Factors associated with prelacteal feeding practices in Debre Berhan district, North Shoa, Central Ethiopia: a cross-sectional, community-based study

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.

Determinants of Feeding Patterns with Stunting in Children in the Coastal Area of Bengkulu City

BACKGROUND: The age of 0–2 years is a golden period for human growth and development known as the “golden age,” characterized by rapid growth. This period is the First 1000 Days of Life (HPK). The proper diet greatly affects the nutritional status of children. AIM: The purpose of the study was to determine child feeding patterns with the incidence of stunting in children in the Coastal area of Bengkulu City. METHODS: This study was an analytical observational study with a cross-sectional design. The research sample was children under five aged 6–24 months in the coastal area of Bengkulu City as many as 75 children were selected using the accidental sampling technique. Children’s nutritional intake using the Semi Food Frequency questionnaire for energy, protein, fat, carbohydrates, calcium, iron, zinc, and phosphorus. Nutritional intake data were processed by nutrisurvey. Data analysis with Chi-square test and the level of significant 0.05. RESULTS: The frequency of food consumed by children 6–24 months in the form of mashed food 2 times a day was 54.2%, soft food 3 times a day was 54.5%, and family food 3 times a day was 82.5%. The percentage of children with energy, protein, fat, and carbohydrate intake below the recommendation was much higher in normal children (in sequence 84.6%, 81.8%, 84.9%, and 86.3%) compare to stunted children (in sequence 15.4%, 18.2%, 15.1%, and 13.7%). Likewise, calcium, fe, zinc, and phosphor intake below the recommendation was much higher in normal children (in sequence 82%, 85.5%, 80.6%, and 82.1%) compare to stunted children (in sequence 18%, 14.5%, 19.4%, and 17.9%). CONCLUSIONS: There was no relationship between the type of food, macronutrient and micronutrient intake with stunting. Education and counseling at Integrated Healthcare Center need to be carried out, regarding the importance of consuming the proper food and the proper frequency of eating, surveys of nutritional consumption and routine health checks for pregnant women and children under five.

Nearly one-in-five mothers avoid colostrum in North Wollo Zone, Ethiopia: an institution-based cross-sectional study

Colostrum contains antibodies that protect the newborn against disease. Despite this fact, many Ethiopian mothers see colostrum feeding as a cause of neonatal morbidity and mortality. These mothers believe that colostrum must discard to alleviate this effect. However, the cause of this misconception about colostrum was not well researched, particularly in this study area. The main aim of the present study was to assess colostrum avoidance and associated factors among mothers having children aged 6-59 months in North Wollo Zone, Northeastern Ethiopia. An institution-based cross-sectional study design was used. Descriptive statistics, binary and multivariable logistic regression analyses were used for the statistical analysis. The prevalence of colostrum avoidance was 19 % (95 % CI 15⋅03, 22⋅89 %) among mother-child pair aged 6-59 months. In multivariable logistic regression analysis, the most important predictors were breast-feeding initiation Adjusted Odds Ratio (AOR) 6⋅369; 95 %, Confidence Interval (CI) (3⋅067, 13⋅224), pre-lacteal feeding AOR 3⋅464; 95 % CI (1⋅721, 6⋅973), shared household decision about child feeding AOR 3⋅585; 95 % CI (1⋅563, 7⋅226), Index child sex AOR 2⋅103; 95 % CI (1⋅015, 4⋅358) and health facility delivery AOR 3⋅033; 95 % CI (1⋅293, 7⋅117). The colostrum avoidance in the present study was 19 %. The study recommends the promotion of institutional delivery, timely initiation of breast-feeding, the shared household decisions about child feeding, avoiding sex preferences and stopping pre-lacteal feeding were critically important.

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.

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.

Pre-lacteal feeding practices and associated factors among mothers of children aged less than 12 months in Jinka Town, South Ethiopia, 2018/19

Background

Pre-lacteal feeding is one of the major harmful practices being faced while feeding the newborns. Although it affects child health, little is known about the extent of the problem and its contributing factors in the study area. Therefore, this study aimed to figure the prevalence of pre-lacteal feeding practices and associated factors among mothers of children aged less than 12 months in Jinka Town.

Methods

A community-based cross-sectional study was conducted at Jinka Town from March 1 to 30, 2019. A total of 430 mothers, having children less than 12 months of age, were selected by systematic sampling technique. The data were collected by using pretested and interviewer- administered structured questionnaires. The data were entered using epidata 4.2.1 and exported to SPSS version 23 for analysis. Adjusted odds ratios, 95% confidence intervals and p-values were reported.

Results

The prevalence of pre-lacteal feeding practice was 12.6% [95% CI (9.5–15.7)]. Having no maternal education [AOR = 4.82(95%CI 1.60–14.24)], colostrum avoidance [AOR = 4.09(95% CI 1.62–7.67)], lack of breast feeding counseling [AOR: = 2.51(95% CI 1.20–5.25)], home delivery [AOR = 3.34 (95% CI 1.52–7.33)], lack of knowledge about risks of pre-lacteal feeding [AOR = 2.86 (95% CI 1.30–6.29] and poor knowledge on breast feeding practices [AOR = 3.63(95% CI 1.62–8.11)] were factors associated with pre-lacteal feeding practices.

Conclusion

Pre-lacteal feeding practice among mothers of children aged less than 12 months in Jinka town was found to be higher than the national prevalence. Illiterate, colostrum avoidance, lack of breastfeeding counseling, home delivery, lack of knowledge on the risk of pre-lacteal feeding, and poor knowledge on breastfeeding practice were factors associated with pre-lacteal feeding practices.

Prelacteal feeding practices in Pakistan: a mixed-methods study

BACKGROUND

Prelacteal feeding, the feeding a newborn substances or liquids before breastfeeding, is a common cultural practice in Pakistan, but is associated with neonatal morbidity and mortality because it delays early initiation of breastfeeding. In this study, we sought to examine the social and cultural factors associated with prelacteal feeding in Pakistan.

METHODS

This mixed-method study used data from the Pakistan Demographic and Health Survey (PDHS) 2012-13. Findings from the survey were complemented by qualitative interviews with mothers and healthcare providers. In a subset of PDHS dyads (n = 1361) with children (0-23 months), descriptive statistics and bivariate and multivariable logistic regression analysis examined factors associated with prelacteal feeding. The qualitative study included in-depth interviews with six mothers and six health care providers, which were analyzed using NVivo software version 10.

RESULTS

In PDHS, a majority of children (64.7%) received prelacteal feeding. The most common prelacteal food was milk other than breast milk (24.5%), while over a fifth (21.8%) of mothers reported giving honey and sugar water. Factors associated with prelacteal feeding included: birth at public health facilities (AOR 0.46, 95% CI 0.02, 0.95), maternal primary education (AOR 2.28, 95% CI 1.35, 3.85), and delayed breastfeeding initiation (AOR 0.03, 95% CI 0.01, 0.61). In our qualitative study, the major themes found associated with prelacteal feedings included: easy access to prelacteal substances at health facilities, deliveries in private health facilities, prelacteals as a family tradition for socialization, insufficient breast milk, Sunna of Holy Prophet, and myths about colostrum.

CONCLUSIONS

These data indicate that prelacteal feeding is a well-established practice and social norm in Pakistan. Policies and interventions aimed at promoting breastfeeding need to take these customs into consideration to achieve the desired behavioral changes.