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ARTICLES: Karen M. Edmond, Charles Zandoh, Maria A. Quigley, Seeba Amenga-Etego, Seth Owusu-Agyei, and Betty R. Kirkwood Delayed Breastfeeding Initiation Increases Risk of Neonatal Mortality Pediatrics 2006; 117: e380-e386 [Abstract] [Full text] [PDF]

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Should breastfeeding be initiated within the first 10 minutes after birth?

Carol A Walshaw, Owens Jenny M   (29 March 2006)

Should breastfeeding be initiated within the first 10 minutes after birth?

Carol A Walshaw, Jenny Owens Health Visitor   (20 April 2006)

Should breastfeeding be initiated within the first 10 minutes after birth? 29 March 2006
Carol A Walshaw, GP North Bradford and Airedale PCT, Owens Jenny M Send letter to journal: Re: Should breastfeeding be initiated within the first 10 minutes after birth? anne.walshw{at}bradford.nhs.uk Carol A Walshaw, et al.	Edmond et al1 have shown in a study in rural Ghana, a 22% reduction in neonatal mortality if breastfeeding is started within the first hour after birth. 43 % of infants in the study initiated breastfeeding at this time. The authors stated “The mother was asked when she initiated breastfeeding and was prompted for the exact timing (within 1 hour…” More precise timing of the first feed may however be important. Previous studies have examined breastfeeds within the first hour. Righard et al2 studied babies allowed uninterrupted skin-to-skin contact for at least 1 hour after birth. At an average of 50 minutes after birth only 63% of babies were sucking correctly at the breast. Babies of mothers receiving pethidine during labour were more likely to suck incorrectly or not at all. In a study assessing early initiation and frequency of breastfeeding Salariya et al3 observed that babies put to the breast within the first 10 minutes of life had no fixing or sucking difficulties even though 75% of the mothers of these babies had received pethidine during labour. In order to obtain the benefits of an early feed, it may be that this should be initiated within the first 10 minutes after birth as waiting until later in the first hour may be too late for some babies, particularly those whose mothers received sedation during labour. Recent advice is that the baby should have skin-to-skin contact with the mother after birth, thereby having free access to the breast so that the baby will be able to feed when he or she is ready.4 In light of the evidence in Edmond’s study, perhaps mothers should be advised that an early feed is important, and they should initiate this within the first hour and possibly within the first 10 minutes, rather than wait until the baby is ready, since the opportunity for an early feed may then have been lost. 1 Edmond K.M. Zandoh C. Amengo-Etego S. Kirkwood B R. Delayed breastfeeding initiation increases risk of neonatal mortality. Pediatrics Vol 117 No. 3 March 2006 ppe380-e386 2 Righard L. Alade M.O. Effect of delivery room routines on success of first breast-feed. Lancet Vol 336. Nov 3 1990. pp1105-1107 3 Salariya E.M. Cater J.I. Easton P.M. Duration of breast-feeding after early initiation and frequent feeding. Lancet Nov 25, 1978 pp1141- 1143 4 Renfrew M. J. Woolridge M. W. McGill H. R. Enabling women to breastfeed. The Staionery Office. ISBN 0 11 321873 7 Conflict of Interest: Researching into infant growth and breastfeeding
Should breastfeeding be initiated within the first 10 minutes after birth? 20 April 2006
Carol A Walshaw, General Medical Practitioner North Bradford & Airedale Primary Care Trust, Jenny Owens Health Visitor Send letter to journal: Re: Should breastfeeding be initiated within the first 10 minutes after birth? anne.walshaw{at}bradford.nhs.uk Carol A Walshaw, et al.	Edmond et al1 have shown in a study in rural Ghana, a 22% reduction in neonatal mortality if breastfeeding is started within the first hour after birth. 43 % of infants in the study initiated breastfeeding within this time. The authors stated “The mother was asked when she initiated breastfeeding and was prompted for the exact timing (within 1 hour…” More precise timing of the first feed may however be important. Previous studies have examined breastfeeds within the first hour. Righard et al2 studied babies allowed uninterrupted skin-to-skin contact for at least 1 hour after birth. At an average of 50 minutes after birth only 63% of babies were sucking correctly at the breast. Babies of mothers receiving pethidine during labour were more likely to suck incorrectly or not at all. In a study assessing early initiation and frequency of breastfeeding Salariya et al3 observed that babies put to the breast within the first 10 minutes of life had no fixing or sucking difficulties even though 75% of the mothers of these babies had received pethidine during labour. In order to obtain the benefits of an early feed, it may be that this should be initiated within the first 10 minutes after birth as waiting until later in the first hour may be too late for some babies, particularly those whose mothers received sedation during labour. Recent advice is that the baby should have skin-to-skin contact with the mother after birth, thereby having free access to the breast so that the baby will be able to feed when he or she is ready.4 In light of the evidence in Edmond’s study, perhaps mothers should be advised that an early feed is important, and they should initiate this within the first hour and possibly within the first 10 minutes, rather than wait until the baby is ready, since the opportunity for an early feed may then have been lost. 1 Edmond K.M. Zandoh C. Amengo-Etego S. Kirkwood B R. Delayed breastfeeding initiation increases risk of neonatal mortality. Pediatrics Vol 117 No. 3 March 2006 ppe380-e386 2 Righard L. Alade M.O. Effect of delivery room routines on success of first breast-feed. Lancet Vol 336. Nov 3 1990. pp1105-1107 3 Salariya E.M. Cater J.I. Easton P.M. Duration of breast-feeding after early initiation and frequent feeding. Lancet Nov 25, 1978 pp1141- 1143 4 Renfrew M. J. Woolridge M. W. McGill H. R. Enabling women to breastfeed. The Stationery Office. ISBN 0 11 321873 7 Conflict of Interest: None declared

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