Prevalence of early skin-to-skin contact and its impact on exclusive breastfeeding during the maternity hospitalization.

BACKGROUND: Early essential newborn care has been implemented in countries regardless high or low neonatal mortality. This study aims to investigate the current practice of skin-to-skin contact (SSC) and its effect on exclusive breastfeeding during the hospital stay. METHODS: This is a cross-sectional study of 1812 Vietnamese mothers in multicenter. A questionnaire answered by the mothers was used to assess the duration of both SSC and breastfeeding practices. Multivariable logistic regression was used to identify a dose-response relationship between early SSC and prevalence of exclusive breastfeeding in hospital. RESULTS: There were 88.7% of mothers experiencing SSC with their infants right after birth and the highest prevalence of SSC was found in district hospitals. Among those experiencing SSC, 18.8% of the infants received more than 90 min of SSC and completed the first breastfeeding during SSC time. Prevalence of exclusive breastfeeding during maternity hospital stay was 46.7%. We found a significant dose-response relation between the duration of SSC and exclusive breastfeeding in hospital. Compared with infants without SSC, the prevalence of exclusive breastfeeding was higher in infants who experienced SSC for 15-90 min (adjusted odds ratio [aOR], 95% confidence interval [95%-CI]: 2.62 [1.61-4.27]) and more than 90 min (aOR [95%-CI]: 5.98 [3.48-10.28]). Completed first breastfeeding during SSC time (aOR [95%-CI]: 4.24 [3.28-5.47]) and being born in district hospitals (aOR [95%-CI]: 2.35 [1.79-3.09]) were associated with increased prevalence of exclusive breastfeeding during hospital stay. On the other hand, mother education level as high school/intermediate (aOR [95%-CI]: 0.58 [0.42-0.82]) and place of residence classified as rural decreased odds of exclusive breastfeeding in hospital (aOR [95%-CI]: 0.78 [0.61-0.99]). CONCLUSION: Our results demonstrate a strong dose-response relationship between duration of SSC and exclusive breastfeeding in hospital. Interventions that support exclusive breastfeeding during hospital stay, especially achieving prolonged uninterrupted SSC, could improve the duration of breastfeeding.

Improving small molecule force fields by identifying and characterizing small molecules with inconsistent parameters.

Many molecular simulation methods use force fields to help model and simulate molecules and their behavior in various environments. Force fields are sets of functions and parameters used to calculate the potential energy of a chemical system as a function of the atomic coordinates. Despite the widespread use of force fields, their inadequacies are often thought to contribute to systematic errors in molecular simulations. Furthermore, different force fields tend to give varying results on the same systems with the same simulation settings. Here, we present a pipeline for comparing the geometries of small molecule conformers. We aimed to identify molecules or chemistries that are particularly informative for future force field development because they display inconsistencies between force fields. We applied our pipeline to a subset of the eMolecules database, and highlighted molecules that appear to be parameterized inconsistently across different force fields. We then identified over-represented functional groups in these molecule sets. The molecules and moieties identified by this pipeline may be particularly helpful for future force field parameterization.

Genetic Determinants and Genotype-Phenotype Correlations in Vietnamese Patients With Dilated Cardiomyopathy.

BACKGROUND: Dilated cardiomyopathy (DCM) is an important cause of heart failure and cardiac transplantation. This study determined the prevalence of DCM-associated genes and evaluated the genotype-phenotype correlation in Vietnamese patients.Methods and Results:This study analyzed 58 genes from 230 patients. The study cohort consisted of 64.3% men; age at diagnosis 47.9±13.7 years; familial (10.9%) and sporadic DCM (82.2%). The diagnostic yield was 23.5%, 44.0% in familial and 19.6% in sporadic DCM.TTNtruncating variants (TTNtv) were predominant (46.4%), followed byTPM1,DSP,LMNA,MYBPC3,MYH6,MYH7,DES,TNNT2,ACTC1,ACTN2,BAG3,DMD,FKTN,PLN,TBX5,RBM20,TCAP(2-6%). Familial DCM, genotype-positive andTTNtv-positive patients were younger than those with genotype-negative and sporadic DCM. Genotype-positive patients displayed a decreased systolic blood pressure and left ventricular wall thickness compared to genotype-negative patients. Genotype-positive patients, particularly those withTTNtv, had a family history of DCM, higher left atrial volume index and body mass index, and lower right ventricle-fractional area change than genotype-negative patients. Genotype-positive patients reached the combined outcomes more frequently and at a younger age than genotype-negative patients. Major cardiac events occurred more frequently in patients positive with genes other thanTTNtv. CONCLUSIONS: The study findings provided an overview of Vietnamese DCM patients' genetic profile and suggested that management of environmental factors may be beneficial for DCM patients.

