Читать книгу Global Landscape of Nutrition Challenges in Infants and Children - Группа авторов - Страница 28

Early initiation of breastfeeding, within the first hour of life, provides many benefits to the newborn infant. First, it ensures the infant receives colostrum. Colostrum is important because it is rich in antibodies that confer passive immunity to the infant [7, 17]. Compared to infants who were put to breast within 1 hour of birth, the risk of death is 41% higher for those who initiated 2–23 h after birth and 79% higher for those who initiated 1 day or longer after birth [7]. Globally, only 41% of infants were put to breast within 1 hour of birth between years 2013 and 2018 [18]. East Asia and the Pacific region had the lowest rates with 32%, while the highest rates occurred in Eastern and Southern Africa at 65% [18]. In India, a nationally representative household survey conducted in 2015–2016 found that 41.6% of children under 3 years old had been breastfed within 1 hour of birth. This was a positive increase compared to the survey conducted in 2005–2006, where 23.4% of children under 3 years old had been breastfed within 1 hour of birth (Table 1) [19, 20].

Table 1. Child feeding practices and nutritional status of children in India comparing NFHS-4 and NFHS-3

In addition to the multiple benefits of early initiation, breastfeeding initiation within the first hour of life increases the likelihood of exclusive breastfeeding through the first 6 months [7]. Despite the important benefits of breastfeeding, less than half of all infants are exclusively breastfed through the first 6 months of life [18]. The most recent data from UNICEF show global exclusive breastfeeding rates at 41%. East Asia and the Pacific region had the lowest rates of exclusive breastfeeding at 22%, while Eastern and Southern Africa had the highest rates at 56% [18]. Within India, the exclusive breastfeeding rate was 54.9% in 2015–2016, compared to 46.4% in 2005–2006 (Table 1) [19, 20].

Multiple factors influence why mothers do not exclusively breastfeed, including beliefs and cultural norms [21]. Mothers encounter multiple challenges that discourage exclusive breastfeeding through 6 months of age. Prenatally, women who lack access to breastfeeding information and education are less likely to initiate after birth [22]. During labor, both the maternal labor experience and the breastfeeding attitudes of the hospital staff can impact the maternal breastfeeding intention, which is associated with early weaning [23]. In the postpartum period, women who have clinical problems, such as low supply or problems with infant latch, are more likely to discontinue breastfeeding. Women who identify a lack of clinical/provider support are more likely to discontinue breastfeeding before 6 months. Also, women who return to work before 6 months are less likely to be exclusively breastfeeding for 6 months [24-26].