Irrespective of the place and mode of delivery, ‘delayed’ initiation of breastfeeding beyond the first hour of birth can negatively influence maternal and newborn health outcomes. In Bangladesh, 49% of newborns initiate breastfeeding after the first hour. The rate is higher among deliveries at a health facility (62%). This study investigates the maternal, health service, infant, and household characteristics associated with delayed initiation of breastfeeding among health facility deliveries in Bangladesh. We used data from the 2014 Bangladesh Demographic and Health Survey. We included 1277 last-born children born at a health facility in the 2 years preceding the survey. ‘Delayed’ breastfeeding was defined using WHO recommendations as initiating after 1 h of birth. We performed univariate and multivariable logistic regression to determine factors associated with delayed initiation. About three-fifth (n = 785, 62%) of the children born at a health facility delayed initiation of breastfeeding beyond 1 h. After adjusting for potential confounders, we found delayed initiation to be common among women, who delivered by caesarean section (adjusted Odds Ratio (aOR): 2.93; 95% CI 2.17, 3.98), and who were exposed to media less than once a week (aOR: 1.53; 95% CI 1.07, 2.19). Women with a higher body mass index had an increased likelihood of delaying initiation (aOR: 1.05; 95% CI 1.01, 1.11). Multiparous women were less likely to delay (aOR: 0.71; 95% CI 0.53, 0.96). Delayed initiation of breastfeeding following caesarean deliveries continues to be a challenge, but several other health facility and maternal factors also contributed to delayed initiation. Interventions to promote early breastfeeding should include strengthening the capacity of healthcare providers to encourage early initiation, especially for caesarean deliveries.

中文翻译：

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卫生机构延迟开始母乳喂养的相关因素：2014 年孟加拉国人口和健康调查的二次分析


无论分娩地点和方式如何，在出生第一个小时之后“延迟”开始母乳喂养都会对孕产妇和新生儿的健康结果产生负面影响。在孟加拉国，49% 的新生儿在出生后一小时后开始母乳喂养。在医疗机构分娩的比例更高（62%）。本研究调查了孟加拉国卫生机构分娩中与延迟开始母乳喂养相关的孕产妇、卫生服务、婴儿和家庭特征。我们使用 2014 年孟加拉国人口和健康调查的数据。我们纳入了调查前 2 年内在医疗机构出生的 1277 名最后出生的孩子。根据世界卫生组织的建议，“延迟”母乳喂养被定义为在出生 1 小时后开始母乳喂养。我们进行了单变量和多变量逻辑回归以确定与延迟启动相关的因素。大约五分之三（n = 785，62%）在医疗机构出生的儿童将母乳喂养开始时间推迟到 1 小时以上。在调整潜在的混杂因素后，我们发现延迟启动在剖腹产分娩的女性中很常见（调整后的优势比 (aOR)：2.93；95% CI 2.17, 3.98），并且每周接触媒体少于一次（aOR：1.53；95% CI 1.07，2.19）。体重指数较高的女性推迟开始治疗的可能性更大（aOR：1.05；95% CI 1.01，1.11）。经产妇推迟妊娠的可能性较小（aOR：0.71；95% CI 0.53，0.96）。剖腹产后延迟开始母乳喂养仍然是一个挑战，但其他一些卫生设施和孕产妇因素也导致了延迟开始母乳喂养。 促进早期母乳喂养的干预措施应包括加强医疗保健提供者鼓励早期母乳喂养的能力，特别是剖腹产时。