Survey of knowledge, attitude and practice of healthcare professionals on dengue transmission, diagnosis and clinical classification.

BACKGROUND: To investigate the knowledge, attitudes, and practices of the healthcare professionals (HCPs) including physicians and nurses regarding dengue transmission, diagnosis and clinical classification using the warning signs of World Health Organization (WHO) 2009 classification. RESULTS: Out of 471 respondents from three countries, 80.9% of physicians and 74% of nurses did not receive previous training regarding the dengue infection. The majority of respondents could identify the primary dengue vector (86%), while only a third of HCPs knew the biting time of dengue mosquitoes. Only half of our respondents knew about immunity induced by serotypes; Moreover, half of our participants could determine the diagnostic tests. On the other hand, about 90% of the respondents took responsibility for talking to the patients about preventive measures. Our respondents also showed wide variations in definition of warning signs listed in the WHO 2009 classification. Multivariate analysis linked the impact of different cofactors including prior training on dengue infection, type of profession, frequency of taking care of dengue patients and country on how HCPs defined these warning signs. CONCLUSIONS: This study could declare the variation in employing the warning signs listed in the WHO 2009 classification. We have figured that most of the HCPs did not take prior training on the dengue viral infection; Also, we found gaps in the knowledge regarding various topics in dengue fever. This paper recommends the gathering of efforts to establish the proper knowledge of dengue infection and the warning signs listed by the WHO.

Feto-Maternal Outcomes of Breastfeeding during Pregnancy: A Systematic Review and Meta-Analysis.

BACKGROUND: Breastfeeding is beneficial to both mother and infant. However, overlap of lactation with pregnancy and short recuperative intervals may impact mothers nutritionally. We aimed to investigate the possible effects of pregnancy during breastfeeding. METHODS: In October 2018, we searched systematically in nine electronic databases to investigate any association of breastfeeding during pregnancy with fetal and/or maternal outcomes. The study protocol was registered in PROSPERO (CRD41017056490). A meta-analysis was done to detect maternal and fetal outcomes and complications during pregnancy. Quality assessment was performed using the Australian Cancer Council bias tool for included studies. RESULTS: With 1992 studies initially identified, eight were eligible for qualitative analysis and 12 for quantitative analysis. Our results showed no significant difference in different abortion subtypes between lactating and non-lactating ones. In delivery, no difference between two groups regarding the time of delivery in full-term healthy, preterm delivery and preterm labor. No significant difference was detected in rates of antepartum, postpartum hemorrhage and prolonged labor between two groups. The women with short reproductive intervals may have higher supplemental intake and greater reduction fat store. The present studies showed that breastfeeding during pregnancy does not lead to adverse outcomes in the mother and her fetus in normal low-risk pregnancy, although it may lead to the nutritional burden on the mother. CONCLUSION: The present studies showed that breastfeeding during pregnancy did not lead to the adverse outcomes in the mother and her fetus.

Protocol registration issues of systematic review and meta-analysis studies: a survey of global researchers.

