Low prevalence of breastfeeding initiation within the first hour of life in a rural area of Sichuan Province, China

Background: The World Health Organization recommends that newborn infants be breastfed within the first hour of life, a practice that improves infant health and reduces neonatal mortality. The objectives of this study were to report the rate of breastfeeding initiation within 1 hour of birth in Jiangyou, China, to determine its impact on "full breastfeeding" at discharge, and to investigate factors associated with early breastfeeding initiation.

Methods: A prospective cohort study of infant feeding practices was undertaken during 2010 and 2011 in Jiangyou, 2 years after an earthquake caused extensive damage. A total of 695 mothers were recruited from hospitals and health centers and interviewed at discharge.

Results: In this study, 9.1 percent of women began breastfeeding within 1 hour postpartum. Mothers who initiated breastfeeding early were more likely to be fully breastfeeding at discharge (OR 2.10, 95% CI 1.23-3.60). Multivariate logistic regression analysis revealed that giving birth at a health center was associated with delayed breastfeeding initiation (OR 0.11, 95% CI 0.04-0.32), whereas attending antenatal classes (OR 2.57, 95% CI 1.36-4.87) and receiving encouragement from hospital staff to initiate breastfeeding (OR 5.60, 95% CI 2.31-13.55) were correlated with putting the baby to the breast soon after delivery.

Conclusions: Early breastfeeding initiation rate was low and the use of prelacteal foods was widespread in Jiangyou. Early breastfeeding initiation was associated with higher "full breastfeeding" rates at discharge. It is important to educate doctors and nurses to assist mothers with early breastfeeding initiation and to discourage the use of non-breastmilk prelacteal feeds.