Prelacteal feeding practice and its associated factors among mothers of children age less than 24 months old in Southern Ethiopia

Factors influencing the utilisation of Youth Friendly Health Services in Blantyre, Malawi

Background

Usage of Youth Friendly Health Services (YFHSs) remains unsatisfactory in sub-Saharan Africa despite global agreements on the utilisation of these services among the youths.

Aim

The aim of the study was to identify factors that influence the utilisation of YFHSs in Blantyre, Malawi.

Setting

Four health centres in Blantyre, Malawi.

Methods

A descriptive quantitative research design using multistage sampling was used to randomly sample (N = 293) unmarried youths and collect data using a structured questionnaire. Data were analysed using a computerised statistical package for social sciences (SPSS) version 26. Chi-square (χ²) was used to test the significance of the association between variables, and the p-value (p < 0.05) was considered significant. Regression analysis was used to examine the influence of independent variables on the utilisation of the services.

Results

Less than half of the respondents have ever accessed YFHSs (43%). The Chi-square test showed that the following variables had a significant association with utilisation of the services (p < 0.05): gender, age, knowledge, signage, printed health education materials, provider attitudes and being shy or fear of being seen at the services.

Conclusion

Age, knowledge, signpost, printed health education materials, provider attitudes and being shy or fear of being seen at the YFHSs are factors that influenced the utilisation of the services. Working on these factors would help to increase utilisation.

Contribution

The study findings will help to fill the gap in the provision of YFHSs and thus increase utilisation of the services.

Pre-lacteal feeding practice and its associated factors among mothers with children under the age of two years in Dubti town, Afar region, North East Ethiopia: a community based mixed study design

Background

Pre-lacteal feeding prevents the early initiation of breastfeeding and exclusive breastfeeding. It is understudied in Afar, a pastoral region in northeast Ethiopia. The study assessed the prevalence of pre-lacteal feeding practice and its associated factors among mothers with children under the age of two years in Dubti, North East Ethiopia.

Methods

A community-based mixed-study design was employed. A systematic sampling technique was used to recruit 370 study participants for the quantitative study, while purposive sampling was used to select 17 study participants for the qualitative study. Logistic regression analysis was used to determine the association between independent variables and dependent variable. The results of logistic regression analysis were presented as an odd ratio with a 95% CI. A P-value <0.05 was used as a cutoff point to determine statistical significance. The qualitative data were analyzed using a thematic approach.

Results

Pre-lacteal feeding was practiced by 36% of mothers. Afar ethnicity (AOR = 2.5, 95% CI: 1.2-5.1), an extended family size (≥5) (AOR = 1.73, 95% CI: 1.02-2.9), a birth interval of less than 2 years (AOR = 2.77, 95% CI: 1.59-4.82), the first birth order of an indexed child (AOR = 3.87, 95% CI: 2.14-7.0), male-indexed children (AOR = 2.95, 95% CI: 1.67-5.2), and no antenatal care visits (AOR = 2.67, 95% CI: 1.67), or once or twice antenatal visits were significantly associated with pre-lacteal feeding practice. Breastfeeding counseling (AOR = 0.38, 95% CI: 0.2-0.7) and delivery at a health institution (AOR = 0.3, 95% CI: 0.17-0.55) were protective factors of pre-lacteal feeding practice. The most common pre-lacteal foods were dairy products, water, and certain plant species. Cultural beliefs are the main reason for practicing these pre-lacteal feedings.

Conclusion

A significant number of study participants practiced prelacteal feeding. A public health campaign emphasizing the importance of antenatal care follow-ups should be initiated. Breastfeeding counseling and delivery in a health facility should also be strengthened. Community health education about the disadvantages of pre-lacteal feeding practices should be provided to reduce traditional beliefs.

