ABSTRACT
INTRODUCTION: Rates and relationships of early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) of mothers in rural Haiti were examined. Prelacteal and complementary feedings were identified. METHODS: With a cross-sectional descriptive design, survey data from mothers (Nâ¯=â¯195) were collected at three intervals after birth. Data were analyzed for indicators of EIBF, EBF, and complementary feedings. RESULTS: Overall, 148 (75.9%) mothers reported EIBF, and 75 (38.5%) reported EBF. EIBF was associated with EBF, with an adjusted relative risk 1.35 (95% confidence intervalâ¯=â¯[0.84, 2.18]). Several nutritive and nonnutritive substances interrupted EBF during the first 6 months of life. DISCUSSION: Haiti has an under-five mortality rate of 67.0/1,000 live births, exceeding the mean of 46.5/1,000 live births for developing regions. Both EIBF and EBF are associated with decreased neonatal and early infant mortality. Country-specific data are needed to inform and develop breastfeeding initiatives and community-level campaigns to improve the prevalence of EIBF and EBF in Haiti.
Subject(s)
Breast Feeding/statistics & numerical data , Adult , Breast Feeding/psychology , Cross-Sectional Studies , Culture , Female , Haiti , Humans , Infant , Infant, Newborn , Male , Mothers/psychology , Mothers/statistics & numerical data , Rural Population/statistics & numerical data , Surveys and QuestionnairesABSTRACT
BACKGROUND: Chlorhexidine topical cord application is recommended to prevent umbilical cord infections in newborns delivered at home in low-resource settings. A community campaign introducing chlorhexidine for the first time in Haiti was developed. Traditional birth attendants (TBAs) were identified as implementers since they typically cut newborns' cords. TBAs were trained to apply chlorhexidine to the cord and demonstrate this procedure to the mother. Concurrently TBAs explained reasons for using chlorhexidine exclusively instead of traditional cord care practices. The campaign's effectiveness was evaluated 7-10 days post-delivery using a survey administered by community health workers (CHWs) to 198 mothers. RESULTS: Nearly all mothers heard about chlorhexidine use and applied it as instructed. Most mothers did not initially report using traditional cord care practices. With further probing, the majority reported covering the cord but few applied an unhygienic substance. No serious cord infections were reported. CONCLUSION: The campaign was highly successful in reaching mothers and achieving chlorhexidine use. In this study, the concomitant use of traditional cloth coverings or bindings of the cord did not appear harmful; however more research is needed in this area. This campaign provides a model for implementing chlorhexidine use, especially where trained TBAs and CHWs are present.
