Prelacteal feeding of newborns in postconflict Timor-Leste

Spatial distribution and determinants of the change in pre-lacteal feeding practice over time in Ethiopia: A spatial and multivariate decomposition analysis

Background

Pre-lacteal feeding persists in low and middle-income countries as deep-rooted nutritional malpractice. It imposes significant negative consequences on neonatal health, including increased risk of illness and mortality. Different studies revealed that pre-lacteal feeding practice is decreased over time. Even though different studies are done on the prevalence and determinants of pre-lacteal feeding practice, up to our knowledge, the spatial distribution and the determinants of the change in pre-lacteal feeding practice over time are not researched.

Objective

To assess the spatial distribution and determinants of the change in pre-lacteal feeding practice over time in Ethiopia.

Methods

We used the Ethiopian demographic and health surveys (EDHSs) data. For this study, a total weighted sample of 14672 (5789 from EDHS 2005, 4510 from EDHS 2011, and 4373 from EDHS 2016) reproductive-age women who gave birth within two years preceding the respective surveys and whoever breastfeed were used. The logit-based multivariate decomposition analysis was used to identify factors that contributed to the decrease in pre-lacteal feeding practice over the last 10 years (from 2005 to 2016). Using the 2016 EDHS data, we also conducted a spatial analysis by using ArcGIS version 10.3 and SaTScan version 9.6 software to explore the spatial distribution and hotspot clusters of pre-lacteal feeding practice.

Result

Pre-lacteal feeding practice was decreased from 29% [95% Confidence interval (CI): 27.63–29.96%] in 2005 to 8% [95% CI: 7.72–8.83%] in 2016 with annual rate of reduction of 7.2%. The overall decomposition analysis showed that about 20.31% of the overall decrease in pre-lacteal feeding practice over the last 10 years was attributable to the difference in composition of women (endowment) across the surveys, while, the remaining 79.39% of the overall decrease was explained by the difference in the effect of characteristics (coefficient) across the surveys. In the endowment component, the difference in composition of residence, perception of distance from the health facility, maternal educational level, wealth status, occupation, ANC visit, place of delivery, the timing of breastfeeding initiation, and wanted last-child/pregnancy were found to be significant contributing factors for the decrease in pre-lacteal feeding practice. After controlling for the role of compositional changes, the difference in the effect of distance from the health facility, wealth status, occupation, antenatal care (ANC) visit, and wanted last-child/pregnancy across the surveys were significantly contributed to the observed decrease in pre-lacteal feeding practice. Regarding the spatial distribution, pre-lacteal feeding practice was non-random in Ethiopia in which the primary and secondary clusters’ of pre-lacteal feeding identified in Somalia and the Afar region respectively.

Conclusion

Pre-lacteal feeding practice has shown a significant decline over the 10-year period. Program interventions considering women with poor maternal health service utilization such as ANC visits, women with poor socioeconomic status, women with an unintended pregnancy, and women from remote areas especially at border areas such as Somali and Afar could decrease pre-lacteal feeding practice in Ethiopia.

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.

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 and associated factors among newborns in rural Sidama, south Ethiopia: a community based cross-sectional survey

Background

The practice of giving prelacteal feeds deprive a newborn of valuable nutrients and expose the newborn to risks of infection. Despite its negative health outcomes, prelacteal feeding prevails in Ethiopia. Therefore, the current study was undertaken to assess the prevalence of prelacteal feeding practices and its associated factors in a rural community in south Ethiopia.

Methods

We conducted a community based cross-sectional study of 597 mothers of children aged less than six months. Mothers were selected using a multistage cluster sampling technique from Hawela Tula, a rural catchment under Hawassa City Administration. Newborns exposed to any foods, substances or drinks other than human milk before the initiation of breastfeeding or during the first three days of birth were regarded as receiving prelacteal feeds. Descriptive summaries were done to present the main findings; bivariate and multivariate logistic regression analyses were undertaken to identify variables associated with prelacteal feeding practices.

