Table 5 Summary of included studies presenting estimates of association between early breastfeeding initiation and morbidity outcomes

Appoh [29], Ghana, facility

case-control

early vs. late

Reported an association between early breastfeeding initiation and a reduction in underweight children

LOW

Kumar [33], India, community

cross sectional survey

<6h vs. >6h

Reported an association between early breastfeeding initiation and a reduction in underweight children

LOW

Malnutrition WLZ

Engebretsen [32], Uganda, community

cross sectional survey

<2h vs 2-24h<2h vs>24h

There was no statistically significant relationship comparing >24hr&<24 hours to <2hours (reference)

LOW

Kumar [33], India, community

cross sectional survey

<6h vs. >6h

The infant feeding practices studied were not significantly associated with wasting

LOW

Malnutrition, LAZ

Engebretsen [32], Uganda, community

cross sectional survey

<2h vs 2-24h<2h vs>24h

There was no statistically significant relationship comparing >24hr&<24 hours to <2hours (reference

LOW

Kumar [33], India, community

cross sectional survey

<6h vs. >6h

Reported a significant association between early breastfeeding initiation and reduction in stunting

LOW

Early Weight Loss

Enzunga [23], Zaire, facility

prospective cohort

early vs. late

Reports a direct relationship between the delay in initiation of breast-feeding and subsequent weight loss

LOW

Caglar [34], Turkey, facility

prospective matched case control

mean time to bf initiation

Infants with a weight loss of >10% were significantly more likely to have received their first breastfeeding later than controls

MEDIUM

Diarrhea

Badruddin [30], Pakistan, mixed facility/community

case-control

early vs. late

Reported a significant higher likelihood of late breastfeeding in cases (i.e. those with acute and/or persistent diarrhea)

LOW

Clemens [19], Egypt, community

prospective cohort

<72h vs. >72h

Reported a significant association between early breastfeeding initiation and reduction in diarrhea in the first six months of life

LOW

Acute Diarrhea

Badruddin [30], Pakistan, mixed facility/community

case-control

early vs. late

Reported a significant higher likelihood of late breastfeeding in cases (i.e. those with acute diarrhea)

LOW

Persistent Diarrhea

Badruddin [30], Pakistan, mixed facility/community

case-control

early vs. late

Reported a significant higher likelihood of late breastfeeding in cases (i.e. those with persistent diarrhea)

LOW

Omphalitis

Mullany [26], Zanzibar, community

prospective cohort

<1h vs. >=1h

Risk of omphalitis was 71% lower among babies breastfed within 1 hour

MEDIUM

Mullany [25], Nepal, community

prospective cohort

early vs. late

There was no statistically significant evidence to suggest that early breastfeeding initiation is protective against omphalitis

MEDIUM

Hypoglycemia

Sasidharan [28], India, hospital

prospective cohort

early vs. late

Reported a significant association between early breastfeeding initiation and reduction in hypoglycemia

LOW

Hypothermia

Mullany [27], Nepal, community

prospective cohort

early vs. late

The adjusted prevalence rate of hypothermia was 16% lower among babies for whom bf was initiated w/in 24hours

MEDIUM

Van den Bosch [35], Malawi, facility

randomized trial

Immediate vs. mother’s choice of initiation time

Reported a significant association between early initiation and a reduction in low body temperature

LOW