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Abstract
Early initiation of breastfeeding (EIBF) refers to the initiation of breastfeeding within the first hour after delivery, and is a key intervention for enhancing neonatal survival and maternal and child health. The World Health Organization (WHO) has recommended that all babies be breastfed within one hour of birth and this is not the practice in many developing countries, including Pakistan, where there is a high prevalence of delayed initiation of breastfeeding. The objective of the study was to find out the prevalence of EIBF and factors associated with timely initiation of breastfeeding among the postnatal mothers visiting the tertiary care hospitals of Bajaur District of KP, Pakistan. Structured interviewer-administered questionnaires were used to carry out a cross-sectional analytical study of 288 postnatal mothers. Data pertaining to socio-demographic aspects, obstetric history, breastfeeding practices, counseling, myths and support systems was gathered and analyzed with SPSS version (28). Descriptive statistics were used and Chi-square tests were used to test associations between independent variables and EIBF. The study revealed that 77.8% of the mothers started breasts-feeding within one hour after birth of their child. The mean age of participants was 28.23 ± 5.46 years, while the mean parity was 2.48 ± 1.75. Significant associations with EIBF were observed for maternal education (p=0.001), socioeconomic status (p=0.015), normal vaginal delivery (p=0.007), timing of breastfeeding education (p=0.005), reasons for failure of antenatal breastfeeding education (p=0.026), hospital-related barriers to breastfeeding initiation (p<0.001), prelacteal feeding practices (p=0.002), postnatal practical assistance (p<0.001), and indicators of adequate milk consumption (p<0.001). But, maternal antenatal breastfeeding education and the breastfeeding education provider were not significantly associated with early initiation. A number of breastfeeding myths were found, most notably lack of milk and that babies need water after birth. The results indicate that there is a great deal of variation in breastfeeding initiation practices, maternal support, and cultural beliefs. Improvements in early breastfeeding initiation through strengthening breastfeeding support in the postnatal period, discouraging prelacteal feeding, correcting common misconceptions about breastfeeding and encouraging breastfeeding friendly hospital practices may further enhance early breastfeeding initiation and help to ensure better neonatal health outcomes in this under-served population