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dc.contributor.authorEngebretsen, Ingunn Marie S.en_US
dc.contributor.authorNankabirwa, Victoriaen_US
dc.contributor.authorDoherty, Tanya Marken_US
dc.contributor.authorDiallo, Abdoulaye Hamaen_US
dc.contributor.authorNankunda, Jollyen_US
dc.contributor.authorFadnes, Lars Thoreen_US
dc.contributor.authorEkström, Eva-Charlotteen_US
dc.contributor.authorRamokolo, Vundlien_US
dc.contributor.authorMeda, Nicolasen_US
dc.contributor.authorSommerfelt, Halvoren_US
dc.contributor.authorJackson, Debraen_US
dc.contributor.authorTylleskär, Thorkilden_US
dc.contributor.authorTumwine, James K.en_US
dc.contributor.authorFor the PROMISE-EBF study groupen_US
dc.description.abstractBackground: Immediate and exclusive initiation of breastfeeding after delivery has been associated with better neonatal survival and child health and are recommended by the WHO. We report its impact on early infant feeding practices from the PROMISE-EBF trial. Methods: PROMISE-EBF was a cluster randomised behaviour change intervention trial of exclusive breastfeeding (EBF) promotion by peer counsellors in Burkina Faso, Uganda and South Africa implemented during 2006-2008 among 2579 mother-infant pairs. Counselling started in the last pregnancy trimester and mothers were offered at least five postnatal visits. Early infant feeding practices: use of prelacteal feeds (any foods or drinks other than breast milk given within the first 3 days), expressing and discarding colostrum, and timing of initiation of breastfeeding are presented by trial arm in each country. Prevalence ratios (PR) with 95% confidence intervals (95%CI) are given. Results: The proportion of women who gave prelacteal feeds in the intervention and control arms were, respectively: 11% and 36%, PR 0.3 (95% CI 0.2, 0.6) in Burkina Faso, 13% and 44%, PR 0.3 (95% CI 0.2, 0.5) in Uganda and 30% and 33%, PR 0.9 (95% CI 0.6, 1.3) in South Africa. While the majority gave colostrum, the proportion of those who expressed and discarded it in the intervention and control arms were: 8% and 12%, PR 0.7 (95% CI 0.3, 1.6) in Burkina Faso, 3% and 10%, PR 0.3 (95% CI 0.1, 0.6) in Uganda and 17% and 16%, PR 1.1 (95% CI 0.6, 2.1) in South Africa. Only a minority in Burkina Faso (<4%) and roughly half in South Africa initiated breastfeeding within the first hour with no large or statistically significant differences between the trial arms, whilst in Uganda the proportion of early initiation of breastfeeding in the intervention and control arms were: 55% and 41%, PR 0.8 (95% CI 0.7, 0.9). Conclusions: The PROMISE-EBF trial showed that the intervention led to less prelacteal feeding in Burkina Faso and Uganda. More children received colostrum and started breastfeeding early in the intervention arm in Uganda. Late breastfeeding initiation continues to be a challenge. No clear behaviour change was seen in South Africa.en_US
dc.publisherBioMed Centraleng
dc.rightsAttribution CC BYeng
dc.subjectExclusive breastfeedingeng
dc.subjectPrelacteal feedingeng
dc.titleEarly infant feeding practices in three African countries: the PROMISE-EBF trial promoting exclusive breastfeeding by peer counsellorsen_US
dc.typePeer reviewed
dc.typeJournal article
dc.rights.holderCopyright 2014 Engebretsen et al.; licensee BioMed Central Ltd.
dc.rights.holderMarie S Ingunn Engebretsen et al.; licensee BioMed Central Ltd.
dc.source.journalInternational Breastfeeding Journal

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