Abstract:
Background: Initiation of breastfeeding later than 1 hour after birth is associated with
increased neonatal morbidity and mortality.
Objective: To determine the prevalence and factors associated with delayed initiation of
breastfeeding.
Methods: We conducted a survey in 2016 of 930 children under the age of 2 years in Lira
district, northern Uganda. Mothers of the children were interviewed and data was collected
on mobile phones using Open Data Kit software (https://opendatakit.org). Multivariable
logistic regression was used to determine factors associated with delayed initiation of
breastfeeding.
Results: Almost half [48.2%, 95% confidence interval (CI) (44.3–52.1)] of the mothers delayed
initiation of breastfeeding. Factors significantly associated with delayed initiation of breastfeeding
in multivariable analysis included caesarean delivery [Adjusted Odds Ratio (AOR)
11.10 95% CI (3.73–33.04)], discarding initial breast milk [AOR 2.02 95% CI (1.41–2.88)], home
delivery [AOR 1.43 95% CI (1.04–1.97)] and mother being responsible for initiating breastfeeding
as compared to a health worker or relative [AOR 1.73 95% CI (1.33–2.26)]. Mothers having
a secondary education were less likely [AOR 0.54 95% CI (0.30–0.96)] to delay initiation of
breastfeeding as compared to those with no education.
Conclusion: About half the mothers delayed initiation of breastfeeding until after 1 hour after
birth. Programs to promote, protect and support breastfeeding in this post conflict region are
urgently needed.