Results

Among the total infants, 25.5% (95% confidence interval [CI] 23.5%, 27.5%) were found to be exposed to prelacteal feeds. Boiled water (36.8%) and fresh butter (32.2%) were the top two prelacteal foods. The prevalence of prelacteal feeding was higher among infants whose mothers are housewives, and among infants born to mothers aged between 21 and 34 years. Almost two-third (64.3%) of mothers who exposed their newborn to prelacteal feeds did so with advice from their parents. Mothers who had poor knowledge on breastfeeding were nine times more likely to practice prelacteal feeding compared to those with good knowledge (adjusted odds ratio [AOR] 8.9, 95% CI 4.2, 18.7). Lack of knowledge on the risks associated with prelacteal feeding (AOR 6.8; 95% CI 2.6, 17.8) and misconceptions about breastfeeding (AOR 8.1; 95% CI 3.9, 16.6) were associated with prelacteal feeding. However, mothers’ place of delivery and attendance at breastfeeding counseling sessions showed no association with the practice of prelacteal feeding.

Conclusions

Prelacteal feeding is commonly practiced in the study area. Raising women’s awareness on the consequences of prelacteal feeding is warranted. Involving parents of women when promoting optimal infant feeding practices should be emphasized.

Risk factors for prelacteal feeding in sub-Saharan Africa: a multilevel analysis of population data from twenty-two countries

OBJECTIVE

To examine the risk factors of prelacteal feeding (PLF) among mothers in sub-Saharan Africa (SSA).

DESIGN

We pooled data from Demographic and Health Surveys in twenty-two SSA countries. The key outcome variable was PLF. A multilevel logistic regression model was used to explore factors associated with PLF.

SETTING

Demographic and Health Surveys in twenty-two SSA countries.

SUBJECTS

Mother-baby pairs (n 95348).

RESULTS

Prevalence of PLF in SSA was 32·2 %. Plain water (22·1 %), milk other than breast milk (5·0 %) and sugar or glucose water (4·1 %) were the predominant prelacteal feeds. In the multivariable analysis, mothers who had caesarean section delivery had 2·25 times the odds of giving prelacteal feeds compared with mothers who had spontaneous vaginal delivery (adjusted OR=2·25; 95 % CI 2·06, 2·46). Other factors that were significantly associated with increased likelihood of PLF were mother's lower educational status, first birth rank, fourth or above birth rank with preceding birth interval less than or equal to 24 months, lower number of antenatal care visits, home delivery, multiple birth, male infant, as well as having an average or small sized baby at birth. Mothers aged 20-34 years were less likely to give prelacteal feeds compared with mothers aged ≤19 years. Belonging to the second, middle or fourth wealth quintile was associated with lower likelihood of PLF compared with the highest quintile.

CONCLUSIONS

To achieve optimal breast-feeding, there is a need to discourage breast-feeding practices such as PLF. Breast-feeding promotion programmes should target the at-risk sub-population groups discovered in our study.

The supplemental use of infant formula in the context of universal breastfeeding practices in Western Nepal

Background

While the initiation of breastfeeding is universal in Nepal, little has been reported on formula feeding practices. This study aimed to report the prevalence of, and factors associated with, the use of infant formula as supplementary feeds in the Western region of Nepal.

Methods

A community-based cohort study was conducted to collect infant feeding information among 735 postpartum mothers using structured questionnaires. Complete formula feeding data were collected from 711 women in the first, fourth and sixth month postpartum. Factors independently associated with formula feeding were investigated using multiple logistic regression.

