|Does postnatal care have a role in improving newborn feeding? A study in 15 sub-Saharan African countries|
||Shane M Khan, Ilene S Speizer, Kavita Singh, Gustavo Angeles, Nana AY Twum–Danso, and Pierre Barker
||Journal of Global Health, 7(2): 020506; DOI: 10.7189/jogh.07.020506
Multiple African Countries
||Background Breastfeeding is known as a key intervention to improve
newborn health and survival while prelacteal feeds (liquids other than
breastmilk within 3 days of birth) represents a departure from optimal
feeding practices. Recent programmatic guidelines from the WHO and
UNICEF outline the need to improve newborn feeding and points to postnatal
care (PNC) as a potential mechanism to do so. This study examines
if PNC and type of PNC provider are associated with key newborn feeding
practices: breastfeeding within 1 day and prelacteal feeds.
Methods: We use data from the Demographic and Health Surveys for 15
sub–Saharan African countries to estimate 4 separate pooled, multilevel,
logistic regression models to predict the newborn feeding outcomes.
Findings: PNC is significantly associated with increased breastfeeding
within 1day (OR = 1.35, P < 0.001) but is not associated with PLFs
(OR = 1.04, P = 0.195). PNC provided by nurses, midwives and untrained
health workers is also associated with higher odds of breastfeeding within
1 day of birth (OR = 1.39, P < 0.001, (OR = 1.95, P < 0.001) while PNC
provided by untrained health workers is associated with increased odds
of PLFs (OR = 1.20, P = 0.017).
Conclusions: PNC delivered through customary care may be an effective
strategy to improve the breastfeeding within 1 day but not to discourage
PLFs. Further analysis should be done to examine how these variables
operate at the country level to produce finer programmatic insight.