Colostrum avoidance and associated factors among mothers of less than 6-month-old children in Dilla town, Southern Ethiopia.

Background: Colostrum, often referred to as "golden milk," is the initial milk produced after birth, crucial for preventing childhood malnutrition and boosting natural immunity. Neglecting colostrum intake heightens vulnerability to infections and mortality, particularly in developing regions of the world. Colostrum avoidance is prevalent in Ethiopia. This research aims to investigate the frequency and factors that contribute to colostrum avoidance in Dilla town, Southern Ethiopia. Method: A community-based, cross-sectional study was carried out in late 2023. Data were gathered from 350 participants, selected through multistage sampling, using structured questionnaires and face-to-face interviews. Data entry was conducted using Epi Data version 4.2.0 and transferred to Stata version 18 for analysis. Bivariate and multivariable logistic regression analyses were employed to identify the factors associated with colostrum avoidance, with a significance level of p < 0.05. Result: The rate of prevalence of colostrum avoidance was 28.3% [95% confidence interval (CI): 18.4%-38.2%]. Late initiation of breastfeeding [adjusted odds ratios (AOR) 4.15, 95% CI: 2.51-6.84] prelacteal feeding, non-use of postnatal care (PNC) (AOR 1.79, 95% CI: 1.05-3.04), and lack of information about colostrum (AOR 1.88, 95% CI: 1.14-3.08) were the factors significantly associated with colostrum avoidance. Conclusions and recommendations: A high prevalence of colostrum avoidance was observed, with prelacteal feeding, delayed initiation of breastfeeding, lack of PNC, and inadequate maternal knowledge about colostrum identified as contributing factors. Consequently, interventions aimed at reducing colostrum avoidance should prioritize improving access to and promotion of PNC, promoting timely initiation of breastfeeding, and intensifying awareness campaigns highlighting the advantages of colostrum, while emphasizing the risks associated with prelacteal feeding.

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.

The multiple factors of suboptimal early feeding practices among infants aged 0-5 months in Indonesia.

Background: Optimal early infant feeding practices are critical to ensure adequate nutrition for infants' growth and development. This study aimed to examine the determinants of suboptimal early feeding practices (i.e., delayed initiation of breastfeeding, prelacteal feeding, and non-exclusive breastfeeding) among infants aged 0-5 months in Indonesia. Methods: We used data collected in the 2012 and 2017 Indonesia Demographic and Health Surveys. Analyses were conducted using information from 3,198 live-born singleton infants aged 0-5 months. The primary outcomes used were: (1) delayed initiation of breastfeeding in the first hour after birth, (2) prelacteal feeding in the first 3 days, and (3) non-exclusive breastfeeding in the last 24 h preceding the survey. Potential predictors analyzed were categorized into the environmental, household, maternal, pregnancy, delivery, and child characteristics. Logistic regression analyses were performed to identify factors significantly associated with each outcome. Results: Approximately 78,6% of infants aged 0-5 months in Indonesia had at least one of the three suboptimal early infant feeding practices. We found a strong association between the three outcome indicators analyzed. The determinants of delayed initiation of breastfeeding included infants from Sumatera region (adjusted odds ratios (aOR) = 2.02, p < 0.001), infants delivered by Cesarean section (aOR = 2.78, p < 0.001), and in non-health facilities (aOR = 1.53, p = 0.003). The determinants of prelacteal feeding in the first 3 days included infants living in urban areas (aOR = 1.32, p = 0.035), the first birth-ranked infants (aOR = 1.32, p = 0.019), and infants who had delayed initiation of breastfeeding in the first hour of life (aOR = 3.90, p < 0.001). The determinants of non-exclusive breastfeeding in the last 24 h included infants whose mothers worked in non-agricultural fields (aOR = 1.52, p < 0.001), infants delivered by Cesarean section (aOR = 1.33, p = 0.044), and the first birth-ranked infants (aOR = 1.28, p = 0.039). Conclusion: There was a high percentage of infants aged 0-5 months who had suboptimal feeding practices in Indonesia. As we found multiple factors associated with suboptimal early feeding practices among infants, integrated approaches, including health promotion and supportive public policy, are required to ensure infants receive adequate nutrition in the early stages of life.

