Effect of breastfeeding on neonatal morbidity and mortality in Dhaka city

Abstract

Breastfeeding is an important practice to prevent morbidity and mortality among the neonate. It is widely recommended and endorsed by WHO. Exclusive breastfeeding is defined as no other food or drink, not even water, except breast milk for six month of life and early or timely initiation of breastfeeding, specifically within 1 h of birth, refers to the best practice recommendation by the World Health Organization (WHO). In this study I have examined the effect of breastfeeding on neonatal infants with regard to morbidity and mortality. This study also aimed to see the breast-feeding pattern and socio-economic condition of the study population. It was an observational analytical cross sectional study. A longitudinal Study was conducted on some newborn from several hospitals in Dhaka city. A pre-tested semi structured questionnaire was used to interview 422 mothers with their neonates. In this study the investigator visited hospital multi times to the mothers for data collection within first 3 days of a child birth. First interview of the mothers was undertaken after the delivery during first 3 days of the neonate and a follow up was taken after 28 days of the first interview. Loss of follow up was 22(5.2%). In this study the indicators were mother's education, pre-lacteal feeding, birth weight of the neonatal child, colostrums feeding, exclusive breastfeeding, time of initiation of breastfeeding, weight gain of the neonates, BMI of mothers, neonatal morbidity, neonatal mortality etc. The study results indicated; that percentage of exclusive breastfeeding was 50.8%, non-exclusive breastfeeding was 49.3%, Colostrum’s feeding was 97.5%, initiation of breastfeeding within one hour of birth was 37.5%, initiation of breastfeeding after 1hour was 37.5%, pre-lacteal feeding was 49.3%, neonatal morbidity was 73.3%,the neonates who were non-morbid was 26.8%, morbidity for exclusively breastfed neonate was 65.0%,morbidity for non-exclusively breastfed neonate was 81.7%,neonatal mortality was 0.5%. In this study a comparison has been made between the mothers who have exclusively breastfed their neonates and those who didn’t. There were 203 exclusively breastfed mothers and 197 non-exclusively breastfed mothers. It has been found that educational backgrounds of the mothers influence the colostrum’s feeding of the neonates significantly. It has been also found that the neonates of the educated mothers have less suffered by morbidity. The neonates who were given pre-lacteal feeding suffered more by morbidity. The neonates who were exclusively breastfed gained larger weight than those who were not exclusively breastfed. Those who were breastfed more times (9-11times) gained larger weight than those who were breastfed less times. It has been also found morbidity was higher among the low birth weight neonates. The incidence of morbidity was lower among the neonates who were exclusively breastfed than the neonates who were non- exclusively breastfed. The mothers who were breastfed their neonates within one hour morbidity percentage was lower than the mothers who were breastfed their neonates after one hour. So, Earlier the breastfeeding lower the morbidity. This study confirmed that type of feeding practices (e.g. Exclusive breastfeeding and early initiation of breastfeeding) in the neonatal period is the main element for reducing neonatal morbidity (e.g. Fever, pneumonia, diarrhea, jaundice, sepsis, hypoglycemia, allergies etc.) and mortality. The goal of the study is to significantly lower the morbidity and mortality of the neonate through successful breastfeeding. The study results recommend that health sector need to give more concern for breastfeeding in general and early initiation of exclusive breastfeeding in particular.