Association between mass media exposure and infant and young child feeding practices in India: a cross-sectional study

The first two years of life is a critical window for good nutrition. Promoting infant and young child feeding (IYCF) practices in the first two years can help improve child survival and promote healthy growth and development. Assessment of IYCF practices is important, especially in developing countries like India where optimal IYCF practices can potentially prevent 12% of all deaths under 5 years of age, to promote awareness and intervene appropriately. The objective of our study is to generate evidence for the association between different types of mass media and appropriate IYCF practices in India, including optimal breastfeeding and appropriate complementary feeding practices. A positive association between them can point to intervention at scale. We analyzed data from India's National Family Health Survey 5 (NFHS-5), 2019-2021. Multivariable logistic regression was used to examine the association of appropriate IYCF practices with mass media exposure. After controlling for demographics and socioeconomic status, the analyses showed that, overall, women who had exposure to television followed by newspaper and movies, had higher odds of adopting the recommended IYCF practices. The results also showed that the association of media exposure varied for different IYCF practices by geography. For instance, in the rural areas, television exposure was positively associated with all the IYCF practices, but in the urban areas, television exposure was positively associated with only early initiation of breastfeeding [OR 1.25; (95% CI 1.1-1.42)]. The study strengthens our understanding that an appropriate selection of mass media channels for intervention programs can promote IYCF practices at scale. Appropriately selecting the type of mass media to create awareness about different IYCF practices, in specific urban-rural settings, could help customize intervention programs to successfully influence IYCF behaviors.

Comparative Assessment of Exclusive Breastfeeding Rates From 24-Hour Recall and Since Birth Methods in Southwestern Pennsylvania Using Ecological Momentary Assessment

BACKGROUND

Accurate measurement of exclusive breastfeeding is important in maternal and child health research. Exclusive breastfeeding is often measured using the 24-hour recall or the since birth method for the first 6 months. These methods can produce different estimates, introducing problems in interpreting breastfeeding behavior and making accurate comparisons across settings or countries.

RESEARCH AIM

Our aim was to compare the exclusive breastfeeding rates between the 24-hour recall and since birth methods among a diverse cohort of birthing people using the ecological momentary assessments method. In addition, we compared the exclusive breastfeeding rates between the two methods across race and other maternal characteristics.

METHODS

This study is a secondary analysis using data from the Postpartum Mothers Mobile Study (PMOMS), a prospective longitudinal study which recruited participants during pregnancy and followed them for 12 months after delivery. Participants completed surveys in real-time via ecological momentary assessment. Individual exclusive breastfeeding rates from months 1-6 were computed using 24-hour recall and since birth methods for 284 participants. We calculated the percentage point difference between the two methods across child age and maternal characteristics. We used a two-sample test of proportions to determine if the differences observed in the proportions were significant.

RESULTS

Exclusive breastfeeding rates from the 24-hour recall were higher than the since birth rates across all ages and maternal characteristics. The difference between the two methods at 3 months was 25.7 percentage points and at 6 months was a 17.2 percentage points. Irrespective of the method used to measure exclusive breastfeeding, White participants had higher exclusive breastfeeding rates than Black participants.

CONCLUSION

The 24-hour recall and the since birth methods of assessing exclusive breastfeeding provided substantially different estimates. These findings highlight the importance of specificity in measuring and reporting exclusive breastfeeding.

Breastfeeding-Related Practices in Rural Ethiopia: Colostrum Avoidance

The practices of colostrum avoidance and prelacteal feeding, which are common in many developing countries, including Ethiopia, are firmly rooted in ancient traditions. The main objective of this work is to identify the prevalence of colostrum avoidance and study its associated factors among mothers of children aged less than 2 years old in the Oromia region of Ethiopia. A cross-sectional study on the practice of colostrum avoidance/prelacteal feeding was conducted in a rural community with 114 mothers of children under 2 years old. Our results reflected that colostrum avoidance and prelacteal feeding were practiced by 56.1% of mothers. The percentage of women who started breastfeeding in the first hour after birth, as recommended by the WHO, was 2.6%. Of the women who practiced colostrum avoidance, 67.2% gave birth at home, and 65.6% were attended by relatives. The likelihood of avoiding colostrum increases in mothers who have a lower educational level, who did not receive health care at the time of delivery, who think that colostrum is dirty and dangerous and who did not receive information about breastfeeding from healthcare professionals. The knowledge emanating from this work may be useful in designing new breastfeeding education programs and/or interventions in Ethiopia and other developing countries.

