Delayed Breastfeeding Initiation and Associated Factors in Tanzania: A Cross-Sectional Study

Area of Science:

• Public Health
• Maternal and Child Health
• Pediatrics

Background:

• Delayed breastfeeding initiation is a significant public health concern in low- and middle-income countries, linked to adverse child development and increased infant mortality.
• Despite global efforts, early breastfeeding initiation remains suboptimal in many parts of Sub-Saharan Africa, necessitating localized research.
• This study specifically addresses the prevalence and associated factors of delayed breastfeeding initiation within Tanzania.

Purpose of the Study:

• To determine the prevalence of delayed breastfeeding initiation in Tanzania.
• To identify key child, maternal, health-related, and geographical factors associated with delayed breastfeeding initiation in the Tanzanian population.

Main Methods:

• Analysis of secondary data from the nationally representative 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey.
• Inclusion of children under 24 months, with delayed breastfeeding initiation defined as not starting within the first hour of life.
• Multilevel mixed-effects logistic regression was employed to identify factors associated with delayed initiation using weighted data.

Main Results:

• A prevalence of 24.4% for delayed breastfeeding initiation was observed among 4478 children.
• Significant associations included higher birth order, maternal age (35-49 years), absence of immediate skin-to-skin contact, cesarean delivery, lack of skilled birth assistance, and geographical region (Zanzibar and Southern zone).
• Cesarean delivery (aPR=2.45) and absence of skin-to-skin contact (aPR=1.85) were strongly linked to delayed initiation.

Conclusions:

• Nearly one in four Tanzanian newborns experience delayed breastfeeding initiation, influenced by a range of factors.
• Interventions should focus on promoting immediate skin-to-skin contact, skilled birth attendance, and support during cesarean deliveries.
• Addressing geographical disparities and providing targeted counseling for mothers of specific age groups and birth orders can improve early initiation rates and contribute to SDG target 3.2.