Proportion of Suboptimal Neonate Breastfeeding Behavior and Association of Risk Factors: A Cross-sectional Study

Introduction: Importance of breastfeeding is known to all. Less than optimal breastfeeding skills in neonates is termed as Suboptimal Neonate Breastfeeding Behavior (SNBB). It is often observed that if any breastfeeding issue is reported, the focus of attention is the mother while the essential breastfeeding skills of the neonate may remain unevaluated. In this background, the assessment of breastfeeding skills of the newborns in the initial days is essential. Infant Breastfeeding Assessment Tool (IBFAT) is a comprehensive outcome measure which is widely used for breastfeeding skills assessment. It assesses readiness to feed, rooting, fixing and sucking and assigns a numerical value for each item, thus giving objective findings. The study aimed at finding the proportion of SNBB and association of maternal and neonatal risk factors with it.

Method: A Proforma of maternal and neonatal factors was designed (based on the review of literature and pilot study). During the 5 months duration of data collection, all mother-newborn dyads in the Post Natal Care fulfilling the inclusion and exclusion criteria were recruited for the study. Assessment was done using IBFAT on either day 1, 2 or 3 after birth (considering day of birth as day 0), before the mother-newborn dyad got discharged. Data collected was tabulated and coded using relevant software, statistical analysis was done by an expert using appropriate tests and results were obtained.

Results: Proportion of SNBB was 34%. Risk factors independently associated with SNBB (Multivariate Logistic Regression) are Mother’s evaluation (fairly pleased/ pleased), Cesarean mode of delivery, Use of non-breast milk feeds, Gestational age (pre-term) of the neonate, Abnormal APGAR score at birth and Meconium stained liquor (P-value<0.05 for all).

Conclusion: Study highlighted the need for establishing screening procedure as a routine practice. Association of risk factors may lead to proactive referrals and management.