Impact of early infant feeding practices on mortality in low birth weight infants from rural Ghana

J Perinatol. 2008 Jun;28(6):438-44. doi: 10.1038/jp.2008.19. Epub 2008 Mar 6.


Objective: To assess the impact of early infant feeding practices on low birth weight- (LBW) specific neonatal mortality in rural Ghana.

Study design: A total of 11 787-breastfed babies were born between July 2003 and June 2004 and survived to day 2. Overall, 3411 (30.3%) infants had weight recorded within 48 h. Two hundred and ninety-six (8.7%) infants were <2.5 kg and 15 died in the neonatal period. Associations were examined using multivariate logistic regression.

Result: Initiation of breastfeeding after day 1 was associated with a threefold increase in mortality risk (adjusted odds ratio (adjOR) 3.23, 95% confidence interval (95% CI) (1.07-9.82)) in infants aged 2 to 28 days. Prelacteal feeding was associated with a threefold significantly increased mortality risk (adjOR 3.12, 95% CI (1.19-8.22)) in infants aged 2 to 28 days but there was no statistically significant increase in risk associated with predominant breastfeeding (adjOR 1.91, 95% CI (0.60-6.09)). There were no modifications of these effects by birth weight. The sample size was insufficient to allow assessment of the impact of partial breastfeeding.

Conclusion: Improving early infant feeding practices is an effective, feasible, low-cost intervention that could reduce early infant mortality in LBW infants in developing countries. These findings are especially relevant for sub-Saharan Africa where many LBW infants are born at home, never taken to a health facility and mortality rates are unacceptably high.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Age Factors
  • Breast Feeding* / statistics & numerical data
  • Ghana
  • Humans
  • Infant Mortality*
  • Infant, Low Birth Weight*
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Logistic Models
  • Rural Population