Prevalence of cultural malpractice during the perinatal period and its determinants among reproductive age women in southwest Ethiopia: A community-based cross-sectional study

Background

Cultural malpractices are accepted cultural norms and socially shared practices that have a negative impact on health. Cultural malpractices vary in type and number in different communities. This study aimed to determine the prevalence of cultural malpractice during the perinatal period and identify its predictors among reproductive-age women in rural communities of southwestern Ethiopia.

Methods

A community-based cross-sectional study was conducted from May 5 to 31, 2019 in Semen Bench district, southwestern Ethiopia; among reproductive-age women who had experienced at least one prior delivery. A systematic random sampling technique was employed to select 422 women for the interview. After collection, the data were entered into EpiData and exported to STATA-14 for further analysis. Descriptive analyses were performed and presented in texts and tables. Besides, binary and multivariable logistic regressions were computed to identify determinants of cultural malpractice.

Result

A total of 414 women completed the survey, resulting in a response rate of 98%. We found that 26.33% (95% CI: 22.15, 30.85%) had food taboos during pregnancy, 31.88% (95% CI: 27.42, 36.61%) delivered their last child at home, and 33.82% (95% CI: 29.27, 38.6%) practiced pre-lacteal feeding. Lack of formal education (AOR: 11.22, 95% CI: 6.24, 20.15), lack of ANC follow-up (AOR: 10.82, 95% CI: 5.46, 21.42), rural residence (AOR: 6.23, 95% CI: 2.18, 17.78), and avoiding colostrum (AOR: 21.94, 95% CI: 9.73, 49.48) were significantly associated with cultural malpractice during the perinatal period.

Conclusion

The prevalence of cultural malpractice is notably high in the study area. Hence, community-based measures including expansion of education and promotion of maternal health services are important to reduce cultural malpractice during the perinatal period.

Mothers' breastfeeding six weeks postpartum and factors influencing exclusive breastfeeding during the first six months

We aimed to assess the feeding pattern and influencing factors within six weeks postpartum on exclusive breastfeeding duration among Chinese mothers. This study was conducted using 2:1 matched case-control study. Cases and controls were matched for maternal age, parity and mode of birth. A total of 210 women were included. Approximately 67.9% of women stopped exclusive breastfeeding within the first six weeks postpartum. Maternal non-exclusive breastfeeding intention, lower maternal educational level, mother-infant skin to skin contact over one hour, unsatisfied breastfeeding self-evaluation and maternal unhealthy condition within the first six weeks were risk factors for ceasing exclusive breastfeeding early.

Knowledge, preferences, practices, and attitudes about breastfeeding among postnatal mothers in Uttarakhand, India: a cross-sectional study

Background: Breastmilk is the natural and safest first food for the newborn. It has nutritional, immunological, behavioural, and offers mother-infant bonding. Objective: The objective of the study was to explore the knowledge, practice, and attitudes of mothers towards breastfeeding. Material & Methods: A cross-sectional study was conducted among conveniently selected 950 postnatal mothers attending the immunization clinic and paediatric OPD with their children for vaccination and treatment of other minor illnesses from April 2018 to November 2019 in selected hospitals of Rishikesh, Uttarakhand. Mothers were face-to-face interviewed using structured knowledge, preference, practices, and attitude questionnaires about newborn breastfeeding. Tools were validated and tested for reliability. Results: The average knowledge scores (11.72±1.78) indicated that mothers have good knowledge about breastfeeding. Most mothers (81.45%) fed their babies with colostrum, and 82% were exclusively breastfeeding. It was also reported about top feeds like honey, coconut water, grape water, ghuttee, lactogen among about 20% of the participants. The average score of the Iowa Infant Feeding Attitude Scale (IIFAS) (58.11±6.44) lay in the range of neutral attitudes related to breastfeeding practices among the mothers. Conclusion: Breastfeeding practices were adequate among many mothers, but there were practices of throwing colostrum, topfeed baby and early initiation of weaning. Thus, it is necessary to create awareness among the mothers and their families about the correct practices of feeding the newborn baby; eventually, the attitude will change.

