title: Magnitude and factors associated with delayed initiation of breastfeeding among mothers who deliver in Mulago hospital, Uganda.
abstract: BACKGROUND
  Breastfeeding as a determinant of infant health and nutrition saves up to 1.5 million infant lives annually. Though breastfeeding is mostly universal in sub-Saharan Africa, early initiation of breastfeeding is rarely practiced.
  
  
  OBJECTIVE
  To determine magnitude and factors associated with delayed initiation of breastfeeding among mother-infant pairs who deliver in Mulago hospital.
  
  
  METHODS
  We carried out a descriptive cross sectional study, where 665 mother-infant pairs were interviewed within 24 hours following delivery; with additional qualitative data collected using focus group discussions to understand reasons for delaying initiation. The data was analysed by identification and coding of themes.
  
  
  RESULTS
  In this study, 31.4% mothers delayed initiation of breastfeeding. This was associated with maternal HIV positive status (AOR 2.3; 95% CI 1.3-4.2), inadequate prenatal guidance, (AOR 3.6; 95% CI 1.9-6.8), inadequate professional assistance to initiate breastfeeding (AOR 1.8; 95% CI 1.2-2.8) and caesarean section delivery (AOR 8.6; 95% CI 4.7-16.0). Other reasons were perceived lack of breast milk, need of rest for both mother and baby after labor, and negative cultural beliefs.
  
  
  CONCLUSIONS
  In Mulago Hospital 1:3 mothers delayed initiation of breastfeeding. The reasons for delayed initiation include; inadequate information during ANC, HIV positive serostatus, caesarian section delivery and negative cultural ideas.
authors.affiliation: Department of Paediatrics, Ruhengeri district hospital, P.O. Box 54, Musanze, Rwanda.
authors.forename: Richard
authors.initials: R
authors.lastname: Kalisa
authors.affiliation: Department of Paediatrics, Faculty of Health Sciences, Egerton University. P.O Box 536-20115. Egerton, Nakuru, Kenya.
authors.forename: Ombeva
authors.initials: O
authors.lastname: Malande
authors.affiliation: Department of Paediatrics and Child Health, Makerere University, P.O Box 7072, Kampala.
authors.forename: Jolly
authors.initials: J
authors.lastname: Nankunda
authors.affiliation: Department of Paediatrics and Child Health, Makerere University, P.O Box 7072, Kampala.
authors.forename: James K
authors.initials: JK
authors.lastname: Tumwine
mesh_terms: D000328:Adult; D000367:Age Factors; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D017144:Focus Groups; D006679:HIV Seropositivity / Q000523:psychology / Q000635:transmission*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008425:Maternal Behavior; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D010298:Parity; D011247:Pregnancy; D036301:Qualitative Research; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014454:Uganda
keywords: Breastfeeding; HIV; delayed; initiation