Initiation of Breastfeeding in Low- and Middle-Income Countries: A Time-to-Event Analysis

Lindsay Mallick; Wenjuan Wang; Shiza Farid; Thomas Pullum

doi:10.9745/GHSP-D-20-00361

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FIGURE 1
Percentage Distribution of Children by Time to Initiation of Breastfeeding Among Most Recent Live-Born Children in the 2 Years Before the Survey, 2014–2018
*Category includes “don't know” or missing responses.
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FIGURE 2
Time Ratios of Time to Initiation of Breastfeeding for Cesarean Delivery and Immediate Skin-to-skin Contact^a
^aThe reference group for cesarean delivery was vaginal deliveries in a facility and the reference for immediate skin-to-skin contact was no immediate skin-to-skin.

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TABLE 1.

Sample of Most Recent Live-Born Children in the 2 Years Before Each Demographic Health Survey, 2014–2018

Region	Country	Cesarean Delivery, No. (%)	All Births, No.
North Africa, West and Central Asia, Europe	Albania 2017–2018	328 (31.7)	1,034
	Armenia 2015–2016	143 (21.5)	664
	Egypt 2014	3,602 (57.4)	6,271
	Jordan 2017–2018	955 (27.7)	3,452
	Maldives 2016–2017	460 (42.8)	1,074
	Tajikistan 2017	145 (5.9)	2,465
South and Southeast Asia	Bangladesh 2014	780 (24.6)	3,166
	Cambodia 2014	236 (8.1)	2,906
	India 2015–2016	17,838 (19.3)	92,600
	Indonesia 2017	1,260 (19.2)	6,561
	Myanmar 2015–2016	350 (21.2)	1,652
	Nepal 2016	198 (10.1)	1,965
	Pakistan 2017–2018	998 (25.8)	3,864
	Philippines 2017	572 (15.5)	3,693
	Timor-Leste 2016	97 (3.5)	2,815
Sub-Saharan Africa	Angola 2015–2016	203 (3.8)	5,298
	Benin 2017–2018	265 (4.9)	5,405
	Burundi 2016–2017	282 (5.2)	5,368
	Chad 2014–2015	101 (1.5)	6,656
	Ethiopia 2016	110 (2.6)	4,244
	Ghana 2014	276 (12.4)	2,234
	Kenya 2014	288 (8.2)	3,496
	Lesotho 2014	136 (10.1)	1,348
	Malawi 2015–2016	435 (6.6)	6,579
	Senegal 2016	251 (5.7)	4,410
	South Africa 2016	337 (24.7)	1,364
	Tanzania 2015–2016	268 (6.5)	4,106
	Uganda 2016	414 (7.1)	5,797
	Zimbabwe 2015	147 (6.1)	2,421
Latin America and Caribbean	Guatemala 2014–2015	1,403 (29.5)	4,756
Latin America and Caribbean	Haiti 2016–2017	136 (5.7)	2,390

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TABLE 2.

Mean and Median Times (Hours) to Initiation of Breastfeeding, Among All Deliveries, Vaginal at Home, Vaginal at Facility, and Cesarean Delivery, Among Ever-Breastfed Last-Born Children Born in the Past 2 Years

