Timely initiation of breastfeeding, also known as early initiation of breastfeeding, is a well-recognized life-saving intervention to reduce neonatal mortality. However, only one quarter of newborns in Uttar Pradesh, India were breastfed in the first hour of life. This paper aims to understand the association of community-based prenatal counselling and postnatal support at place of delivery with early initiation of breastfeeding in Uttar Pradesh, India. Data from a cross-sectional survey of 9124 eligible women (who had a live birth in 59 days preceding the survey) conducted in 25 districts of Uttar Pradesh, India, in 2018, were used. Simple random sampling was used to randomly select 40 Community Development Blocks (sub district administrative units) in 25 districts. The Primary Sampling Units (PSUs), health service delivery unit for frontline workers, were selected randomly from a linelisting of PSUs in each selected Community Development Block. Bivariate and multivariate logistic regression analyses were performed to assess the association of prenatal counselling and postnatal support on early initiation of breastfeeding in public, private and home deliveries. Overall 48.1% of mothers initiated breastfeeding within an hour, with major variation by place of delivery (61.2% public, 23.6% private and 32.6% home). The adjusted odds ratio (aOR) of early initiation of breastfeeding was highest among mothers who received both counselling and support (aOR 2.67; 95% CI 2.30, 3.11), followed by those who received only support (aOR 1.99; 95% CI 1.73, 2.28), and only counselling (aOR 1.40; 95% CI 1.18, 1.67) compared to mothers who received none. The odds of early initiation of breastfeeding was highest among mothers who received both prenatal counselling and postnatal support irrespective of delivery at public health facilities (aOR 2.49; 95% CI 2.07, 3.01), private health facilities (aOR 3.50; 95% CI 2.25, 5.44), or home (aOR 2.84; 95% CI 2.02, 3.98). A significant association of prenatal counselling and postnatal support immediately after birth on improving early initiation of breastfeeding, irrespective of place of delivery, indicates the importance of enhancing coverage of both the interventions through community and facility-based programs in Uttar Pradesh.

中文翻译：

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印度北方邦产前咨询和产后即时支持与早期母乳喂养协会

及时开始母乳喂养，也称为早期开始母乳喂养，是公认的降低新生儿死亡率的挽救生命的干预措施。然而，在印度北方邦，只有四分之一的新生儿在出生后的第一个小时接受了母乳喂养。本文旨在了解印度北方邦基于社区的产前咨询和分娩地点的产后支持与早期开始母乳喂养之间的关联。使用了 2018 年在印度北方邦 25 个地区对 9124 名符合条件的妇女（在调查前 59 天内有活产）进行的横断面调查的数据。采用简单随机抽样的方法，在25个区中随机抽取了40个社区发展街区（分区行政单位）。初级抽样单位（PSU），前线工作人员的卫生服务提供单位是从每个选定社区发展街区的初级抽样单位名单中随机选择的。进行双变量和多变量逻辑回归分析以评估产前咨询和产后支持与公共、私人和家庭分娩中早期开始母乳喂养的关联。总体而言，48.1% 的母亲在一小时内开始母乳喂养，分娩地点差异很大（61.2% 公共场所、23.6% 私人场所和 32.6% 家庭）。在接受咨询和支持的母亲中，早期开始母乳喂养的调整优势比 (aOR) 最高 (aOR 2.67; 95% CI 2.30, 3.11)，其次是仅接受支持的母亲 (aOR 1.99; 95% CI 1.73, 2.28），并且与没有接受咨询的母亲相比，只有咨询（aOR 1.40；95% CI 1.18, 1.67）。无论是在公共医疗机构 (aOR 2.49; 95% CI 2.07, 3.01)、私人医疗机构 (aOR 3.50; 95% CI 2.25, 5.44），或家（aOR 2.84；95% CI 2.02, 3.98）。产前咨询和产后支持在出生后立即改善早期母乳喂养的重要关联，无论分娩地点如何，表明通过北方邦的社区和设施计划提高干预覆盖率的重要性。私人医疗机构（aOR 3.50；95% CI 2.25, 5.44）或家庭（aOR 2.84；95% CI 2.02, 3.98）。产前咨询和产后支持在出生后立即改善早期母乳喂养的重要关联，无论分娩地点如何，表明通过北方邦的社区和设施计划提高干预覆盖率的重要性。私人医疗机构（aOR 3.50；95% CI 2.25, 5.44）或家庭（aOR 2.84；95% CI 2.02, 3.98）。产前咨询和产后支持在出生后立即改善早期母乳喂养的重要关联，无论分娩地点如何，表明通过北方邦的社区和设施计划提高干预覆盖率的重要性。