Breastfeeding status and determinants of current breastfeeding of Syrian refugee children in Turkey.

BACKGROUND: Turkey hosts the highest number of refugees in the World including 65% of Syrian refugees who reside in Turkey. Mothers and children were the most negatively affected among the Syrian refugees who had to migrate from their countries as a result of the civil war in Syria. One of the most important issues in terms of child health is breastfeeding. Breastfeeding in migrants should be promoted worldwide to mitigate infant mortality and diseases. The aim of this study is to examine the association between breastfeeding status in Syrian refugee children under two years and socio-demographic characteristics of Syrian refugee mothers with further analysis of Turkey Demographic and Health Survey-Syrian Migrant-2018 (TDHS-SM-2018) data.  METHODS: The data source is the TDHS-SM-2018. Data for the last-born children with a gestational duration greater than 32 weeks from the mothers' singleton pregnancy, aged less than two years old and living with the mother were included (unweighted n = 744). The dependent variable was the breastfeeding status (breastfeeding in the last 24 h during the study period) in children under two years. Complex sample logistic regression evaluated the associations. RESULTS: The percentage of breastfeeding in children under the age of two years was found to be 62.4%, and the total median breastfeeding duration was 14.6 months. Univariate analysis showed that the earlier mothers immigrated to Turkey, the higher the current breastfeeding rate. Breastfeeding rates were found to be higher among people living in the South and East regions (65.2% and 65.1% respectively). Multivariable binary complex sample logistic regression revealed that breastfeeding status at the study period was associated with long preceding birth interval; delivery in a public hospital; absence of prelacteal feeding; being non-pregnant; and the region and age of the child. No relationship for current breastfeeding was found with maternal activities, maternal life satisfaction, financial satisfaction, and educational status. CONCLUSION: Current breastfeeding in our sample was more likely among mothers with a longer birth interval who avoided prelacteal feeding. The Baby-Friendly approach and family planning services should be integrated into refugee health centers.

Early Initiation of Breastfeeding (EIBF) and Its Associated Factors Among Mothers With Infants Aged 0 to 6 Months in Jashore District, Bangladesh: A Cross-Sectional Study.

OBJECTIVE: Early initiation of breastfeeding (EIBF) is one of the most successful interventions for minimizing newborn morbidity and death. According to the database (Bangladesh Demographic Health Survey 2014), only around half of babies begin breastfeeding during the first hour of life in Bangladesh. The goal of this study was to determine the prevalence of EIBF in the Jashore area while also investigating its associated factors among mothers of infants aged 0 to 6 months in order to better understand the variables that impacted breastfeeding initiation. METHOD: A cross-sectional study was conducted in the maternity wards of the 3 busiest hospitals in the Jashore district of Bangladesh from May to July 2019. Using random sampling, a total of 423 mother-infant pairs were chosen. Pearson chi-square test and bivariable and multivariable logistic regression statistical analysis were used to identify factors linked to EIBF. RESULTS: The prevalence of EIBF was 46.3% (196/423). Mothers who had skin-to-skin contact after delivery (adjusted odds ratio [AOR], 2.25; 95% confidential interval [CI], 1.40-3.59), who did not deliver prelacteal food (AOR, 3.68; 95% CI, 1.65-8.21), and who provided colostrum (AOR, 5.89; 95% CI, 1.62-21.49) were more likely to begin breastfeeding within 1 hour than were their counterparts. CONCLUSIONS: EIBF was found to be strongly linked with skin-to-skin contact after delivery, avoidance of prelacteal feeding, and colostrum feeding practice. As a result, we strongly urge public health officials and health care practitioners to encourage these feeding behaviors in order to increase EIBF.

Prelacteal feeding practice and associated factors among mothers of children less than two years of age in Ethiopia: A multilevel analysis.