Region	Country	All		Vaginal Delivery-Home		Vaginal Delivery-Facility		Cesarean Delivery
Region	Country	Mean (95% CI)	Med.	Mean (95% CI)	Med.	Mean (95% CI)	Med.	Mean (95% CI)	Med.
North Africa, West and Central Asia, Europe	Albania 2017–2018	5.3 (3.8, 7.5)	0.5	1.2 (0.0, 165.3)	0.5	3.5 (1.7, 7.0)	0.5	9.5 (7.0, 12.8)	1.5
	Armenia 2015–2016	8.0 (6.5, 9.9)	1.5	1.9 (0.0, 148.1)	2.5	5.0 (3.9, 6.4)	1.5	19.9 (13.9, 28.6)	5.5
	Egypt 2014	16.5 (15.2, 17.8)	2.5	12.2 (9.8, 15.2)	1.5	10.1 (8.7, 11.7)	1.5	20.9 (19.1, 22.8)	3.5
	Jordan 2017–2018	8.6 (7.2, 10.2)	0.5	2.5 (0.9, 7.0)	0.5	4.7 (3.6, 6.2)	0.5	19.6 (16.0, 24.1)	0.5
	Maldives 2016–2017	10.0 (6.6, 15.1)	0.5	12.8 (5.4, 30.6)	1.5	9.5 (4.4, 20.6)	0.5	10.2 (7.1, 14.6)	0.5
	Tajikistan 2017	3.7 (3.0, 4.6)	0.5	1.5 (1.0, 2.2)	0.5	2.6 (2.1, 3.2)	0.5	23.5 (15.2, 36.2)	3.5
South and Southeast Asia	Bangladesh 2014	7.4 (6.1, 8.8)	0.5	4.7 (3.7, 5.9)	0.5	5.1 (3.5, 7.3)	0.5	15.4 (11.6, 20.5)	1.5
	Cambodia 2014	7.6 (6.6, 8.9)	0.5	11.6 (8.3, 16.3)	0.5	4.9 (4.0, 5.8)	0.5	31.6 (24.3, 41.1)	3.5
	India 2015–2016	12.7 (12.3, 13.1)	1.5	15.9 (15.2, 16.7)	1.5	8.8 (8.4, 9.3)	1.5	22.4 (21.1, 23.7)	1.5
	Indonesia 2017	17.8 (16.6, 19.2)	0.5	18.6 (16.0, 21.6)	0.5	13.3 (12.0, 14.7)	0.5	33.0 (29.5, 36.9)	3.5
	Myanmar 2015–2016	11.7 (9.8, 13.9)	0.5	10.9 (8.6, 13.7)	0.5	11.0 (7.4, 16.3)	0.5	14.6 (10.6, 20.1)	0.5
	Nepal 2016	7.9 (6.5, 9.6)	0.5	9.6 (7.3, 12.6)	1.5	3.9 (2.9, 5.3)	0.5	24.2 (16.6, 35.3)	2.5
	Pakistan 2017–2018	31.7 (28.9, 34.7)	5.5	26.8 (23.3, 30.8)	3.5	24.2 (21.2, 27.6)	3.5	50.8 (43.6, 59.1)	36.0
	Philippines 2017	8.2 (6.8, 9.8)	0.5	6.1 (4.2, 8.9)	0.5	5.6 (4.5, 7.0)	0.5	21.9 (15.9, 30.2)	1.5
	Timor-Leste 2016	2.8 (2.3, 3.4)	0.5	2.4 (1.8, 3.1)	0.5	2.4 (1.8, 3.2)	0.5	14.4 (10.0, 20.9)	0.5
Sub-Saharan Africa	Angola 2015–2016	8.5 (7.4, 9.7)	0.5	8.0 (6.8, 9.3)	1.5	7.4 (5.6, 9.7)	0.5	26.8 (21.0, 34.4)	6.5
	Benin 2017–2018	9.0 (8.1, 9.9)	0.5	8.1 (6.5, 10.0)	0.5	8.0 (7.1, 9.0)	0.5	28.0 (22.5, 34.9)	5.5
	Burundi 2016–2017	1.7 (1.4, 2.3)	0.5	1.4 (0.8, 2.2)	0.5	1.3 (0.9, 1.7)	0.5	10.4 (6.6, 16.6)	1.5
	Chad 2014–2015	40.4 (38.0, 42.9)	36.0	39.9 (37.1, 42.9)	36.0	40.4 (37.5, 43.6)	36.0	66.4 (52.3, 84.3)	60.0
	Ethiopia 2016	5.4 (4.3, 6.7)	0.5	4.6 (3.4, 6.2)	0.5	5.0 (3.6, 7.0)	0.5	28.8 (14.3, 58.1)	1.5
	Ghana 2014	11.5 (8.2, 16.1)	0.5	9.2 (6.9, 12.4)	0.5	8.7 (5.2, 14.5)	0.5	30.9 (15.8, 60.3)	2.5
	Kenya 2014	8.2 (6.0, 11.2)	0.5	12.3 (7.0, 21.8)	0.5	4.5 (3.6, 5.6)	0.5	16.9 (11.3, 25.4)	2.5
	Lesotho 2014	8.7 (6.7, 11.2)	0.5	10.3 (6.8, 15.7)	0.5	6.4 (4.7, 8.7)	0.5	21.7 (10.8, 43.6)	3.5
	Malawi 2015–2016	2.1 (1.8, 2.5)	0.5	2.5 (1.7, 3.6)	0.5	1.7 (1.4, 2.0)	0.5	7.5 (4.4, 12.6)	0.5
	Senegal 2016	9.0 (8.0, 10.1)	2.5	6.7 (5.7, 7.9)	2.5	6.2 (5.4, 7.2)	1.5	53.4 (44.3, 64.2)	36.0
	South Africa 2016	4.5 (3.3, 6.2)	0.5	15.2 (3.9, 59.6)	0.5	3.4 (2.4, 4.8)	0.5	6.2 (3.6, 10.7)	0.5
	Tanzania 2015–2016	5.1 (4.5, 5.8)	0.5	6.8 (5.8, 8.0)	1.5	3.3 (2.6, 4.1)	0.5	11.9 (8.3, 16.8)	4.5
	Uganda 2016	4.2 (3.6, 5.0)	0.5	4.5 (3.3, 6.1)	0.5	3.0 (2.4, 3.8)	0.5	15.2 (10.0, 23.2)	1.5
	Zimbabwe 2015	4.6 (3.8, 5.6)	0.5	7.7 (5.7, 10.4)	1.5	3.0 (2.1, 4.1)	0.5	16.0 (12.4, 20.6)	3.5
Latin America and Caribbean	Guatemala 2014–2015	18.5 (15.4, 22.1)	0.5	7.1 (5.3, 9.5)	0.5	11.1 (8.4, 14.6)	0.5	40.9 (32.0, 52.2)	3.5
Latin America and Caribbean	Haiti 2016–2017	11.7 (10.0, 13.7)	1.5	8.9 (7.3, 10.8)	1.5	10.4 (8.0, 13.6)	0.5	52.7 (36.1, 77.0)	6.5