BACKGROUND: Although protocol registration of systematic reviews/meta-analysis (SR/MA) is still not mandatory, it is highly recommended that authors publish their SR/MA protocols prior to submitting their manuscripts for publication as recommended by the Cochrane guidelines for conducting SR/MAs. our aim was to assess the awareness, obstacles, and opinions of SR/MA authors about the protocol registration process. METHODS: A cross-sectional survey study included the authors who published SR/MAs during the period from 2010 to 2016, and they were contacted for participation in our survey study. They were identified through the literature search of SR/MAs in Scopus database. An online questionnaire was sent to each participant via e-mail after receiving their approval to join the study. We have sent 6650 emails and received 275 responses. RESULTS: A total of 270 authors responses were complete and included in the final analysis. Our results has shown that PROSPERO was the most common database used for protocol registration (71.3%). The registration-to-acceptance time interval in PROSPERO was less than 1 month (99.1%). Almost half of the authors (44.2%) did not register their protocols prior to publishing their SR/MAs and according to their opinion that the other authors lack knowledge of protocol importance and mandance to be registered, was the most commonly reported reason (44.9%). A significant percenatge of respondents (37.4%) believed that people would steal their ideas from protocol databases, while only 5.3% reported that their SR/MA had been stolen. However, the majority (72.9%) of participants have agreed that protocol registries play a role in preventing unnecessary duplication of reviews. Finally, 37.4% of participants agree that SR/MA protocol registration should be mandatory. CONCLUSION: About half of the participants believes that the main reason for not registering protocols, is that the other authors lack knowledge concerning obligation and importance to register the SR/MA protocols in advance. Therefore, tools should be available to mandate protocol registration of any SRs beforehand and increasing awareness about the benefits of protocol registration among researchers.

Appropriate care for neonates born to mothers with COVID-19 disease.

The global COVID-19 pandemic has been associated with high rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, morbidity and mortality in the general population. Evidence-based guidance on caring for babies born to mothers with COVID-19 is needed. There is currently insufficient evidence to suggest vertical transmission between mothers and their newborn infants. However, transmission can happen after birth from mothers or other carers. Based on the currently available data, prolonged skin-to-skin contact and early and exclusive breastfeeding remain the best strategies to reduce the risks of morbidity and mortality for both the mother with COVID-19 and her baby.

Prevalence and Pattern of Congenital Anomalies in a Tertiary Hospital in Central Vietnam.

BACKGROUND: Burden and pattern of congenital anomalies are insufficiently reported in Vietnam. This study aims to determine the prevalence and pattern of congenital anomalies in neonates in a tertiary hospital in central Vietnam. METHODS: A prospective cross-sectional study recruited all newborns with congenital anomalies in Da Nang Hospital for Women and Children-where nearly 60% neonates in the city are delivered. RESULTS: Over a 1-year period, 551 out of 14 335 registered live births were found to have congenital anomalies, equivalent to an overall prevalence of 384.4 per 10 000 live births. Congenital heart defects were the most common type (52.3%) with the prevalence of 200.9 per 10 000 live births, followed by anomalies of musculoskeletal system, digestive system. CONCLUSIONS: This study revealed a high prevalence of congenital anomalies with the most common type being congenital heart defects in central Vietnam compared to both higher income countries and resource-limited settings.

Methodological steps used by authors of systematic reviews and meta-analyses of clinical trials: a cross-sectional study.

BACKGROUND: The quality of systematic reviews and meta-analyses (SR/MAs) depends on the extent of the methods used. We investigated the methodological steps used by authors of SR/MAs of clinical trials via an author survey. METHODS: We conducted an email-based cross-sectional study by contacting corresponding authors of SR/MAs that were published in 2015 and 2016 and retrieved through the PubMed database. The 27-item questionnaire was developed to study the methodological steps used by authors when conducting a SR/MA and the demographic characteristics of the respondent. Besides the demographic characteristics, methodological questions regarding the source, extraction and synthesis of data were included. RESULTS: From 10,292 emails sent, 384 authors responded and were included in the final analysis. Manual searches were carried out by 69.2% of authors, while 87.3% do updated searches, 49.2% search grey literature, 74.9% use the Cochrane tool for risk of bias assessment, 69.8% assign more than two reviewers for data extraction, 20.5% use digital software to extract data from graphs, 57.9% use raw data in the meta-analysis, and 43.8% meta-analyze both adjusted and non-adjusted data. There was a positive correlation of years of experience in conducting of SR/MAs with both searching grey literature (P = 0.0003) and use of adjusted and non-adjusted data (P = 0.006). CONCLUSIONS: Many authors still do not carry out many of the vital methodological steps to be taken when performing any SR/MA. The experience of the authors in SR/MAs is highly correlated with use of the recommended tips for SR/MA conduct. The optimal methodological approach for researchers conducting a SR/MA should be standardized.

