Abstract

Although breast feeding (BF) is protective against infectious disease amongst children, its timing initiation effect after birth is unknown, whether immediate (<1 h), hours (>1 to <24 h) or days (>24 h). The authors examined relationships between early initiation time of BF and the prevalence of pneumonia and diarrhea in infants and under 5 children adjusting for gender, previous sibling death, maternal educational level, place of delivery and birth weight. This study utilized secondary database analysis of the de-identified and publicly available Multiple Indicator Cluster Survey (MICS) 4 data for the period between 2009-2011. A cross-sectional study was conducted for children under 5 years, using the data from Nigeria (n=26018), Ghana (n=7586), Togo (n=4908) and Sierra Leone (n=8798). A total of 47310 children were recorded for the four countries in West Africa with a mean age and birth weight distribution of 1.72±2 (0.45) years and 2.17±2 (0.62) kg, respectively. ‘Hours’ breast fed infants were significantly more likely to be protected from diarrhea than ‘days’ breast fed with a crude OR of 0.74 (95% CI= 0.68-0.80 P=0.0292). The estimated adjusted OR for ‘hours’ breast feeding in relation to protection against diarrhea as compared to ‘days’ is 0.81 (95% CI= 0.72-0.92 P=0.0478). In this population representing infants and children less than 5 years of age from four countries within the West African sub-region, breast feeding within 24 h after birth showed a protective effect against diarrhea as compared to breast feeding which commenced days after birth even after all adjustments for confounding variables had been considered.

Key words: Breast feeding initiation, breast feeding protection, infectious disease and breast feeding trends.