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Breast-feeding initiation time and neonatal mortality risk among newborns in South India

Journal of Perinatology volume 31, pages 397–403 (2011)Cite this article

Subjects

Abstract

Objective:

To examine the association between breast-feeding initiation time and neonatal mortality in India, where breast-feeding initiation varies widely from region to region.

Study Design:

Data were collected as part of a community-based, randomized, placebo-controlled trial of the impact of vitamin A supplementation in rural villages of Tamil Nadu, India. Multivariate binomial regression analysis was used to estimate the association between neonatal mortality and breast-feeding initiation time (<12 h, 12 to 24 h, >24 h) among infants surviving a minimum of 48 h.

Result:

Among 10 464 newborns, 82.1% were first breast-fed before 12 h, 13.8% were breast-fed between 12 and 24 h, and 4.1% were breast-fed after 24 h. After adjusting for birth weight, gestational age and other covariates, late initiators (>24 h) were at ∼78% higher risk of death (relative risk=1.78 (95% confidence interval (CI)=1.03 to 3.10)). There was no difference in mortality risk when comparing babies fed in the first 12 h compared with the second 12 h after birth.

Conclusion:

Late (>24 h) initiation of breast-feeding is associated with a higher risk of neonatal mortality in Tamil Nadu. Emphasis on breast-feeding promotion programs in low-resource settings of India where early initiation is low could significantly reduce neonatal mortality.

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Acknowledgements

Sources of support: This study was conducted with support received under Cooperative Agreement No. HRN-A-00-97-00015-00 between the Johns Hopkins Bloomberg School of Public Health and the Office of Health and Nutrition, US Agency for International Development, Washington DC, the National Institutes for Health Grant R03 HD049406-01, a grant from the Bill and Melinda Gates Foundation, Seattle, Washington, and commodity support from Task Force Sight and Life, Roche, Ltd, Basel, Switzerland

Author information

Authors and Affiliations

  1. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    C R Garcia, L C Mullany, J Katz, C Coles & J M Tielsch

  2. Aravind Centre for Women, Children and Community Health, Madurai, India

    L Rahmathullah & R D Thulasiraj

  3. Lions-Aravind Centre for Community Ophthalmology, Madurai, India

    R D Thulasiraj & S Sheeladevi

Authors
  1. C R Garcia
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  2. L C Mullany
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  3. L Rahmathullah
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  4. J Katz
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  5. R D Thulasiraj
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  6. S Sheeladevi
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  7. C Coles
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  8. J M Tielsch
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Corresponding author

Correspondence to L C Mullany.

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Garcia, C., Mullany, L., Rahmathullah, L. et al. Breast-feeding initiation time and neonatal mortality risk among newborns in South India. J Perinatol 31, 397–403 (2011). https://doi.org/10.1038/jp.2010.138

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