Does Postnatal Care Have a Role in Improving Newborn Feeding? A Study in 15 Sub-Saharan African Countries

Background: Breastfeeding is known as a key intervention to improve newborn health and survival while prelacteal feeds (liquids other than breastmilk within 3 days of birth) represents a departure from optimal feeding practices. Recent programmatic guidelines from the WHO and UNICEF outline the need to improve newborn feeding and points to postnatal care (PNC) as a potential mechanism to do so. This study examines if PNC and type of PNC provider are associated with key newborn feeding practices: breastfeeding within 1 day and prelacteal feeds.

Methods: We use data from the Demographic and Health Surveys for 15 sub-Saharan African countries to estimate 4 separate pooled, multilevel, logistic regression models to predict the newborn feeding outcomes.

Findings: PNC is significantly associated with increased breastfeeding within 1day (OR = 1.35,  < 0.001) but is not associated with PLFs (OR = 1.04,  = 0.195). PNC provided by nurses, midwives and untrained health workers is also associated with higher odds of breastfeeding within 1 day of birth (OR = 1.39,  < 0.001, (OR = 1.95,  < 0.001) while PNC provided by untrained health workers is associated with increased odds of PLFs (OR = 1.20,  = 0.017).

Conclusions: PNC delivered through customary care may be an effective strategy to improve the breastfeeding within 1 day but not to discourage PLFs. Further analysis should be done to examine how these variables operate at the country level to produce finer programmatic insight.