Incidence, Risk Factors, and Adverse Outcomes of Inadequate Breastfeeding Practices Among 10 Week Old Infants Delivered at Selected Health Facilities in Bushenyi District, Western Uganda. A prospective cohort study.

Abstract Background Breastfeeding is crucial for infant health and development, especially during the first 6 months of life. Despite the importance of these practices, many infants do not receive adequate breastfeeding practices during this critical period, leading to potential health risks. In many low-resource settings, including Uganda, the incidence and the factors contributing to inadequate breastfeeding practices are not poorly understood. This study aimed to determine the incidence, risk factors, and adverse outcomes of inadequate breastfeeding practices among 10-week-old infants delivered at three health facilities in the Bushenyi district, Western Uganda. Methods This was a multicenter prospective cohort study involving infants followed from birth to 10 weeks of life at three health facilities in Bushenyi District. All babies born after 28 weeks of gestation and their mothers were included. Inadequate breastfeeding was defined as delayed initiation of breastfeeding or lack of exclusive breastfeeding. Poisson regression in SPSS (version 26.0) was used to identify significant risk factors. Results A total of 260 newborns were enrolled, but 12 were lost to follow-up. Of the remaining 248 followed up to 10 weeks, 55.8% were female, and 84.6% were term. Overall, inadequate breastfeeding was 56% (95% CI 50.0%, 62.1%). Early initiation of breastfeeding was done in 79.2%. Exclusive breastfeeding declined from 100% during the neonatal period to 83.7% at 6 weeks and 65.7%at 10 weeks. Risk factors included lack of tertiary education, preterm birth, low birth weight, firstborn status, and prolonged labor (P < 0.05). The rates of diarrhea, respiratory tract infections, underweight, and wasting were significantly higher among infants who had inadequate breastfeeding. Conclusion More than half of the infants experienced inadequate breastfeeding by the 10th week of life. Continuous encouragement and support for mothers to practice exclusive breastfeeding until six months is essential. Infants identified with inadequate breastfeeding should undergo routine nutritional assessment to ensure timely initiation of nutritional support.