Background: Prelacteal feeding is the main obstacle for exclusive breastfeeding and the major causes of neonatal morbidity and mortality. The practice is one of a deep-rooted public health problem of Ethiopia that needs further investigation. Therefore, this study aimed to assess the prevalence and independent predictors of prelacteal feeding practice in Ethiopia. Methods: This study used data from the 2019 Ethiopia Mini Demographic and Health Survey. A two-stage multilevel mixed-effects logistic regression model was conducted to identify individual and community-level predictors of prelacteal feeding practice of mothers. In the multivariable analysis, variables with a p-value less than 5% and an adjusted odds ratio with a 95% confidence interval were reported as statistically significant variables with prelacteal feeding practice. Result: The prevalence of prelacteal feeding practice among mothers of children less than 2 years old in Ethiopia was 16.31% (95% CI: 14.7%, 17.9%). Women who had multiple births [AOR = 4.62; 95%CI: 1.63, 13.08], delivered through cesarean section [AOR = 2.66; 95%CI: 1.63, 4.33], initiated breastfeeding after 1 hour of delivery [AOR = 3.16; 95%CI: 2.25, 4.47] and mothers who were from pastoralist region [AOR = 2.12; 95%CI: 1.22, 3.68] were more likely to practice prelacteal feeding than their counterparts. Conclusion: This study revealed that the prevalence of prelacteal feeding practice remained a great public health concern of the country. Type of birth, mode of delivery, initiation of breastfeeding and geographic region where the mothers reside were factors that were positively associated with prelacteal feeding practice. Therefore, behavior change communication need to be applied using a variety of communication channels to halt this harmful traditional practice. In addition, promotion of institutional delivery and early initiation of breastfeeding practice using the existing strategies need to be strengthened with special emphasis given to marginalized women in order to diminish the practice in Ethiopia.

Disparities in early initiation of breast feeding and prelacteal feeding: A study of low- and middle-income countries.

BACKGROUND: Early initiation of breast feeding (EIBF) reduces the risk of neonatal mortality. However, only 45% of newborns are breast-fed within the first hour after birth and prelacteal feeding (PLF) is widely prevalent in low- and middle-income countries (LMICs). OBJECTIVE: To assess within- and between-country disparities in EIBF and PLF practices by household wealth and place of birth and to investigate the national-level correlation between these feeding indicators in LMICs. METHODS: Data from Demographic Health Surveys and Multiple Indicator Cluster Surveys (2010-2019) in 76 LMICs were used to investigate within-country disparities in EIBF, any PLF, milk-based prelacteal feeding (MPLF), and water-based prelacteal feeding (WPLF) by wealth quintiles and place of childbirth (institutional [private or public sector] or in-home) for children under two years. We examined the between-country Pearson's correlation between EIBF and types of PLF, later adjusted for per capita gross domestic product (GDP). RESULTS: No clear wealth-related differences were found for EIBF and WPLF; however, any PLF and MPLF were significantly higher in children belonging to the richest 20% of households but are also prevalent among lower income groups. Prevalence of any PLF was higher among institutional births in all LMICs, but especially for MPLF in private sector deliveries in East Asia & the Pacific, Eastern Europe & Central Asia, and Latin America & the Caribbean. WPLF was more common in all African regions. EIBF was inversely correlated with any PLF (r = -0.59, 95% CI -0.72, -0.42), MPLF (r = -0.41, 95% CI -0.58, -0.21) and WPLF (r = -0.34, 95% CI -0.53, -0.13). Adjustment for log-GDP did not affect the magnitude and direction of the results. CONCLUSION: Clear prorich disparities exist in the prevalence of PLF, especially MPLF. Children born in private sector facilities are more likely to receive MPLF. EIBF is negatively associated with PLF practices in LMICs. The promotion of better early feeding practices is urgent to achieve the Sustainable Development Goal to reduce neonatal mortality to 12 deaths per 1000 live births.

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.

Trends and Dynamics in the First Four Years of Operation of the First Human Milk Bank in Vietnam.