Dengue hemophagocytic syndrome: A systematic review and meta-analysis on epidemiology, clinical signs, outcomes, and risk factors.

We systematically searched and meta-analyzed the epidemiological characteristics, frequency of clinical signs, and outcomes of dengue-associated hemophagocytic lymphohistiocytosis. Ten electronic databases were searched systematically plus manual search of reference lists to identify relevant articles published until May 2017. The highest number of reported cases were from South-East Asia region (62 cases), followed by Western Pacific region (20 cases), and America (31 cases). The term "dengue hemorrhagic fever" predominated in studies that used the World Health Organization 1997 definition (59.7%), whereas "severe dengue" predominated in studies using the World Health Organization 2009 definition (76.8%). Among 122 cases, fever, splenomegaly, hepatomegaly, anemia, thrombocytopenia, and serum ferritin ≥500 µg/L were likely to report by articles representing by large sample size. The pooled proportion of these findings were as follows: fever 97.2%, hepatomegaly 70.2%, splenomegaly 78.4%, thrombocytopenia 90.1%, anemia 76.0%, and serum ferritin ≥500 µg/L 97.1%. This study highlighted a high case fatality rate (14.6%) and co-infection among dengue hemophagocytic lymphohistiocytosis patients. We suggest that long fever duration, persistent thrombocytopenia, elevated serum ferritin, and lactate dehydrogenase levels could be good diagnostic indicators for dengue-associated hemophagocytic syndrome. Bone marrow aspiration could be used as one criterion for diagnosis but is not obligatory. Further research is needed to examine the possible risk difference for development of hemophagocytic syndrome and to explore potential relationships between specific dengue classifications and dengue-associated hemophagocytic syndrome.

Stillbirth and preterm birth and associated factors in one of the largest cities in central Vietnam.

AIM: Little is known about the rate of stillbirths, preterm births and associated risk factors in resource-limited settings like Vietnam. This study reports those rates for Da Nang, which is one of the largest cities in central Vietnam. METHODS: Data on 20 762 births including stillbirths and preterm births and associated risk factors were prospectively collected from health facilities from April 2015 to March 2016. RESULTS: The data represented 85% of the total births in Da Nang during the study period, and a stillbirth rate of 9.7 per 1000 live births was recorded. The preterm rate for live births was just under 5%. Independent factors associated with an increased risk of stillbirth and preterm births were mothers aged 35 plus, working as farmers, living in the provinces and a history of abortion. Mothers under 20 years with previous preterm births faced a higher risk of another preterm birth. CONCLUSION: The stillbirth and premature birth rates in Da Nang were higher than rates in high-income countries. Developing registration programmes in Vietnam will provide improved data that will enable researchers and policymakers to identify strategies to reduce the number of stillbirths and premature births.

Introduction of Novel Surgical Techniques: A Survey on Knowledge, Attitude, and Practice of Surgeons.

