Is childbirth location associated with higher rates of favourable early breastfeeding practices in Sub-Saharan Africa?

Natasha Bergamaschi, Laura Oakley, Lenka Benova

Research output: Contribution to journalA1: Web of Science-articlepeer-review

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Background: Favourable early breastfeeding practices have a beneficial impact throughout an infants' lifespan. Childbirth location is likely to affect these practices through support during the intrapartum and immediate postpartum period. This study aimed to investigate the association between childbirth location and favourable early breastfeeding practices in Sub-Saharan Africa (SSA).

Methods: Demographic and Health Survey (2000-2013) data across 30 SSA countries were utilised. Childbirth location was categorised as home vs facility, and further into public vs private sector. Early breastfeeding practices included: early initiation of breastfeeding (EIBF) (within 1 hour of birth), and no prelacteal feeding (fed only breast milk in the first 3 days). Multivariate logistic regression models adjusted for confounders were used to assess this association.

Results: Overall, 50.0% (country range 32.6%-95.5%) of infants received EIBF and 61.0% had no prelacteal feeding. Compared with home births, facility deliveries had higher adjusted odds of EIBF (adjusted odds ratio, aOR = 1.39, 95% confidence interval (CI) = 1.30-1.48, P <0.001) and no prelacteal feeding (aOR = 1.75, 95% CI = 1.63-1.89, P <0.001). Private sector facilities had lower adjusted odds of no prelacteal feeding (aOR = 0.89, 95% CI = 0.81-0.99, P = 0.036) when compared to public sector facilities. There was no evidence to suggest delivery sector was associated with EIBF (aOR = 0.93, 95% CI = 0.85-1.03, P=0.212).

Conclusions: This study showed early breastfeeding practices are suboptimal and are associated with delivery location in SSA. Further research is required to better understand how characteristics of care may explain these patterns in order to improve feeding practices.

Original languageEnglish
Article number010417
JournalJournal of Global Health
Issue number1
Number of pages9
Publication statusPublished - 2019


  • Adolescent
  • Adult
  • Africa South of the Sahara
  • Breast Feeding/statistics & numerical data
  • Delivery, Obstetric/statistics & numerical data
  • Female
  • Health Facilities/statistics & numerical data
  • Home Childbirth/statistics & numerical data
  • Humans
  • Infant, Newborn
  • Middle Aged
  • Pregnancy
  • Private Sector/statistics & numerical data
  • Public Sector/statistics & numerical data
  • Time Factors
  • Young Adult


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