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

An Erratum to this article was published on 28 January 2009



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.


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.


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.

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This study was supported by the UK Department for International Development (DFID), the US Agency for International Development (USAID), Ghana Health Service and the London School of Hygiene and Tropical Medicine. We thank the mothers who participated in this study for their cooperation and patience, the field and computer centre staff at Kintampo Health Research Centre (KHRC) for their dedication and attention to detail and the ObaapaVitA trial steering committee for their support and encouragement. KHRC is a member of the Indepth network. Sources of support: This work was funded by the United Kingdom Department for International Development (DFID) and the United States Agency for International Development (USAID).

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Correspondence to K M Edmond.

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Edmond, K., Kirkwood, B., Tawiah, C. et al. Impact of early infant feeding practices on mortality in low birth weight infants from rural Ghana. J Perinatol 28, 438–444 (2008).

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  • breastfeeding
  • premature
  • small for gestational age

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