Purpose. To investigate the knowledge, attitude, and practice of surgeons toward introducing novel surgical techniques in Egypt, Palestine, and Vietnam. Summary Background Data. Despite the recent advances in modern surgical care and its role in advancing the quality and the length of lives, surgery in the developing world has stagnated or even regressed. Methods. A survey was undertaken among the surgeons in 9 hospitals belonging to the 3 countries. Questions were categorized into knowledge, attitude, and practice questions. Meta-analyses were performed to estimate the event rate and compare between knowledge and practice, senior and junior surgeons. Results. A total of 244 responses, with a response rate of 79.7%, were included in the analysis. Regarding knowledge and attitude, the results were satisfactory except that only 55.8% of surgeons appraised their level of education and 43.3% wanted to earn money from the novel procedure. There was a significant difference between knowledge and practice regarding getting informed consent from the patients (P = .024), discussing the novelty of the procedure (P < .001), discussing the alternative procedures (P < .001), discussing the surgeons' experience and level of skills (P < .001), discussing the risk of the new procedure (P < .001), and monitoring the outcomes after the new procedure (P < .001). Conclusions. Most surgeons have sufficient knowledge and are motivated regarding adopting novel surgical techniques in order to provide the best care for the patients. However, there was a gap between knowledge and practice. Training programs and evidence-based guidelines regarding the introduction of novel surgical techniques are needed to overcome these challenges.

Prediction Model for Antimalarial Activities of Hemozoin Inhibitors by Using Physicochemical Properties.

The rapid spread of strains of malaria parasites that are resistant to several drugs has threatened global malaria control. Hence, the aim of this study was to predict the antimalarial activity of chemical compounds that possess anti-hemozoin-formation activity as a new means of antimalarial drug discovery. After the initial in vitro anti-hemozoin-formation high-throughput screening (HTS) of 9,600 compounds, a total of 224 hit compounds were identified as hemozoin inhibitors. These 224 compounds were tested for in vitro erythrocytic antimalarial activity at 10 µM by using chloroquine-mefloquine-sensitive Plasmodium falciparum strain 3D7A. Two independent experiments were conducted. The physicochemical properties of the active compounds were extracted from the ChemSpider and SciFinder databases. We analyzed the extracted data by using Bayesian model averaging (BMA). Our findings revealed that lower numbers of S atoms; lower distribution coefficient (log D) values at pH 3, 4, and 5; and higher predicted distribution coefficient (ACD log D) values at pH 7.4 had significant associations with antimalarial activity among compounds that possess anti-hemozoin-formation activity. The BMA model revealed an accuracy of 91.23%. We report new prediction models containing physicochemical properties that shed light on effective chemical groups for synthetic antimalarial compounds and help with in silico screening for novel antimalarial drugs.

Monitoring and interventions are needed to reduce the very high Caesarean section rates in Vietnam.

AIM: The aim of this study was to estimate the prevalence of Caesarean sections in the third largest city in Vietnam and identify the associated risk factors. METHODS: This descriptive study was conducted in Da Nang from April 2015 to March 2016 and the hospital-based sample comprised 20 535 women who delivered during this period. Caesarean section cases were categorised into private and public hospitals and groups of primiparous and multiparous women. RESULTS: We recruited 10 of the 12 hospitals in the City and they covered 90% of births during the study period. The overall Caesarean section rate was 58.6%: 57.9% in public hospitals and 70.6% in private hospitals. The three main indications for Caesarean sections were previous Caesarean sections, cephalopelvic disproportion and foetal distress. The factors that increased the likelihood of Caesarean sections were the mother being over 30, having an office job, a history of abortions, having a male infant and a higher neonatal birth weight. CONCLUSION: Our study demonstrated an extremely high rate of Caesarean section and associated factors in public and private hospitals in one of the biggest cities in Vietnam. The findings highlight the need for monitoring and interventions to reduce the Caesarean section rates.

Tracking the establishment of local endemic populations of an emergent enteric pathogen.

Shigella sonnei is a human-adapted pathogen that is emerging globally as the dominant agent of bacterial dysentery. To investigate local establishment, we sequenced the genomes of 263 Vietnamese S. sonnei isolated over 15 y. Our data show that S. sonnei was introduced into Vietnam in the 1980s and has undergone localized clonal expansion, punctuated by genomic fixation events through periodic selective sweeps. We uncover geographical spread, spatially restricted frontier populations, and convergent evolution through local gene pool sampling. This work provides a unique, high-resolution insight into the microevolution of a pioneering human pathogen during its establishment in a new host population.

The Electrochemical Behavior of TiN/316LSS Material in Simulated Body Fluid Solution.

