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
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