Antenatal care follow-up decreases the likelihood of cultural malpractice during childbirth and postpartum among women who gave birth in the last one-year in Gozamen district, Ethiopia: a community-based cross-sectional study

Background

Recent evidence has found widespread reports of women experiencing cultural malpractice during childbirth in Asia and sub-Saharan African countries. Despite an endeavor made to drop maternal and neonatal mortality, Ethiopia remains amongst the highest mortality rate. Thus, strengthening antenatal care (ANC) follow-up is the midst of cultural malpractice reduction during childbirth. This study was aimed to assess the magnitude of cultural malpractice and associated factors during childbirth and postpartum among women who gave birth within one year in Gozamen district, Ethiopia.

Methods

A community-based cross-sectional study was conducted from November 1st to December 30th, 2019. A two-stage sampling technique was used to get a total of 600 women who gave birth within the last one year. Data were collected by using a semi-structured and pretested questionnaire. Then, data were entered into Epi info version 7.0 and exported to SPSS version 25 for analysis. Both bivariate analysis and a multivariable logistic regression model were fitted. The level of significance was declared based on the adjusted odds ratio (AOR) with its 95% confidence interval (CI) and a p-value of ≤0.05.

Result

The Overall magnitude of cultural malpractices during childbirth and postpartum was found to be 31.2% (95%CI: 27.8, 34.7). Out of 600 women, 203(33.9%) were delivered at home, 67(11.2%) practiced abdominal massage, 31(16.6%) avoided colostrum, 24(12.8%) practiced pre-lacteal feeding and 138 (23%) washed their baby before 24 h after delivery. Mothers who have antenatal follow-up (AOR=0.52 95%CI 0.28, 0.94), married marital relation (AOR=0.24, 95%CI:0.07, 0.89), being farmer husband occupation (AOR=6.25 (95%CI: 1.22, 30.30), parity ≥5 (AOR=5, 95%CI: 2.44, 9.52), had significant association with cultural malpractice during childbirth and postpartum.

Conclusions

This study showed there is an improvement in the magnitude of cultural malpractices during childbirth and postpartum, but still it’s high as compared to the country’s maternal health service utilization aim. A well-enforced health education program by well-trained healthcare personnel besides sufficient number of ANC visits are needed to overcome these cultural practices. Further, intervention modalities health education communication outreach programs would be very important to reduce the prevalence of cultural malpractices in the community.

Prelacteal feeding among infants within the first week of birth in eastern Uganda: evidence from a health facility-based cross-sectional study

Background

Prelacteal feeding hinders early initiation of breastfeeding and exclusive breastfeeding but is understudied in Uganda. We examined the prevalence and factors associated with prelacteal feeding among postpartum mothers in Kamuli district in rural eastern Uganda.

Methods

We conducted a cross-sectional study between December 2020 and January 2021 at four large healthcare facilities and randomly sampled mother-baby pairs attending postnatal care and immunization clinics. Prelacteal feeding was defined as giving anything to eat or drink to a newborn other than breast milk within the first 0–3 days of life. Data were collected using a researcher-administered questionnaire and summarized using frequencies and percentages. The Chi-squared, Fisher’s exact, and Student’s t-tests were used for comparison while the factors independently associated with prelacteal feeding were determined using modified Poisson regression analysis, reported as an adjusted prevalence risk ratio (aPRR) with corresponding 95% confidence intervals (CI).