We report on the fabrication and the electrochemical behavior of TiN film on the 316L stainless steel (316LSS) material in simulated body fluid (SBF) solution for implant application. The characterization results indicate that the coated TiN is completely crystalline with (111) crystal orientation. Electrochemical results of 316LSS and TiN/316LSS material after 21 days of immersion in SBF show that the durability of the TiN/316LSS is much higher than that of 316LSS, which registers a very low corrosion current density (about tens of nA cm(-2)). The formation of hydroxyapatite on the surface of the TiN/316LSS is also confirmed by SEM, EDX, X-ray and IR spectroscopy.

Carbon Nitride Coupled Co3O4: A Pyrolysis-Based Approach for High-Performance Hybrid Energy Storage.

Graphitic carbon nitride (CN) is a cost-effective and easily synthesized supercapacitor electrode material. However, its limited specific capacity has hindered its practical use. To address this, we developed a binary nanostructure by growing nanosized Co3O4 particles on CN. The CN-Co-2 composite, synthesized via thermal decomposition, exhibited a remarkable specific capacity of 280.64 C/g at 2 A/g. Even under prolonged cycling at 10.5 A/g, the retention rate exceeded 95%, demonstrating exceptional stability. In an asymmetric capacitor device, the CN-Co composite delivered 20.84 Wh/kg at 1000 W/kg, with a retention rate of 99.97% over 20,000 cycles, showcasing outstanding cycling stability. Controlled cobalt source adjustments yielded high-capacity electrode materials with battery-like behavior. This optimization strategy enhances energy density by retaining battery-like properties. In summary, the CN-Co composite is a promising, low-cost, easily synthesized electrode material with a high specific capacity and remarkable cycling stability, making it an attractive choice for energy storage applications.

Endoscopic and Histopathological Characteristics of Gastrointestinal Lymphoma: A Multicentric Study.

Background: Extranodal non-Hodgkin lymphoma (NHL) is more prevalent in the gastrointestinal (GI) tract than in other sites. This study aimed to determine the endoscopic characteristics of primary gastrointestinal non-Hodgkin lymphomas. Methods: We investigated 140 patients from three tertiary referral hospitals with primary malignant lymphoma of the gastrointestinal tract. Characteristics of the lesions were evaluated and analyzed using image-enhanced endoscopy, endoscopic ultrasound, and histopathology. Results: The median age was 60.5 (range: 11-99), and 59 (42.1%) were female. The most frequent complaint was abdominal pain (74.3%), followed by bloody feces (10%) and diarrhea (2.9%). B symptoms were observed in 15 (10.7%) patients. GI obstruction was the most common complication (10.0%), followed by hemorrhage (7.9%) and perforation (1.5%). Regarding endoscopic findings, the identified sites were the following: the stomach (61.4%), colon (10%), small intestine (10%), ileocecum (8.6%), rectum (6.4%), and duodenum (3.6%). Diffuse large B-cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue (MALT) lymphoma are most prevalent in the stomach. Helicobacter pylori was identified in 46 cases (39.0%), with MALT lymphoma being the most infected subtype. Nearly all gastrointestinal non-Hodgkin lymphomas manifested as superficial type (25-59.6%) and ulcer type (15.6-50%) under endoscopy. We found that fungating type and protruding with ulcer type were more frequent types of aggressive lymphomas (diffuse large B-cell lymphoma, mantle cell lymphoma, and T-cell lymphoma) compared to the indolent types (MALT lymphoma, follicular lymphoma, duodenal-type follicular lymphoma, and small lymphocytic lymphoma) (p < 0.05). Conclusions: This study showed that most subtypes of gastrointestinal non-Hodgkin lymphomas exhibited same endoscopic features (superficial type and ulcer type). Aggressive gastrointestinal non-Hodgkin lymphomas (diffuse large B-cell lymphoma, mantle cell lymphoma, and T-cell lymphoma) were highly suspected when fungating lesions and protruding with ulcer lesions were encountered under endoscopy. Endoscopists should be aware of the connection between enhanced endoscopic characteristics and histological varieties of gastrointestinal lymphoma to improve diagnosis.

