Publication:

Exclusive breastfeeding practices among mothers delivering at a tertiary hospital in Antananarivo, Madagascar

Background Exclusive breastfeeding (EBF) is a cost-effective intervention that significantly reduces infant morbidity and mortality. However, its practice remains suboptimal in many low- and middle-income countries. The aim of the study is to assess breastfeeding practices and maternal knowledge among mothers delivering at a tertiary hospital in Antananarivo, Madagascar.

Methods A cross-sectional study was conducted from July to September 2024 at the maternity ward of the Centre Hospitalier de Soavinandriana. Mothers who initiated breastfeeding and consented to participate were enrolled. Data were collected at discharge and at one month postpartum. Statistical analyses were performed using Epi Info 7, with p < 0.05 considered significant.

Results Among 106 mothers (mean age 29.3±4.7 years), early initiation of breastfeeding within one hour occurred in 41.5%. Exclusive breastfeeding was reported in 61.3% at discharge and declined to 48.1% at one month. Formula feeding was introduced in 34.0% of cases, and 27.4% of infants received non-breast milk liquids. Factors significantly associated with EBF at one month included early initiation (63% vs 37%, p < 0.001), vaginal delivery (52% vs 48%, p=0.03), and receipt of breastfeeding counseling (58% vs 42%, p=0.01). Mother–infant separation was negatively associated with EBF (29% vs 71%, p=0.002). Although 60.4% of mothers received breastfeeding information, only 46% correctly identified the recommended duration of EBF.

Conclusions Despite moderate breastfeeding initiation rates, EBF declined substantially within the first month. Strengthening early initiation, counseling, and postnatal support is essential to improve breastfeeding outcomes.