Results

Of 875 participants enrolled, 319 (36.5%) practiced prelacteal feeding. The likelihood of prelacteal feeding was lower among participants who were unemployed (aPRR 0.70; 95% CI 0.5, 0.91), married (aPRR 0.71; 95% CI 0.58, 0.87), had received health education on infant feeding practices (aPRR 0.72; 95% CI 0.60, 0.86), had a spontaneous vaginal delivery (aPRR 0.76; 95% CI 0.61, 0.95), had delivered in a health facility (aPRR 0.73; 95% CI 0.60, 0.89), and who knew that prelacteal feeding could lead to difficulties in breathing (aPRR 0.70; 95% CI 0.57, 0.86). Conversely, prelacteal feeding was more likely among participants who had attended antenatal care at a public health facility during the most recent pregnancy (aPRR 2.41; 95% CI 1.71, 3.39) and those who had travelled more than 5 km to a health facility for postnatal care services (aPRR 1.46; 95% CI 1.23, 1.72).

Conclusions

The prevalence of prelacteal feeding among postpartum mothers in rural eastern Uganda is slightly higher than the national average. Accordingly, there is a need to continuously educate mothers and staff on infant feeding practices to tackle the factors influencing prelacteal feeding and promote appropriate infant and young child feeding practices as emphasized in the baby-friendly health facility initiative policy.

Prelacteal feeding practice and its associated factors among mothers having children less than 2 years of age in East Africa: a multilevel analysis of the recent demographic and health surveys

Background

Prelacteal feeding is a major public health problem that increases the risk of morbidity and mortality in children. It also result delayed breastfeeding initiation and interferes with exclusive breastfeeding. Although numerous studies have been done on prelacteal feeding in individual East African countries, most of them did not consider community-level factors that could affect the likelihood of prelacteal feeding. This study, thus, aimed to assess the pooled prevalence and associated factors of prelacteal feeding practice in East Africa.

Methods

We used pooled data from the 12 east Africa countries Demographic and Health Surveys (DHS). A total weighted sample of 33,423 women was included in the final analysis. We employed multilevel logistic regression analysis to assess factors associated with prelacteal feeding practice. Finally, the Adjusted odds ratio (AOR) with 95% Confidence (CI) interval was reported and variables with p value< 0.05, in the multivariable analysis, were declared to be significant predictors of prelacteal feeding practice.

Result

In this study, the pooled prevalence of prelacteal feeding practice was 11.85% (95%CI: 11.50, 12.20) with great variation between countries, ranging from 3.08% (95%CI: 2.35, 3.81) in Malawi to 39.21% (95%CI: 36.36, 42.06) in Comoros. Both individual and community-level factors were associated with prelacteal feeding practice. Of the individual-level factors, home delivery, multiple birth, cesarean delivery, non-exposure to media, delayed initiation of breastfeeding, and being a small-sized baby were associated with higher odds of prelacteal feeding practice. Among the community-level factors, rural residence and higher community-level of media exposure were associated with lower odds of prelacteal feeding practice.

Conclusion

In this study, the pooled prevalence of prelacteal feeding is high. Both individual and community level variables were associated with prelacteal feeding practice. Therefore, individual and community-level interventions that encourage mothers to deliver in the health facility and promoting timely initiation of breastfeeding are needed to reduce prelacteal feeding practices in east Africa. Moreover, media campaigns regarding this harmful traditional practice could be strengthened.

Determinants of pre-lacteal feeding practices among mothers having children aged less than 36 months in Ethiopia: Evidence from 2016 Ethiopian demographic and health survey

Background:

Pre-lacteal feeding is associated with infant morbidity and mortality especially during the neonatal period. About 96% infant deaths in developing countries are attributable to inappropriate feeding practice during the first 6 months of life. This study assessed determinants of pre-lacteal feeding practices in Ethiopia using the data from nationally representative survey.

Methods:

Data were extracted from the 2016 Ethiopian Demographic and Health Survey to assess determinants of pre-lacteal feeding practices in Ethiopia. The analysis included a weighted sample of 5303 mothers having children aged 0–36 months. A multivariable logistic regression analysis was conducted and the results were presented with adjusted odds ratio at 95% confidence interval, declaring statistical significance at a p-value < 0.05 in all analyses.

