Advertisement

Maternal and Child Health Journal

, Volume 19, Issue 3, pp 468–479 | Cite as

Timing of Breastfeeding Initiation and Exclusivity of Breastfeeding During the First Month of Life: Effects on Neonatal Mortality and Morbidity—A Systematic Review and Meta-analysis

  • Jehangir Khan
  • Linda Vesel
  • Rajiv Bahl
  • José Carlos Martines
Article

Abstract

The purpose of this study was to review the evidence on the effect of initiation of breastfeeding early after birth and of exclusive breastfeeding during the first month in reducing neonatal mortality and morbidity. We searched Cochrane and PubMed databases for all available papers addressing our review questions and identified eleven papers. Data were extracted using a standard abstraction form. Evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation system. Meta-analysis was done using STATA 11.0. Early initiation of breastfeeding was associated with a reduced risk of neonatal mortality. Initiating breastfeeding after the first hour doubled the risk of neonatal mortality. Exclusively breastfed neonates had a lower risk of mortality and infection-related deaths in the first month than partially breastfed neonates. Exclusively breastfed neonates also had a significantly lower risk of sepsis, diarrhea and respiratory infections compared with those partially breastfed. The pooled evidence indicates that substantial benefits in reducing neonatal mortality and morbidity can be achieved with effective promotion of early initiation of breastfeeding and exclusive breastfeeding during the first month of life.

Keywords

Breastfeeding Neonates Mortality and morbidity 

Notes

Acknowledgments

We are grateful to Dr Karen Edmond, Dr Luke Mullany and Dr Cesar Victora for providing us additional information on the results of their studies. We are also thankful to Tomas Allen, the librarian at the WHO Geneva for his support in developing the search strategy for this review. This work was supported by the Department of Maternal, Newborn, Child and Adolescent Health of the World Health Organization, Geneva, Switzerland.

Conflict of interest

None.

Supplementary material

10995_2014_1526_MOESM1_ESM.tif (74 kb)
Supplementary material 1 (TIFF 74 kb)
10995_2014_1526_MOESM2_ESM.tif (80 kb)
Supplementary material 2 (TIFF 80 kb)
10995_2014_1526_MOESM3_ESM.tif (94 kb)
Supplementary material 3 (TIFF 93 kb)
10995_2014_1526_MOESM4_ESM.tif (83 kb)
Supplementary material 4 (TIFF 82 kb)
10995_2014_1526_MOESM5_ESM.tif (73 kb)
Supplementary material 5 (TIFF 73 kb)
10995_2014_1526_MOESM6_ESM.tif (74 kb)
Supplementary material 6 (TIFF 74 kb)
10995_2014_1526_MOESM7_ESM.tif (71 kb)
Supplementary material 7 (TIFF 71 kb)
10995_2014_1526_MOESM8_ESM.doc (136 kb)
Supplementary material 8 (DOC 136 kb)

