Predictors of Effective Breastfeeding in Newborns and 6-Week-Old Infants: Modifiable Pre-Feeding, Positioning and Latching-On Elements.

Aim: Although breastfeeding assessment elements arise from compelling expert opinion, they have generally not been subject to rigorous evaluation. This project aimed to ascertain which elements, if any, are associated with effective breastfeeding and identify key modifiable findings for clinical practice.

Methods: This observational descriptive study analysed the breastfeeding sessions of 300 newborns in the postpartum unit and 166 infants attending their 6-week young-child clinic visit, from January to February 2024 in a regional referral hospital in Masaka, Uganda using the Lactation Assessment & Comprehensive Intervention Tool (LAT). Effective breastfeeding was defined as 1 or 2 sucks to 1 swallow by cervical auscultation, and/or observed rocker jaw motion. Associations were analysed using Pearson's Chi-square test.

Results: Nine elements were significantly related to effective breastfeeding: two pre-feeding behaviours (infant state, feeding cues); four positioning behaviours (tummy-to-mummy, arms around breast, breast not held or shaped, head free of restrictions) and three latching-on behaviours (gape, head tilt, lower lip reaches first). All but one, head free from restrictions, were also significant for 6-week-old babies.

Conclusion: Key findings for clinical practice were identified including evidence for modifiable pre-feeding, positioning and latching-on behaviours, which were significantly associated with effective breastfeeding.