†
Timing of initiation, patterns of breastfeeding, and infant survival: prospective analysis of pooled data from three randomised trials
although benefits exclusive breastfeeding child health survival particularly postneonatal period established independent beneficial effect early breastfeeding initiation remains unclear studied association timing breastfeeding initiation postenrolment neonatal postneonatal mortality 6 months age well associations breastfeeding pattern mortalitywe examined associations timing breastfeeding initiation postenrolment neonatal mortality enrolment 28 days postneonatal mortality 6 months age 29180 days large cohort three neonatal vitamin trials ghana india tanzania newborn babies eligible trials mother reported likely stay study area next 6 months could feed orally aged less 3 days primary caregiver gave informed consent excluded infants initiated breastfeeding 96 h initiate missing initiation status pooled data randomised groups three trials categorised time breastfeeding initiation 1 h 223 h 2496 h defined breastfeeding patterns exclusive predominant partial breastfeeding 4 days 1 month 3 months age estimated relative risks using log binomial regression poisson regression robust variances multivariate models controlled site potential confoundersof 99 938 enrolled infants 99 632 babies initiated breastfeeding 96 h age included prospective cohort 56 981 572 initiated breastfeeding 1 h 38 043 382 223 h 4608 46 2496 h compared infants initiating breastfeeding within first hour life neonatal mortality enrolment 28 days higher infants initiating 223 h adjusted relative risk 141 95 ci 124162 p00001 initiating 2496 h 179 139230 p00001 associations similar deaths first 4 days life excluded 132 110158 p0003 breastfeeding initiation 223 h 190 138262 p00001 initiation 2496 h data stratified exclusive breastfeeding status 4 days age p value interaction0690 associations also similar magnitude wider confidence intervals initiation 223 h 141 112177 p0003 initiation 2496 h 151 063365 p0357 exclusive breastfeeding also associated lower mortality first 6 months life 13 months mortality exclusive vs partial breastfeeding 1 month 183 145232 p00001 exclusive breastfeeding vs breastfeeding 1 month 1088 8271431 p00001our findings suggest early initiation breastfeeding reduces neonatal early infant mortality increasing rates exclusive breastfeeding additional mechanisms practices promoted public health programmes used models estimate lives savedbill melinda gates foundation grant