Early, Exclusive Breastfeeding Reduces Newborn Death

Early breast-feeding reduces newborn deaths

CHENNAI, India (Reuters Health) - Initiation of breast-feeding within the first hour after birth or during the first day of life reduces the risk of death for the newborn, according to results of a study from Nepal.

Dr. Luke Mullany and colleagues from the Johns Hopkins Bloomberg School of Public Health in Baltimore and a team with the Nepal Nutrition Intervention Project, Katmandu, analyzed data on measures to reduce newborn deaths.

As a part of the study, reported in the Journal of Nutrition, 22,838 newborns were seen by health visitors at their homes soon after birth, then on multiple occasions till the 28th day of life.

Information on feeding practices and illness was collected, height and weight measurements were carried out, and causes of death after 48 hours up to 28 days were determined using a structured questionnaire.

Breast-feeding was initiated in 3.4 percent of babies within the first hour of birth, in 56.6 percent by 24 hours and in 97.2 percent by 72 hours, Mullany's team reports. Others received formula and animal milk, they add.

Two hundred and ninety seven infant deaths were recorded between day 2 and day 28 of life in their group, they note.

The investigators also noted a trend toward higher mortality that correlated with increasing delays in the state of breast-feeding. For instance, babies who were not breast-fed until after the third day were four times more likely to die than those fed within one hour.

The death risk was also 77 percent higher among partially breast-fed infants compared with those who were exclusively breast-fed, they note.

"Approximately 7.7 percent and 19.1 percent of all neonatal deaths may be avoided with universal initiation of breast-feeding within the first day or hour of life, respectively," Mullany and colleagues estimate.

"Infants breast-fed in the first hours of life receive milk with the highest level of protective factors including (antibodies) and protein," Mullany told Reuters Health. Early breast-feeding may also help establish successful breast-feeding patterns throughout infancy.

Improving breast-feeding practices in low-resource regions with high infant mortality rates "may substantially improve survival," he believes.

"Our challenge is to improve culturally appropriate messages that promote this behavior change, and provide the necessary home and community support to enable mothers to provide early breast-feeding," Mullany concluded.

SOURCE: Journal of Nutrition, March 2008.

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