BACKGROUND: Since 1979, the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) have recommended the use of pasteurized human milk from a human milk bank (HMB) to feed low birthweight (LBW) and preterm newborns as the 'first alternative' when mothers are unable to provide their own milk. However, they have not issued any guidelines for the safe establishment and operation of an HMB. This gap contributes to the demand for gathering experiences from HMB networks, especially those from lower-middle income countries. To fill this knowledge gap, this study examines the characteristics of donors, donation, pasteurization, and recipients during the first four years of operation in the first HMB in Vietnam. METHODS: Data about the donors, donation, pasteurization, and recipients were extracted from the web-based electronic monitoring system of the HMB from 1 February 2017 to 31 January 2021. RESULTS: In the first four years of operation there were 433 donors who donated 7642 L of milk (66% from the community) with an increased trend in the amount of donated milk, donation duration, and average amount of milk donated by a donor. Approximately 98% of the donated milk was pasteurized, and 82% passed both pre- and post-pasteurization tests. Although the pass rate tended to increase with time, a few dips occurred. Of 16,235 newborns who received pasteurized donor milk, two thirds were in the postnatal wards. The main reason for the prescription of pasteurized donor milk was insufficient mothers' own milk in the first few days after birth. There was a decreased trend in the amount and duration of using pasteurized donor milk in both postnatal wards and the neonatal unit. CONCLUSIONS: The HMB has operated efficiently in the previous four years, even during the COVID-19 pandemic, to serve vulnerable newborns. Ongoing evidence-based adjustments helped to improve the operation to recruit suitable donors, to increase the access to and quality of raw donor milk, to improve the pasteurization process, and to meet the need of more newborns.

Factors Associated with the Use of Pasteurized Donor Milk for Healthy Newborns: Experience from the First Human Milk Bank in Vietnam.

BACKGROUND: Pasteurized donor milk (PDM) is typically prescribed to preterm or low birthweight newborns when their mother's own milk is unavailable. In surplus, PDM is prescribed to meet the nutritional needs of healthy newborns in the first few days of life. However, its overuse can undermine efforts to promote and support breastfeeding, waste resources, and reduce the availability of PDM for at-risk newborns. We conducted this study to examine factors associated with the prescription and prolonged use (>48 h) of privately purchased PDM to healthy newborns. METHODS: Prospective observational study of 2440 mothers of healthy, term, and normal birthweight newborns born at Da Nang Hospital for Women and Children between April and August 2019. In addition to the descriptive analysis, we performed multiple logistic regressions to examine factors associated with the prescription of PDM (n = 2440) and prolonged PDM use among those who used PDM (n = 566). RESULTS: Twenty-three percent (566/2440) of healthy, term, and birthweight ≥2500 g newborns received PDM and were included in the study. The prevalence of PDM use was higher for cesarean births (OR: 2.05; 95% CI: 1.66, 2.55) and among male newborns (OR: 1.33; 95% CI: 1.09, 1.62), but lower for farmers or workers (vs. other jobs; OR: 0.71; 95% CI: 0.54, 0.93), family income <10 million VND (vs. ≥10 million VND; OR: 0.67; 95% CI: 0.55, 0.82), and duration of skin-to-skin ≥90 min (vs. <90 min; OR: 0.54; 95% CI: 0.39, 0.76). Prolonged PDM use (12.4% of 566 newborns who used PDM) was associated with the mother having a higher socioeconomic status job (professional, small trader or homemaker; OR: 4.00; 95% CI: 1.39, 12.5), being a first-time mother (OR: 3.39; 95% CI: 1.92, 6.01) or having a cesarean birth (OR: 2.09; 95% CI: 1.02, 4.28). CONCLUSIONS: The prescription and prolonged use of privately purchased PDM was associated with non-medical factors unrelated to the ability to breastfeed effectively. The findings suggest the need for improved breastfeeding communication, counseling and support skills for health staff, development, and application of strict criteria on PDM use for healthy newborns and better routine monitoring of PDM use over time.

Determinants of Prelacteal Feeding Practices in Ethiopia: Unmatched Case-Control Study Based on the 2016 Ethiopian Demographic and Health Survey Data.