Results:

From a total of 5303 mothers having children aged 0–36 months, 423 (8%, 95% confidence interval, 7.06%, 8.99%) had given pre-lacteal foods to their newborn baby. Being from agrarian region (adjusted odds ratio = 0.15, 95% confidence interval, 0.11, 0.20), poorest wealth status (adjusted odds ratio = 1.50, 95% confidence interval, 1.02, 2.22), home delivery (adjusted odds ratio = 1.35, 95% confidence interval, 1.01, 1.79), late initiation of breast feeding (adjusted odds ratio = 4.52, 95% confidence interval, 3.62, 5.64), having no counseling on breast feeding (adjusted odds ratio = 1.33, 95% confidence interval, 1.01, 1.75), and cesarean delivery (adjusted odds ratio = 2.47, 95% confidence interval, 1.45, 4.20) were factors significantly associated with pre-lacteal feeding practice.

Conclusion:

A significant proportion of Ethiopian mothers had given pre-lacteal foods to their newborn babies. Poorest wealth index, region, late initiation of breast feeding, not counseled on breast feeding, home delivery, and cesarean delivery were identified as determinants of pre-lacteal feeding. Thus, emphasis should be given to improve mothers’ Infant and Young Child Feeding practice through counseling and utilization of institutional delivery. Moreover, special attention should be given to mothers from pastoralist regions and poor socio-economic status to reduce pre-lacteal feeding practice.

Delayed breast feeding initiation increases the odds of colostrum avoidance among mothers in Northwest Ethiopia: a community-based cross-sectional study

BACKGROUND

Colostrum is a yellowish and sticky breast milk produced in late pregnancy. Annually, 60% of 10.9 million under-five deaths globally are due to malnutrition. Of these, over two-thirds of the deaths are accounted by sub-optimal feeding practices in the first year of life, including colostrum discarding. However, evidence on the magnitude of colostrum avoidance and its associated factors at the community level is very limited in Ethiopia, particularly in the study area. Thus, this study aimed to assess the magnitude of colostrum avoidance and associated factors among mothers who gave birth in the last six months in Gozamen district, northwest Ethiopia, 2019.

METHODS

A community-based cross-sectional study was conducted among 741 (741) mothers who gave birth in the last six months in Gozamen district from August 1 to September 12, 2019. A stratified cluster sampling technique was used to select the study participants. Data were collected by face-to-face interviewer-administered, pretested, and semi-structured questionnaire. Binary logistic regressions (bi-variable and multivariable) were fitted to identify statistically significant variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to declare statistically significant variables on the basis of p-value < 0.05 in the multivariable binary logistic regression.

RESULTS

This study indicated that the magnitude of colostrum avoidance was 22.1% (95% CI, 19.0, 25.2%). Mothers who did not get counseling on timely initiation of breast feeding (AOR = 3.91[95% CI, 1.98, 7.72]), not participate in pregnant woman forum (AOR = 2.59[95% CI, 1.30, 5.14]), initiate breast-feeding lately (more than 1 h) (AOR 2.27[95% CI, 1.18, 4.34]), and those having unfavorable attitude towards colostrum feeding (AOR = 7.35[95% CI, 3.89, 13.91]) were factors associated with the increased likelihood of colostrum avoidance. However, institutional delivery (AOR; 0.06[95% CI, 0.02, 0.19]) and prelacteal feeding (AOR; 0.10[95% CI, 0.05, 0.21]) were predictors associated with reduced likelihood of colostrum avoidance.

CONCLUSION

Colostrum avoidance is a common practice in the study area. Therefore, in order to reduce this practice, strengthening infant feeding counseling, promoting institutional delivery, timely initiation of breastfeeding, health education, and community advocating are recommended interventions. In addition, creating awareness on the benefits of colostrum feeding is very instrumental to tackle the practice of colostrum avoidance.

