Table 2. Frequency (%) of feeding problems classified by CHWs during breastfeeding assessments and χ² for association between CHW classification and physicians’ ascertainment of a history of a feeding problem^a in 317 neonates, Mirzapur, Bangladesh, 2005–2006.

Feeding problems	Frequency			Association
	%	95% CI		χ² (DF = 1)	P-value
Feeding observation by CHWs
Sign of improper attachment
Chin not touching breast	5.4	3.2–8.4		6.2	0.013
Lower lip not turned outward	10.7	7.5–14.7		6.1	0.013
More areola below than above mouth	9.1	6.2–12.9		7.9	0.005
Mouth not wide open	5.4	3.2–8.4		16.7	0.000
Sign of improper positioning
Head and body not straight	9.1	6.2–12.9		0.8	0.363
Body not close to mother	10.1	7.0–14.0		0.1	0.819
Entire body not fully supported	10.1	7.0–14.0		0.1	0.819
Not facing breast, nose not opposite nipple	1.9	0.7–4.1		5.0	0.026
Classification of feeding problems
Attachment problem
Not attachedb	1.6	0.5–3.6		29.0	0.000
Not well attachedc	11.0	7.8–15.0		0.0	0.894
Not attached or not well attached	12.6	9.2–16.8		4.6	0.032
Positioning problem
Not well positionedd	16.4	12.5–20.9		0.1	0.763
Sucking problem
Not sucking at all	0.9	0.2–2.7		117.0	0.000
Not sucking effectivelye	5.0	2.9–8.1		1.0	0.329
Not sucking at all or not sucking effectivelye	6.0	3.6–9.2		28.2	0.000
Any attachment, positioning or sucking problem	20.2	16.2–25.4		4.4	0.036

CHW, community health worker; CI, confidence interval; DF, degree of freedom (Pearson’s χ² test for associations).
^a Of 317 mothers, 8 (2.5%, 95% CI: 1.1–4.9%) reported that the baby “had a feeding problem” when asked by a physician.
^b Neonate unable to take the nipple into the mouth and keep it there to suck.
^c Neonate with one or more of the four signs of improper attachment listed above.
^d Neonate with one or more of the four signs of improper positioning listed above.
^e Effective sucking was defined as slow, deep sucking with occasional pausing.