INTRODUCTION: Prelacteal feeding is feeding a newborn ritual foods - solids or fluids - before the baby commence breastfeeding in the first three days of its life. It affects exclusive breastfeeding, exposes infants to infections, and contributes to infant mortality. This study aimed to identify determinants of prelacteal feeding in Ethiopia. METHODS: This study used data from the 2016 Ethiopian Demographic and Health Survey. A total of 649 cases and 2596 controls were included in the analysis. Cases were from women who has given prelacteal foods; and controls were from women whom, otherwise, never gave prelacteal foods. Socio-demographics and obstetric characteristics were examined to assess for associations with prelacteal feeding. Bivariate and multivariate logistic regression analyses were employed to check for significant associations. Data were analyzed using Stata version 14. A p-value <0.05 in multivariate logistic regression analysis was used to declare statistical significance. RESULTS: Primi parous mothers had 1.24 times (AOR = 1.24, 95% CI: 1.00-1.51) higher odds of prelacteal feeding; mothers who gave birth at home had 1.49 times (AOR = 1.49, 95% CI: 1.11-2.00) higher odds; and mothers who gave birth by cesarean section had 2.09 times (AOR = 2.09, 95% CI: 1.27- 3.44) higher odds compared to their counterparts. In another note, small sized children at birth had 27% (AOR = 0.73, 95% CI: 0.57-0.93) less likely to receive prelacteal feedings. The administrative region of the mothers was also significantly associated with prelacteal feeding. CONCLUSION: Parity, small size at birth, home delivery, caesarean delivery and administrative region were significantly associated with prelacteal feeding practices. Mothers are encouraged to give birth in the health facilities, and promotion and early exclusive breastfeeding practices in post-operative and postpartum times are greatly encouraged.

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.

Determinants of prelacteal feeding practice in Uganda; a population based cross-sectional study using Uganda demographic and health survey data.

Background: Breastfeeding has well-established short-term and long-term health benefits for both the mother and infant. Initiating breastfeeding immediately after birth stimulates breast milk production. Prelacteal feeding (PLF) may result in late initiation of breastfeeding, and thus insufficient production of breast milk. This study aimed to identify the determinants of PLF among children under five years in Uganda. Methods: This cross-sectional study was conducted using the data from the database of Uganda Demographic and Health Survey 2011. The data of 4,774 children/mothers were evaluated in this study. Results: The prevalence of PLF was 40.3%. The rate of PLF practice was found to be 2.15 times higher in women with moderate economic status and 2.02 times higher in women with high economic status compared to those who have low economic status. The rate of PLF practice was found to be 1.73 times higher in newborns delivered by an unskilled birth attendant and 4.35 times higher in newborns delivered with no birth attendant compared to those infants delivered by a skilled birth attendant. The ratio of PLF practice was found to be 2.49 times higher in multiple births. Mothers who initiated breastfeeding in the first 24 hours after birth had higher odds of PLF. No relationship was found between PLF practice with some sociodemographic characteristics of mother's (age, marital status, educational status, religion, residential location), maternal factors (number of children, antenatal and postnatal care attendance, place of delivery), and characteristics of the newborn infants (sex, type of delivery, birth order number) in the multivariate logistic regression analysis. Conclusions: All mothers should be informed about the importance of initiation of breastfeeding immediately after delivery, the risks associated with PLF, the optimal practices for breastfeeding, and the presence of a skilled birth attendant at delivery.

Prevalence and Determinants of Early Initiation (EI), Exclusive Breastfeeding (EBF), and Prelacteal Feeding among Children Aged 0-24 Months in Slums of Pune City, in Maharashtra.

