Background
Methods
Source of literature
Search terms
Inclusion and exclusion criteria
Inclusion criteria | Exclusion criteria |
---|---|
Countries in South Asia encompassing 8 countries namely Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka. | Studies conducted among South Asian women living in other regions |
Studies published in or after 1990. In English language | Full-text not accessible |
Published quantitative, qualitative and mixed method studies | Studies not demonstrating a clear research methodology - commentaries, letters and editorials. |
Studies reporting factors or barriers on initiation of breastfeeding within 1 h of birth. | Studies on initiation of breastfeeding after 1 h of birth. |
Study selection and data extraction
Quality appraisal
Synthesis of results
Results
Study selection
Serial number | Source | Study setting | Outcomes – reported factors or barriers | Study methods | Quality grading |
---|---|---|---|---|---|
1 | Dibley et al., 2010 [43] | Bangladesh, India, Nepal and Sri Lanka | Delivery by caesarean section Home delivery No antenatal check-up No decision-making participation Lack of access to media | Quantitative cross sectional survey: secondary analysis of DHS | Moderate |
2 | Haider et al., 2010 [41] | Dhaka, Bangladesh | Lack of knowledge No milk secretion Traditional belief Mother’s ill-health Baby’s ill-health Grandmothers’ decision Midwife discouraged Lack of support | Quantitative cross-sectional survey. Qualitative | Weak quantitative and moderate qualitative |
3 | Parveen et al., 2012 [39] | Haryana, India | Custom Mother’s illness No milk secretion | Quantitative cross-sectional survey | Weak |
4 | Kaushal et al., 2005 [44] | Haryana, India | Custom | Quantitative cross-sectional survey. Qualitative | Weak quantitative and qualitative |
5 | Badruddin et al., 1997 [37] | Karachi, Pakistan | Mother unable to sit Caesarean section delivery Night time High BP of mother | Quantitative: longitudinal design. Qualitative | Weak quantitative and moderate qualitative |
6 | Dihidar et al., 2002 [33] | Calcutta, India | Living in rural area | Quantitative cross sectional survey | Weak |
7 | Senarath et al., 2012 [25] | Sri Lanka | Male child Low birth weight Home delivery Caesarean section delivery Rural Geography: North Central Mother’s age15-19 years Birth order; first birth No previous birth Living in Sabaragamuwa | Quantitative cross-sectional survey: secondary analysis of DHS 2006-07 | Moderate |
8 | Mihrshahi et al., 2010 [29] | Bangladesh | No maternal education No education of husband Birth order > 5 Home delivery No antenatal check-ups Mothers not watching television Poorest household No decision-making participation Geography: lowest in Barisal | Quantitative cross-sectional survey: secondary analysis of DHS 2004 | Moderate |
9 | Pandey et al., 2010 [28] | Nepal | Caesarean section delivery Delivery assistance from health professionals compared to TBAs No participation in decision making Living in mountainous region | Quantitative cross-sectional survey: secondary analysis of DHS 2006 | Moderate |
10 | Seranath et al., 2010 [35] | Sri Lanka | Birth order; first birth Caesarean section delivery No antenatal visits by midwife Geography: Colombo feeder area | Quantitative cross-sectional survey: secondary analysis of DHS 2000 | Moderate |
11 | Hazir et al., 2013 [27] | Pakistan | Working mothers Caesarean section delivery Residing in Sindh Province | Quantitative cross-sectional survey: secondary analysis of DHS 2006/07 | Moderate |
12 | Khadduri et al., 2008 [47] | Haripur district, Pakistan | Custom; tradition of prelacteal feeding | Qualitative | Moderate |
13 | Bandyopdahyay et al., 2009 [48] | Rural Bengal, India | Customs; perception that first milk is harmful to the baby; insufficient milk; that milk will only come after 48 h | Qualitative | Weak quantitative and moderate qualitative |
14 | Patel et al. 2010 [26] | India | No education Mothers aged 15–19 years No education of husband Home delivery Caesarean section delivery No antenatal check-ups Bivariate analysis No post natal check-ups Lowest wealth quintile No participation in decision making No media – radio, newspaper, television Geography: rural area; Central region | Quantitative cross-sectional survey: secondary analysis of National Family Health Survey 2005-06 | Moderate |
15 | Subedi et al. 2012 [31] | Chepang community, Nepal | Illiterate No antenatal check-ups Home delivery | Quantitative cross- sectional survey | Weak |
16 | Subba et al. 2007 [34] | Pokhara, Nepal | Nuclear family Smaller family size | Quantitative cross-sectional survey | Weak |
17 | Abdulraheem and Binns 2007 [42] | Maldives (several islands) | Caesarean section delivery | Quantitative cross-sectional survey | Weak |
18 | Athavale et al. 2004 [36] | Urban Health Centre, Nagpur, India | Caesarean section delivery Customs; prelacteal feeding, discarding colostrum Premature baby Birth order; first birth | Quantitative cross-sectional survey | Weak |
19 | Ekambaram et al. 2010 [38] | Tertiary care hospital, South India | Child was sick (34 %) Delay in shifting from labour room (25 %) Mother’s motivation/too tired: no consciousness (14 %) Baby was sleeping (5 %) | Quantitative cross-sectional survey | Weak |
20 | Moran et al. 2009 [49] | Dhaka, Bangladesh | Perceptions of no milk supply | Quantitative cross-sectional survey. Qualitative | Weak quantitative and moderate qualitative |
21 | Fikree et al. 2005 [46] | Karachi, Pakistan | Customs; traditional feeding practices and perceived health benefits | Quantitative cross-sectional survey. Qualitative | Moderate quantitative and moderate qualitative |
22 | Rahman et al. 2011 [30] | Bangladesh | No antenatal check-ups Poorest wealth quintile Delivery assistance by non-medically trained provider No Education | Quantitative cross-sectional survey: analysis of Demographic and Health Survey 2007 | Moderate |
23 | Ali et al. 2011 [32] | Semi-urban Pakistan | Lack of education | Quantitative cross-sectional survey | Weak |
24 | Digra et al. 2012 [45] | Jammu, India | Self-decision (22.2 %) Advice of priest (35 %) Advice of elderly lady in family (20.4 %) | Quantitative cross-sectional survey | Weak |
25 | Premani et al. 2011 [40] | Karachi, Pakistan | Mothers too tired after delivery | Qualitative | Weak |
Quality of studies
Factors associated with early initiation of breastfeeding
Geographical factors
Socioeconomic factors
Individual factors
Health related factors
Barriers to early initiation of breastfeeding
Supply-side barriers | Demand-side barriers |
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Acceptability | Acceptability 1. Traditional feeding practices 1.1 breastfeeding according to time of birth 1.2 bathing rituals 1.3 prelacteal feeding and discarding colostrum 2. Advice of priests 3. Influence of mother in law |
Availability 1. Lack of knowledge and misperception | Availability 1. Lack of support 2. Milk insufficiency |
Accessibility 1. No or few antenatal appointments 2. Home delivery 3. Type of delivery assistance and practices 4. No post-natal check-up | Accessibility 1. Low socio economic status linked to lack of access to media: radio and newspaper 2. Mother’s involvement in decision making |