Original Article

Journal of Perinatology (2008) 28, 438–444; doi:10.1038/jp.2008.19; published online 6 March 2008

Impact of early infant feeding practices on mortality in low birth weight infants from rural Ghana

K M Edmond1,2, B R Kirkwood1, C A Tawiah3 and S O Agyei1,3

  1. 1Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
  2. 2Honorary Consultant in Paediatrics, University College London Hospital, London, UK
  3. 3Kintampo Health Research Centre, Ghana Health Service, Ghana

Correspondence: Dr KM Edmond, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E7HT, UK. E-mail: Karen.Edmond@lshtm.ac.uk

Received 9 October 2007; Revised 4 January 2008; Accepted 4 February 2008; Published online 6 March 2008.

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Abstract

Objective:

 

To assess the impact of early infant feeding practices on low birth weight- (LBW) specific neonatal mortality in rural Ghana.

Study Design:

 

A total of 11 787-breastfed babies were born between July 2003 and June 2004 and survived to day 2. Overall, 3411 (30.3% ) infants had weight recorded within 48 h. Two hundred and ninety-six (8.7% ) infants were <2.5 kg and 15 died in the neonatal period. Associations were examined using multivariate logistic regression.

Result:

 

Initiation of breastfeeding after day 1 was associated with a threefold increase in mortality risk (adjusted odds ratio (adjOR) 3.23, 95% confidence interval (95% CI) (1.07–9.82)) in infants aged 2 to 28 days. Prelacteal feeding was associated with a threefold significantly increased mortality risk (adjOR 3.12, 95% CI (1.19–8.22)) in infants aged 2 to 28 days but there was no statistically significant increase in risk associated with predominant breastfeeding (adjOR 1.91, 95% CI (0.60–6.09)). There were no modifications of these effects by birth weight. The sample size was insufficient to allow assessment of the impact of partial breastfeeding.

Conclusion:

 

Improving early infant feeding practices is an effective, feasible, low-cost intervention that could reduce early infant mortality in LBW infants in developing countries. These findings are especially relevant for sub-Saharan Africa where many LBW infants are born at home, never taken to a health facility and mortality rates are unacceptably high.

Keywords:

breastfeeding, premature, small for gestational age

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