Results

All mothers were breastfeeding their infants at the time of recruitment. The prevalence of formula feeding was 7.5 % in the first month and 17 % in the sixth month. About a quarter of mothers (23.8 %) reported providing infant formula at least once during the first six months of life. Infant formula was used commonly as top-up food. Stepwise logistic regression showed that infants born to families residing in urban areas (adjusted odds ratio (aOR): 2.14; 95 % confidence interval (CI): 1.37 to 3.33), mothers with higher education (aOR: 2.08; 95 % CI: 1.14 to 3.80), and infants born by caesarean section (aOR: 1.96; 95 % CI: 1.21 to 3.18) were at greater risk of formula feeding.

Conclusion

The current findings indicate that health workers should support mothers to initiate and continue exclusive breastfeeding particularly after caesarean deliveries. Furthermore, urban health programs in Nepal should incorporate breastfeeding programs which discourage the unnecessary use of formula feeding. The marketing of formula milk should be monitored more vigilantly especially in the aftermath of the April 2015 earthquakes or other natural disasters.

Prevalence and factors associated with prelacteal feeding in Western Nepal

BACKGROUND

Newborn infants are often given prelacteal feeds in Nepal despite government policies encouraging exclusive breastfeeding for the first six months of life.

AIM

This study investigated the prevalence, reasons, types and factors associated with prelacteal feeding in the south-western region of Nepal.

METHODS

Information on prelacteal feeding was obtained from 735 recently delivered women who were recruited for a prospective community-based cohort study conducted during 2014 in the Rupandehi district of Nepal. Factors associated with prelacteal feeding were assessed using logistic regression analysis.

FINDINGS

A total of 225 (30.6%) mothers reported giving prelacteal feeds to their infants. The most popular prelacteal food was formula milk (41.7%), followed by cow or buffalo milk (26.6%), and sugar/glucose water (12.4%). Caesarean delivery (17.3%), cultural preference (16.4%) and being tired after childbirth (10.6%) were the most commonly cited reasons. Almost half (48%) of the mothers were advised by their mother/mother-in-law on prelacteal feeding method. Higher parity (adjusted odds ratio (OR) 2.05; 95% confidence interval (CI) 1.18-3.54), low birthweight (OR 1.97; 95% CI 1.23-3.16), caesarean delivery (OR 3.70; 95% CI 2.37-5.80) and wealthy status (OR 2.49; 95% CI 1.52-4.06) were associated with prelacteal feeding.

CONCLUSION

Nearly one-third of the infants in this study were given prelacteal feeds. Future breastfeeding promotion programmes should focus on the mothers with low birthweight infants, of high parity, from a wealthy family and those who had caesarean delivery.

Aleitamento materno e caracterização dos hábitos alimentares na primeira infância: experiência de São Tomé e Príncipe

Objetivos: avaliação da amamentação, da diversificação e frequência alimentar, em crianças de São Tomé e Príncipe (STP). Métodos: trata-se de uma amostra constituída por 1285 crianças. O protocolo incluiu a prevalência do aleitamento materno exclusivo (AME) e Total (AMT), início da diversificação alimentar (DA) e um questionário de frequência alimentar. O tratamento estatístico foi efetuado no SPSS®. Os resultados foram apresentados de acordo com o total da amostra. Resultados: 45,5% são do sexo feminino e a média de idades 26±18 meses. 46,6% fez AME até aos 6 meses (média 5±2). A média de AMT foi 12±7 meses e o início da DA aos 6±3 meses (mediana=6), sendo as farinhas e a canja de peixe os primeiros alimentos oferecidos. 42% das crianças são incluídas na dieta familiar aos 7±3 meses (mediana=6). Elevada porcentagem de crianças nunca ingere: leite de vaca (74%) ou iogurte (40%), contrariamente ao elevado consumo de óleo alimentar (34%) e açúcar (33%). A idade média de iniciação da cerveja é aos 18±12 meses e vinho de palma 13±10 meses. Conclusões: observa-se uma elevada prevalência de AME e uma precoce introdução da DA. Embora existam recursos alimentares disponíveis, não há informação/ formação adequada para elaborar um plano alimentar saudável durante a infância.