.001).

Conclusion: A majority of mothers in Noakhali did not initiate breastfeeding within the recommended first hour. Addressing this gap requires targeted interventions that enhance female education, systematically integrate breastfeeding counseling into antenatal and postnatal services, and establish supportive protocols for mothers with complicated pregnancies or cesarean deliveries to facilitate timely initiation.