Community-Level Education and Guidance Needed to Enhance First Hour and Exclusive Breastfeeding Adherance Within a Peri-urban Community in Dhaka, Bangladesh

Mortality rates for infants and children under five in Bangladesh remain high, 52 and 69 out of 1000 live births respectively, with most under-five deaths occurring in children under one. Edmond et al. reported that initiating breastfeeding within one hour of birth reduces neonatal mortality by 31% in Ghana. Extrapolating this figure to Bangladesh leads to an estimated 20% decline in under-five mortality yearly with first hour breastfeeding initiation, saving 37,000 newborns and 53,000 children under five. First hour breastfeeding rates in Bangladesh are low (36%), with UNICEF reporting a decline in exclusive breastfeeding (EBF) rates from 46% (1993) to 36% (2006). We administered a questionnaire assessing basic household/socioeconomic parameters and infant feeding practices and perceptions during last pregnancy to a focus group of five women who brought children into a peri-urban clinic in Dhaka, Bangladesh. Four of five respondents received antenatal care and were informed by birth attendants that the first feed should be breast milk and EBF practiced for six months. Four individuals received feeding information through television and radio. All felt breastfeeding was nutritious with no drawbacks for the baby. Four wanted to breastfeed. Yet, only one performed first hour breastfeeding and another, EBF for 5 months. Only one knew a community worker who offered feeding information. Of three asked, all responded that having someone teach infant feeding, at or near home, would be useful. Our results indicate that community-level breastfeeding education, offering personal guidance may be necessary to enhance adherence to first hour and exclusive breastfeeding.