Trends and determinants of breastfeeding within one hour in Ethiopia, further analysis of Ethiopian Demographic and Health Survey: multivariate decomposition analysis

Background

Despite the substantial efforts to improve timely/early initiation of breastfeeding, avoidance of colostrum, and delayed initiation of breastfeeding remains a big challenge in developing countries. Therefore, this study aimed to analyze the trends of early breastfeeding rate over time based on the Ethiopian Demographic and Health Survey (EDHS).

Methods

Secondary data analysis was conducted based on the Ethiopian Demographic Health Surveys (EDHSs) conducted in 2005, 2011, and 2016. A total weighted sample of 9, 111, 10,106, and 8564 in 2005, 2011, and 2016 respectively were included for analysis. Trend and Logistic based decomposition analysis technique was used for analyzing the trends of early breastfeeding initiation over time and factors contributing to the change in early breastfeeding initiation rate. STATA 15 was employed for data management and analyses. All analyses presented in this paper were weighted for the sampling probabilities and non-response.

Result

Among children age less than 5 years the rate of early breastfeeding initiation rate overtime was increased from 70.5% in 2005 to 72.7% in 2016. The highest rate of improvement was seen in the second phase of the study (2011–2016) while it shows a decline in the first phase (2005–2011) from 70.5 to 55.1%. The decomposition analysis indicated that about half of the overall change in early breastfeeding initiation rate was due to the difference in women’s composition. Particularly, an increase in health facility delivery and vaginal delivery was a significant predictor of the increasing rate of early breastfeeding initiation over the surveys.

Conclusion

Early initiation of breastfeeding slightly increasing over the last 10 years in Ethiopia. Half of the overall increase in the early initiation of breastfeeding was due to the change in compositional characteristics of women over 10 years in Ethiopia. Change in the composition of women according to health facility delivery and vaginal delivery were the major source of the increase in early breastfeeding initiation over time. Public interventions including promoting health facility delivery of women for further improvements of early breastfeeding initiation should be needed.

Pooled Prevalence and Determinants of Prelacteal Feeding Practice in Eastern Africa Evidence from Demographic and Health Survey Data: A Multilevel Study

Background

Despite the benefits of breast milk and colostrum for the health and survival of children, early prelacteal feeding is commonly practiced worldwide, particularly in low- and middle-income countries. The aim of this study was to evaluate the pooled prevalence and determinants of prelacteal feeding in Eastern Africa.

Methods

This study was carried out within 11 East African countries from 2010 to 2018, a pooled study of prelacteal feeding was performed. For assessing model fitness and contrast, intra-class correlation coefficient, median odds ratio, proportional change in variance, and deviance were used. In order to identify possible covariates associated with prelacteal feeding in the study area, the multilevel multivariable logistic regression model was adapted. Adjusted Odds Ratio was used with 95% confidence interval to declare major prelacteal factors.

Results

The pooled prevalence of prelacteal feeding in Eastern Africa was 12% (95% CI: 11.42–12.53%), with the highest prevalence of prelacteal feeding in the Comoros (39%) and the lowest in Malawi (3%). Multilevel multivariable logistic regression model; wealth index (AOR = 1.22; 95% CI 1.03–1.34), ANC visit (AOR = 1.42; 95% CI: 1.12–1.79), institutional delivery (AOR = 0.58; 95% CI: 0.58–0.64), small birth size (AOR = 1.14; 95% CI: 1.30–1.26), delivery type (AOR = 2.61; 95% CI: 2.30–2.96), and high community ANC visit (AOR = 0.90; 95% CI: 0.84–0.97) were significantly associated with prelacteal feeding in Eastern Africa.

Conclusion

In East Africa, the magnitude of prelacteal feeding was still high. The possible determinants of prelacteal feeding in Eastern Africa were wealth index, birth interval, delivery mode, place of delivery, ANC visit, and community ANC visit. Structural improvements are required for women with caesarean births to achieve optimal breastfeeding practice in Eastern Africa.

