Table 5

Summary of included studies presenting estimates of association between early breastfeeding initiation and morbidity outcomes

    Study, Location

    Sample Size

    Study Design

    Def of BF Exposure

    Comment/Conclusions

    Grade


Malnutrition WAZ


Appoh [29], Ghana, facility

110

case-control

early vs. late

Reported an association between early breastfeeding initiation and a reduction in underweight children

LOW

Kumar [33], India, community

217

cross sectional survey

<6h vs. >6h

Reported an association between early breastfeeding initiation and a reduction in underweight children

LOW


Malnutrition WLZ


Engebretsen [32], Uganda, community

723

cross sectional survey

<2h vs 2-24h<2h vs>24h

There was no statistically significant relationship comparing >24hr&<24 hours to <2hours (reference)

LOW

Kumar [33], India, community

217

cross sectional survey

<6h vs. >6h

The infant feeding practices studied were not significantly associated with wasting

LOW


    Malnutrition, LAZ


Engebretsen [32], Uganda, community

723

cross sectional survey

<2h vs 2-24h<2h vs>24h

There was no statistically significant relationship comparing >24hr&<24 hours to <2hours (reference

LOW

Kumar [33], India, community

217

cross sectional survey

<6h vs. >6h

Reported a significant association between early breastfeeding initiation and reduction in stunting

LOW


    Early Weight Loss


Enzunga [23], Zaire, facility

330

prospective cohort

early vs. late

Reports a direct relationship between the delay in initiation of breast-feeding and subsequent weight loss

LOW

Caglar [34], Turkey, facility

90

prospective matched case control

mean time to bf initiation

Infants with a weight loss of

    >
10% were significantly more likely to have received their first breastfeeding later than controls

MEDIUM


    Diarrhea


Badruddin [30], Pakistan, mixed facility/community

265

case-control

early vs. late

Reported a significant higher likelihood of late breastfeeding in cases (i.e. those with acute and/or persistent diarrhea)

LOW

Clemens [19], Egypt, community

198

prospective cohort

<72h vs. >72h

Reported a significant association between early breastfeeding initiation and reduction in diarrhea in the first six months of life

LOW


    Acute Diarrhea


Badruddin [30], Pakistan, mixed facility/community

265

case-control

early vs. late

Reported a significant higher likelihood of late breastfeeding in cases (i.e. those with acute diarrhea)

LOW


    Persistent Diarrhea


Badruddin [30], Pakistan, mixed facility/community

265

case-control

early vs. late

Reported a significant higher likelihood of late breastfeeding in cases (i.e. those with persistent diarrhea)

LOW


    Omphalitis


Mullany [26], Zanzibar, community

1653

prospective cohort

<1h vs. >=1h

Risk of omphalitis was 71% lower among babies breastfed within 1 hour

MEDIUM

Mullany [25], Nepal, community

17,198

prospective cohort

early vs. late

There was no statistically significant evidence to suggest that early breastfeeding initiation is protective against omphalitis

MEDIUM


    Hypoglycemia


Sasidharan [28], India, hospital

604

prospective cohort

early vs. late

Reported a significant association between early breastfeeding initiation and reduction in hypoglycemia

LOW


    Hypothermia


Mullany [27], Nepal, community

23,240

prospective cohort

early vs. late

The adjusted prevalence rate of hypothermia was 16% lower among babies for whom bf was initiated w/in 24hours

MEDIUM

Van den Bosch [35], Malawi, facility

160

randomized trial

Immediate vs. mother’s choice of initiation time

Reported a significant association between early initiation and a reduction in low body temperature

LOW


Debes et al. BMC Public Health 2013 13(Suppl 3):S19   doi:10.1186/1471-2458-13-S3-S19

Open Data