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Socio-Economic Differences in Early Initiation of Breastfeeding Among Children in a Ugandan Cross-Sectional Study

Early initiation of breastfeeding reduces neonatal and maternal morbidity and mortality, enhances mother-infant dyad bonding and maternal optimal breastfeeding practices. Studies on socio-economic inequalities in early initiation of breastfeeding are sparse in Uganda. This study therefore aimed to examine the association between socio-economic status and early initiation of breastfeeding among 5504 children aged 0-23 months in a country-wide population based cross-sectional study. Early initiation of breastfeeding defined as initiation of breastfeeding within an hour of birth was the outcome of interest. Proxy measures of socio-economic status (maternal occupation and household wealth index) were the exposure variable of interest. Bivariate analysis was conducted to determine the distribution of the prevalence of early initiation of breastfeeding by infant-mother dyad characteristics. Multivariate binary logistic regression models adjusted for relevant confounders were fitted to examine the association between socio-economic status and early initiation of breastfeeding. The results showed an overall prevalence early initiation of breastfeeding of 67.8% among Ugandan children. Children whose mothers self-reported their occupation as farmers and skilled manual workers had lower odds of early initiation of breastfeeding compared to those whose mothers were doing professional/technical/managerial work; OR: 0.69 (0.51 - 0.95) and 0.70 (0.49 - 0.99) respectively. On the other hand, children that lived in the poorest and poorer households had lower odds of early initiation of breastfeeding OR: 0.46 (0.32-0.67) and 0.64 (0.43-0.94) respectively. In conclusion, we found individual and household socio-economic inequality in EIB among children less than two years of age. Targeting interventions for promotion of EIB to less affluent mother-child dyads and households might be important in increasing optimal breastfeeding practices.