Evidence map›Paper›PMID 35193639›Full record

ArticleInternational breastfeeding journal2022

Promotion of early and exclusive breastfeeding in neonatal care units in rural Rwanda: a pre- and post-intervention study.

Saidath Gato, Francois Biziyaremye, Catherine M Kirk, Chiquita Palha De Sousa, Alain Mukuralinda, Hamissy Habineza, Maya Asir, Himali de Silva, Marie Louise Manirakiza, Egide Karangwa and 3 more

Abstract read
In one paragraph

Article in International breastfeeding journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Safe recovery after cesarean in rural Africa: Technical consensus guidelines for post-discharge care.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2023
    Review
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Saidath GatoPartners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda. gasaido@gmail.com.
Francois BiziyaremyePartners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
Catherine M KirkPartners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
Chiquita Palha De SousaPartners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
Alain MukuralindaPartners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
Hamissy HabinezaPartners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
Maya AsirMAITS, London, UK.
Himali de SilvaMAITS, London, UK.
Marie Louise ManirakizaPartners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
Egide KarangwaPartners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
Alphonse NshimyiryoPartners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
Alex TugumeRwinkwavu District Hospital, Ministry of Health, Kigali, Rwanda.
Kathryn BeckPartners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly initiation of breastfeeding after birth and exclusive breastfeeding for the first six months improves child survival, nutrition and health outcomes. However, only 42% of newborns worldwide are breastfed within the first hour of life. Small and sick newborns are at greater risk of not receiving breastmilk and often require additional support for feeding. This study compares breastfeeding practices in Rwandan neonatal care units (NCUs) before and after the implementation of a package of interventions aimed to improve breastfeeding.

methodsThis pre-post intervention study was conducted at two district hospital NCUs in rural Rwanda from October-December 2017 (pre-intervention) and September 2018-March 2019 (post-intervention). Only newborns admitted before their second day of life (DOL) were included. Data were extracted from patient charts for clinical and demographic characteristics, feeding, and patient outcomes. Exclusive breastfeeding at discharge was based on last recorded infant feeding on the day of discharge. Logistic regression analysis was used to evaluate factors associated with exclusive breastfeeding at discharge.

resultsPre-intervention, 255 newborns were admitted in the NCUs and 793 were admitted in post-intervention. Exclusive breastfeeding on the day of birth (DOL0) increased from 5.4% (12/255) to 35.9% (249/793). At discharge, exclusive breastfeeding increased from 69.6% (149/214) to 87.0% (618/710). The mortality rate decreased from 16.1% (41/255) to 10.5% (83/793). Factors associated with greater odds of exclusive breastfeeding at discharge included admission during the post-intervention period (aOR 4.91; 95% CI 1.99, 12.11), and admission for infection (aOR 2.99; 95% CI 1.13, 7.93). Home deliveries (aOR 0.15; 95% CI 0.05, 0.47), preterm delivery (aOR 0.36; 95% CI 0.15, 0.87) and delayed first breastmilk feed (aOR 0.04 for DOL3 vs. DOL0; 95% CI 0.01, 0.35) reduced odds of exclusive breastfeeding at discharge.

conclusionsExpansion and adoption of evidenced-based guidelines, using innovative approaches, aimed at the unique needs of small and sick newborns may help to improve earlier initiation of breastfeeding, decrease mortality, and improve exclusive breastfeeding on discharge from hospital among small and sick newborns. These interventions should be replicated in similar settings to determine their effectiveness.

Indexed as

Breast FeedingMilk, HumanChildFemaleHumansInfantInfant, NewbornParturitionPatient DischargePregnancyRwandaBaby-friendlyExclusive breastfeeding,Neonatal nutritionNurturing careRwanda,Small and sick newborns

Identifiers

PMID35193639
PMCPMC8864904

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.