Infant and young child feeding practices remain a public health challenge in India. We determined the socio-demographic risk factors for early initiation, exclusive breastfeeding and prelacteal feeding in the urban slums of Pune city.A cross sectional survey of mother (N=1443) children (< 2 years) dyads was performed. Socio-demographic, maternal and child characteristics were recorded. Breastfeeding practices were assessed using WHO indicators. Multiple logistic regression was employed to model associations between socio-demographic factors and breastfeeding indicators.Early initiation was reported by 45.2%, prelacteal feeding by 37.5% and exclusive breastfeeding by 23.7%. Caesarean delivery decreased the odds of early initiation (AOR: 0.403; 95% CI; 0.303.-0.536) and exclusive breastfeeding (OR: 0.675; 95% CI: 0. 478-0.953), while it increased the odds of prelacteal feeding (AOR: 3.525; 95% CI: 2.653-4.683). Delivery in a public health care facility increased the odds of early initiation (AOR: 1.439; 95% CI: 1.095-1.891) and exclusive breastfeeding (OR: 0.514; 95% CI: 0.366-0.720), while it decreased the odds of prelacteal feeding (AOR: 0.421; 95% CI: 0.318-0.559). Odds of early initiation decreased significantly in very low-birth-weight (AOR: 0.209; CI: 0.76-0.567) whereas, it increased odds of prelacteal feeding (AOR: 1.389; 95% CI: 0.640-3.019), (AOR: 0.483; 95% CI: 0.262-0.889). Religion other than Hindu or Muslim, age of the mother between 26-30 years increased the odds of exclusive breastfeeding and parity <2 increased the odds of prelacteal feeding.Interventions that address setting specific determinants, focusing on local contexts are essential to improve child feeding practices in urban slums.

Early feeding practices and associated factors in Sudan: a cross-sectional analysis from multiple Indicator cluster survey.

BACKGROUND: In efforts to reduce neonatal mortality, the World Health Organization (WHO) has included breastfeeding among its recommended packages of interventions. Early initiation of breastfeeding and avoidance of prelacteal feeding are key contributors to optimal feeding practices. This study aims to assess the prevalence and associated factors of early breastfeeding practices in Sudan. METHODS: This study utilises the cross-sectional nationally-representative Sudan Multiple Indicator Cluster Survey (MICS) conducted in 2014. The sample includes women who had a live birth in the two years before the survey and their self-report on early breastfeeding practices, namely early initiation and prelacteal feeding. Percentages of these early breastfeeding practices indicators were estimated accounting for the complex survey design. Multivariable logistic regression analyses were used to examine the factors associated with these outcomes. RESULTS: Of 5622 mothers, 69% initiated breastfeeding within one hour of birth, 72% avoided prelacteal feeding in the first three days after birth, and 51% met the criteria for both (i.e. practised optimal early feeding practice). Optimal early feeding varied across regions of Sudan. Birth by caesarean section (Adjusted Odds Ratio [AOR] 0.34; 95% CI 0.25, 0.47) and at a health facility (AOR 0.75; 95% CI 0.60, 0.94) were negatively associated with optimal early feeding practice. Mothers with secondary education (AOR 1.62; 95% CI 1.30, 2.02), those who desired their pregnancy at the time (AOR 1.31; 95% CI 1.08, 1.60), those who were assisted by a skilled birth attendant at birth (AOR 1.48; 95% CI 1.19, 1.83), and those who gave birth to female infants (AOR 1.16; 95% CI 1.02, 1.33) had higher odds of use optimal early feeding practice. Similarly, the odds of optimal early feeding increased with parity and maternal age. CONCLUSIONS: Only half of Sudanese mothers practised optimal early feeding practice, with important differences between regions in the country. Early feeding practices in Sudan are associated with various maternal, child and community level factors. The findings suggest the need to develop breastfeeding promotion programs with consideration of regional variations and healthcare system interventions.

Determinants of Breastfeeding Duration in Shiraz, Southwest Iran.

