Determinants of breastfeeding initiation among newly delivered women in Yaounde, Cameroon

Abstract

Ngwanou Dany Hermann, Georges Pius Kamsu Moyo, Nguefack Felicitee, Louise Ejake, Mah Evelyn, Minka Basilice, Wafeu Guy, Chiabi Andreas

Exclusive breastfeeding is essential for the mother’s wellbeing, fundamental for the newborn’s development and indispensable for the reinforcement of bonding. According to the World Health Organization (WHO), breastfeeding after childbirth should be initiated within the first 30 minutes following delivery. The Early Initiation of Breastfeeding (EIBF) contributes to the reduction of neonatal morbidity and mortality but is oftentimes not respected. The objective of this survey was to determine the factors associated with breastfeeding initiation and delays. We conducted a cross-sectional study at the Yaoundé Gynaeco-Obstetric and Paediatric Hospital from December 2018 to May 2019. We included women with livebirth infants > 2000g, without breastfeeding contraindications during the first hour of immediate postpartum. We enrolled 250 mothers, mostly from the Centre region (40%), with a secondary school education level in 43%. The vaginal route was the main mode of delivery in 70% of cases. The newborns had a mean gestational age of 38.4 ± 1.6 weeks and a mean birth weight of 3168.6 ± 508.7g; the male sex predominated by a ratio of 1.29. The average time of breastfeeding initiation was 120 minutes and only 40% of mothers had put the baby onto the breast within the first hour after birth. The factors associated with delayed breastfeeding initiation were primary school education level, the Centre region as origin or place of residence, HIV infection in mothers, having delivered through caesarean section, gestational age < 37 weeks, low birthweight < 2500g and neonatal infection. After multivariate analysis, delivery by caesarean section and the Centre region persisted as independent predictors of delayed breastfeeding initiation. Therefore, we concluded breastfeeding initiation in this series was delayed, and was influenced by a number of risk factors pertaining to maternal, neonatal and interventional determinants. However, this may be reduced by the reinforcement of education on good breastfeeding practices and the strengthening of antenatal care in order to prevent complications and hence the delayed initiation of breastfeeding.

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