The effect of skin-to-skin contact on early initiation of breastfeeding among women in Vietnam.

AIM: To describe prevalence of early initiation of breastfeeding and associated factors among Vietnamese mothers. METHODS: A self-administered questionnaire was used to survey 1812 mothers whose infants were aged 0 to less than 30 months in multi-center Vietnam. Multivariate logistic regression was performed to identify factors associated independently with early initiation of breastfeeding. RESULTS: Prevalence of early initiation of breastfeeding was 57.2 % and this prevalence was higher in female infants compared with male infants (p = 0.004). Factors associated with increased odds of early initiation of breastfeeding include female infants (aOR: 1.33; 95%CI: 1.06 to 1.68) living in urban areas (aOR: 1.34, 95%CI: 1.05 to 1.71), giving birth in private hospitals (aOR: 1.94, 95%CI: 1.25 to 3.03), vaginal birth (aOR: 1.70, 95%CI: 1.34 to 2.16). Factors associated with decreased odds of early initiation of breastfeeding include higher educational level, mother's weight gain during pregnancy, and infant complication at birth. Compared with mothers who had not experienced skin-to-skin contact with their babies, the prevalence of early initiation of breastfeeding was higher in mothers who experienced <15 min (aOR: 2.03, 95%CI: 1.32 to 3.14), 15-90 min (aOR: 6.33, 95%CI: 4.11 to 9.76), and >90 min (aOR: 10.98, 95%CI: 6.79 to 17.75). CONCLUSION: Focusing on modifiable factors should be a key priority to help improve early initiation of breastfeeding practice.

Prevalence of exclusive breastfeeding for the first six months of an infant's life and associated factors in a low-middle income country.

BACKGROUND: Although breastfeeding is practiced by 98% of mothers in Vietnam, infant breastfeeding behaviors remain far from World Health Organization recommendations and continues to decline. This study aims to explore the prevalence and factors associated with exclusive breastfeeding in the first six months of an infant's life. METHODS: A cross-sectional study utilized a self-administered maternal questionnaire to collect data on 1072 Vietnamese mothers who brought infants aged between 6 and 30 months to a community health centre (CHC) for routine vaccination. Data collection was conducted from March to May 2021 in two cities in Central and North Vietnam. In order to measure exclusive breastfeeding, we asked mothers to recall (yes / no), if the child had received breast milk, formula, colostrum milk powder, water, vitamin / medicine, fruit juice / honey, and complementary foods aged under six months. RESULTS: In the first six months, 14.2% of mothers exclusively breastfed their infants. Multivariable logistic regression analysis demonstrated a significant association between exclusive infant breastfeeding and the highest maternal education level (university or postgraduate) (adjusted odds ratio (aOR) 2.55; 95% confidence interval (CI) 1.10, 5.91); male infants (aOR 1.72; 95% CI 1.11, 2.68); duration of skin-to-skin contact greater than 90 min (aOR 7.69; 95% CI 1.95, 30.38); receiving first breastfeeding during skin-to-skin contact (aOR 2.31; 95% CI 1.30, 4.10); completely feeding infant directly at the breast (aOR 1.65; 95% CI 1.00, 2.71) and exclusive breastfeeding intention during pregnancy (aOR 2.48; 95% CI 1.53, 4.00). When compared with mothers who were prenatally exposed to infant formula advertising classified as "often", the prevalence of exclusive infant breastfeeding was higher in mothers who classified their prenatal exposure to infant formula advertising as "sometimes" (aOR 2.15; 95% CI 1.13, 4.10), and "seldom" (aOR 2.58; 95% CI 1.25, 5.36). CONCLUSION: The prevalence of mothers who practiced exclusive infant breastfeeding during the first six months in Vietnam was low. Infants should receive early maternal-infant skin-to-skin contact greater than 90 min and complete first breastfeeding during skin-to-skin contact. Further, mothers should be protected against infant formula advertisements to maximise the likelihood of exclusive breastfeeding during the child's infancy.