A prospective cohort study was conducted in Shiraz in the south west of Iran to investigate breastfeeding from birth to six months of age. Mothers were recruited in a face-to-face interview within 48 h of giving birth in three public and two private hospitals (n = 700). They were then followed-up at 4, 12, 16, and 26 weeks postpartum in local Maternal and Child Health Clinics. Upon being discharge from hospital, 98.7% of mothers were breastfeeding and 74.3% were 'fully' breastfeeding, but only 29.9% of mothers had breastfed 'exclusively' since birth. The median duration of 'full' breastfeeding was 13 weeks and less than 1 week for exclusive breastfeeding. In a multivariable Cox proportional hazard regression, after adjustment, shorter durations of 'exclusive', 'full', and 'any' breastfeeding were associated with the introduction of a pacifier. The in-hospital use of formula and prelacteal feeds were also associated with a shorter duration of full and any breastfeeding. Breastfeeding on demand at 3 months and beyond was associated with a longer duration of breastfeeding. The risk factors associated with the premature discontinuation of breastfeeding identified in this study are all related to the "Ten steps to successful breastfeeding" and the Baby Friendly Hospital Initiative (BFHI). The principles that the BFHI provide are reaffirmed in this study as the basis for future breastfeeding promotion programs.

Do Differences in Prelacteal Feeding Explain Differences in Subsequent Breastfeeding Between Haiti and the Dominican Republic?

OBJECTIVE: Although Haiti and the Dominican Republic (DR) share the same island of Hispaniola, exclusive breastfeeding is much higher in Haiti. As prelacteal feeding also differs between the two countries, it was hypothesize that prelacteal feeding would account for the subsequent differences in breastfeeding exclusivity between the two countries, while controlling for other potentially influencing differences. METHODS: Data for infants under 6 months of age were extracted from the cross-sectional Demographic and Health Surveys from Haiti (2012) and the DR (2013). Bivariate analysis and ordered logistic regression models were used. RESULTS: Data were available for 686 Haitian infants [mean age: 2.9 (SD: 1.6) months] and 264 Dominican infants [mean age: 2.6 (SD: 1.6) months]. Haitian infants were more likely to be exclusively breastfed than Dominican infants, 41.3% versus 8.0%, at the time of the survey, and less likely to have been exposed to any prelacteal feeds, 20.1% versus 69.8%, respectively. Furthermore, Dominican infants were more likely to have been exposed to milk-based prelacteal feeds. Dominican status, any prelacteal feeds, and milk-based prelacteal feeds significantly and independently reduced the odds of breastfeeding exclusivity. CONCLUSIONS FOR PRACTICE: Identification of factors beyond prelacteal feeding are necessary to explain the substantially lower breastfeeding exclusivity in the DR compared to Haiti and to determine why so many Dominican infants are exposed to milk-based prelacteal feeds.

Caesarean delivery associated with adverse breastfeeding practices: a prospective cohort study.

Caesarean delivery rates are increasing in many Asian countries. This study investigated the effects of caesarean section on breastfeeding practices from delivery to twelve months postpartum. A prospective cohort study was conducted on 2030 pregnant women recruited from three cities in Vietnam during 2015-2017. The overall caesarean rate was 38.1%. Mothers who underwent caesarean section were more likely to give prelacteal feeds to their infants (adjusted odds ratio (OR) 13.91, 95% confidence interval (CI) 10.52-18.39) and as a result have lower rates of early initiation of breastfeeding (adjusted OR 0.04, 95%CI 0.02-0.05). Having a caesarean section reduced the likelihood of (any, predominant and exclusive) breastfeeding from discharge to 6 months postpartum. After 1 year, the any breastfeeding rate was still lower in the caesarean delivery (70.2%) compared with the vaginal delivery group (72.9%), p = .232. Vietnamese women who give birth by caesarean section need extra support to initiate and maintain breastfeeding.IMPACT STATEMENTWhat is already known on this subject? Early initiation of breastfeeding, and 'exclusive' or 'predominant' breastfeeding rates at discharge are lower in mothers delivering by caesarean section compared to vaginal delivery. Prelacteal feeding rates are higher following caesarean section. However, the association between 'any' breastfeeding duration and caesarean delivery has not been established.What the results of this study add? This study showed that caesarean delivery reduced all breastfeeding rates from discharge to six months and any breastfeeding rate at 12 months postpartum in Vietnamese women.What the implications are of these findings for clinical practice and/or further research? Further breastfeeding interventions are needed during the postpartum period for mothers who deliver by caesarean section.