References

  1. 1.
    Levels & Trends in Child Mortality, report. (2013). Estimates developed by the UN inter-agency group for child mortality estimation. New York: UNICEF.Google Scholar
  2. 2.
    Black, R. E., Cousens, S., Johnson, H. L., Lawn, J. E., Rudan, I., Bassani, D. G., et al. (2010). Child Health Epidemiology Reference Group of WHO and UNICEF. Global, regional, and national causes of child mortality in 2008: A systematic analysis. Lancet, 375(9730), 1969–1987. doi: 10.1016/S0140-6736(10)60549-1.CrossRefPubMedGoogle Scholar
  3. 3.
    Lawn, J. E., Cousens, S., & Zupan, J. (2005). Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: When? Where? Why? Lancet, 365(9462), 891–900. doi: 10.1016/S0140-6736(05)71048-5.CrossRefPubMedGoogle Scholar
  4. 4.
    World Health Organization. (2012). Newborns: Reducing mortality. Available from http://www.who.int/mediacentre/factsheets/fs333/en/. Accessed June 2012.
  5. 5.
    United Nations International Children Emergency Fund (UNICEF). (2012). Early initiation of breast feeding. Available from http://www.childinfo.org/breastfeeding_initiation.php. Accessed June 2012.
  6. 6.
  7. 7.
    Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., et al. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Medicine, 6, e1000100. doi: 10.1371/journal.pmed.1000100.CrossRefPubMedCentralPubMedGoogle Scholar
  8. 8.
    Edmond, K. M., Zandoh, C., Quigley, M. A., Amenga-Etego, S., Owusu-Agyei, S., & Kirkwood, B. R. (2006). Delayed breastfeeding initiation increases risk of neonatal mortality. Pediatrics, 117(3), e380–e386. doi: 10.1542/peds.2005-1496.CrossRefPubMedGoogle Scholar
  9. 9.
    Mullany, L. C., Katz, J., Li, Y. M., Khatry, S. K., LeClerq, S. C., Darmstadt, G. L., et al. (2008). Breast-feeding patterns, time to initiation, and mortality risk among newborns in southern Nepal. Journal of Nutrition, 138(3), 599–603.PubMedCentralPubMedGoogle Scholar
  10. 10.
    Victora, C. G., Smith, P. G., Vaughan, J. P., Nobre, L. C., Lombardi, C., Teixeira, A. M., et al. (1987). Evidence for protection by breast-feeding against infant deaths from infectious diseases in Brazil. Lancet, 2(8554), 319–322.CrossRefPubMedGoogle Scholar
  11. 11.
    GRADE working group. (2012). Available from http://www.gradeworkinggroup.org/. Accessed June 2012.
  12. 12.
    Becker, G. E., Remmington, S., & Remmington, T. (2011). Early additional food and fluids for healthy breastfed full-term infants. Cochrane Database Systematic Review, 12, CD006462. doi: 10.1002/14651858.CD006462.pub2.Google Scholar
  13. 13.
    López-Alarcón, M., Villalpando, S., & Fajardo, A. (1997). Breast-feeding lowers the frequency and duration of acute respiratory infection and diarrhea in infants under six months of age. Journal of Nutrition, 127(3), 436–443.PubMedGoogle Scholar
  14. 14.
    Cushing, A. H., Samet, J. M., Lambert, W. E., Skipper, B. J., Hunt, W. C., Young, S. A., et al. (1998). Breastfeeding reduces risk of respiratory illness in infants. American Journal of Epidemiology, 147(9), 863–870.CrossRefPubMedGoogle Scholar
  15. 15.
    Sinha, A., Madden, J., Ross-Degnan, D., Soumerai, S., & Platt, R. (2003). Reduced risk of neonatal respiratory infections among breastfed girls but not boys. Pediatrics, 112(4), 303. doi: 10.1542/peds.112.4.e303.CrossRefGoogle Scholar
  16. 16.
    Garcia, C. R., Mullany, L. C., Rahmathullah, L., Katz, J., Thulasiraj, R. D., Sheeladevi, S., et al. (2011). Breast-feeding initiation time and neonatal mortality risk among newborns in South India. Journal of Perinatology, 31(6), 397–403. doi: 10.1038/jp.2010.138.CrossRefPubMedGoogle Scholar
  17. 17.
    Arifeen, S., Black, R. E., Antelman, G., Baqui, A., Caulfield, L., & Becker, S. (2001). Exclusive breastfeeding reduces acute respiratory infection and diarrhea deaths among infants in Dhaka slums. Pediatrics, 108(4), E67. doi: 10.1542/peds.108.4.e67.CrossRefPubMedGoogle Scholar
  18. 18.
    Clavano, N. R. (1982). Mode of feeding and its effect on infant mortality and morbidity. Journal of Tropical Pediatrics, 28(6), 287–293. doi: 10.1093/tropej/28.6.287.CrossRefPubMedGoogle Scholar
  19. 19.
    Edmond, K. M., Kirkwood, B. R., Amenga-Etego, S., Owusu-Agyei, S., & Hurt, L. S. (2007). Effect of early infant feeding practices on infection-specific neonatal mortality: An investigation of the causal links with observational data from rural Ghana. The American Journal of Clinical Nutrition, 86(4), 1126–1131.PubMedGoogle Scholar
  20. 20.
    Kasla, R. R., Bavdekar, S. B., Joshi, S. Y., & Hathi, G. S. (1995). Exclusive breastfeeding: Protective efficacy. Indian Journal of Pediatrics, 62(4), 449–453.CrossRefPubMedGoogle Scholar
  21. 21.
    Early Initiation of Breastfeeding: the Key to Survival and Beyond. Available from http://new.paho.org/hq/dmdocuments/2010/Eight%20Pager%20English%20FINAL.pdf. Accessed June 2012.
  22. 22.
    Sobhy, S. I., & Mohame, N. A. (2004). The effect of early initiation of breast feeding on the amount of vaginal blood loss during the fourth stage of labor. Journal of the Egyptian Public Health Association, 79, 1–12.PubMedGoogle Scholar
  23. 23.
    International Institute for Population Sciences (IIPS) and Macro International. (2007). National Family Health Survey (NFHS-3), 2005-06: India: Volume I. Mumbai: IIPS.Google Scholar
  24. 24.
    Tawiah-Agyemang, C., Kirkwood, B. R., Edmond, K., Bazzano, A., & Hill, Z. (2008) Early initiation of breast-feeding in Ghana: Barriers and facilitators. Journal of Perinatology, 28 Suppl 2, S46–S52. doi: 10.1038/jp.2008.173.
  25. 25.
    World Health Organization. (2011). Guidelines on optimal feeding of low birth weight in low and middle income countries. World Health Organization. Available from http://www.who.int/maternal_child_adolescent/documents/9789241548366.pdf. Accessed March 2014.
  26. 26.
    Kramer, M. S., Chalmers, B., Hodnett, E. D., Sevkovskaya, Z., Dzikovich, I., Shapiro, S., et al. (2001). Promotion of Breastfeeding Intervention Trial (PROBIT): A randomized trial in the Republic of Belarus. JAMA, 285(4), 413–420. doi: 10.1001/jama.285.4.413.CrossRefPubMedGoogle Scholar
  27. 27.
    World Health Organization. (1998). Evidence for the ten steps to successful breastfeeding. World Health Organization. Available from http://whqlibdoc.who.int/publications/2004/9241591544_eng.pdf.
  28. 28.
    World Health Organization and UNICEF. (2009). Baby-friendly hospital initiative: Revised, updated and expanded for integrated care. World Health Organization and UNICEF. Available from http://whqlibdoc.who.int/publications/2009/9789241594967_eng.pdf.

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Jehangir Khan
    • 1
  • Linda Vesel
    • 2
  • Rajiv Bahl
    • 3
  • José Carlos Martines
    • 3
  1. 1.Faculty of MedicineLund UniversityMalmoSweden
  2. 2.Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUK
  3. 3.Maternal, Newborn, Child and Adolescent HealthWorld Health OrganizationGenevaSwitzerland

Personalised recommendations