Determinants of Early Days of Newborn Feeding Malpractice Among Mothers of Children Less Than One Year of Age in Mizan-Aman Town, Southwestern Ethiopia, 2020

Background

Suboptimal breastfeeding practices have remained a global public health issue, particularly in Ethiopia due to early days of newborn breastfeeding practices. Although several measures have been taken to comply with the WHO guidelines, newborn feeding malpractices are widely seen in Ethiopia.

Objective

To assess the prevalence and determinant of early days of newborn feeding malpractices among recently delivered women in Mizan-Aman Town, southwestern Ethiopia, 2020.

Methods

A community-based cross-sectional study of recently delivered women was conducted between March 5/2020 and April 8/2020. A total of 487 mother-to-child (<12month) pairs were selected using a multi-stage randomized sampling technique and the data were collected through a face-to-face interview using a structured questionnaire. The result was analyzed via SPSS version 26. Multivariate logistic regression analysis was used to assess the determinant of newborn feeding malpractices and a p<0.05 was deemed to be significant.

Results

Prevalence of prelacteal feeding, delayed initiation of breastfeeding and colostrum avoidance was approximately 21.9%, 35.5% and 15.5%, respectively. The most common prelacteal food was Rue/“Tenadam”/49 (10.1%). The key reasons for this were: 49 (10.1%) Cultural activity followed by 45 (9.3%) intestinal/ghost/birth clean-ups. Determinants of prelacteal feeding were found to be: mothers who recognize the risks of prelactate feeding, multipara mothers, had ≥4 children and infants birth order between 4 and 6. Likewise, exposure to infant formula advertising, absence of home-to-home health education, multipara mothers and spontaneous vaginal birth were the determinants of colostrum avoidance.

Conclusion

The study found that one in four and one-third of newborns had experience with prelacteal and delayed breastfeeding, respectively. This makes the newborn feeding practice suboptimal in the city. As a result, behavioral modification programs on the prevention of prelacteal feeding and enhancement of early initiation of colostrum feeding practices are recommended.

Prevalence of prelacteal feeding and associated risk factors in Indonesia: Evidence from the 2017 Indonesia Demographic Health Survey

Background

Prelacteal feeding (PLF) is a recognised challenge to optimal breastfeeding but remains common in Indonesia. Meanwhile, PLF-related epidemiological research is limited, particularly in this setting. This study examines the prevalence and determinants of overall PLF as well as common PLF types (formula, other milk, and honey) in Indonesia.

Methods

Data from 6127 mothers whose last child was ≤23-month-old were drawn from the 2017 Indonesia Demographic and Health Survey. Multivariable modified Poisson regression was used to measure the prevalence ratio (PR) for selected PLF risk factors. PLF was defined as anything to drink other than breast milk within three days after birth, before breastmilk flows. Additional analyses were performed on mothers who gave formula, other milk, and honey.

Results

About 45% babies in Indonesia received PLF with formula being the most frequent (25%), followed by other milk (14%), plain water (5%), and honey (3%). Factors associated with higher prevalence of any PLF were higher wealth quintiles in rural area (PR 1.07; 95% CI 1.03–1.11 per increase in quintile), baby perceived to be small at birth (PR 1.23; 95% CI 1.12–1.35), caesarean deliveries at either public (PR 1.27; 95% CI 1.13–1.44) or private facilities (PR 1.15; 95% CI 1.01–1.31), and not having immediate skin-to-skin contact after birth (PR 1.32; 95% CI 1.23–1.42). PLF was less prevalent among mothers who gave birth to second/subsequent child (PR 0.82; 95% CI 0.76–0.88) and who had an antenatal card (PR 0.89; 95% CI 0.80–0.99). These patterns did not apply uniformly across all PLF types. For example, honey was more common among home births than deliveries at health facilities, but formula and other milk were more common among caesarean deliveries.

Conclusions

Mapping risk factors for PLF, especially by types, could help to design more targeted interventions to reduce PLF and improve breastfeeding practices in Indonesia.