title: Social support during childbirth as a catalyst for early breastfeeding initiation for first-time Nigerian mothers.
abstract: BACKGROUND
  Initiation of breastfeeding can be difficult in a busy maternity centre with inadequate manpower and social support. This study aims to explore the role of psychosocial support offered by companions on breastfeeding initiation among first-time mothers.
  
  
  METHODS
  This is a secondary data analysis of a randomised controlled trial conducted among women attending the antenatal clinic of the University College Hospital, Ibadan, Nigeria in 2007. Those in the experimental group were asked to bring someone of their choice to the labour room to act as a companion; the comparison group received standard care. The results of 209 HIV negative women who had vaginal births were analysed. The main outcome measure was time to initiation of breastfeeding after childbirth.
  
  
  RESULTS
  Of the total, 94 had companions during labour while 115 did not have a companion. The median time to breastfeeding initiation was significantly shorter in those with companions compared to controls (16 vs. 54 minutes; p < 0.01). The cumulative survival analysis indicated that all in the treatment group had initiated breastfeeding by 26 minutes, while among the control group none had commenced at 30 minutes post-delivery with some as late as 12 hours. After Cox regression analysis was used to adjust for possible confounders, the outcome still showed a significant hazard ratio of 207.8 (95%CI 49.2, 878.0; p < 0.01) among women who were supported by a companion.
  
  
  CONCLUSIONS
  Use of companions during labour is associated with earlier time to breastfeeding initiation among first-time mothers in Nigeria.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry: ACTRN12609000994280.
authors.affiliation: Department of Obstetrics and Gynaecology, College of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria. onembello@yahoo.co.uk.
authors.forename: Imran O
authors.initials: IO
authors.lastname: Morhason-Bello
authors.forename: Babatunde O
authors.initials: BO
authors.lastname: Adedokun
authors.forename: Oladosu A
authors.initials: OA
authors.lastname: Ojengbede