USE OF PRELACTEAL FEEDS- STUDY IN TRADITION

Objective: To find the types and frequency of prelacteal use, factors influencing their use and its impact on breastfeeding. Study Design: Cross-sectional study. Place and Duration of Study: Fatima Memorial Hospital, Lahore, Pakistan from Jul to Dec 2019. Methodology: In the study, mothers and female attendants of newborn babies were interviewed following a specific questionnaire. The given answers were recorded and captured data about socio-demographics, knowledge, attitude and actual practices of mothers and families related to use of prelacteals. The results were analysed using SPSS 22. Results: We interviewed 1601 mothers and female attendants of neonates. The mean age was 32.3 ± 8.2 years. Most of the females were married (1211, 75.6%) and resided in Lahore (1281, 80%). About one third, 581 (36.3%) were either illiterate or had inadequate schooling. Two-thirds (1000, 62.5%) of women wanted to give some prelacteal feed soon after birth. Honey was the most the commonest choice (in 722, 45.1%), seconded by ghutti (107, 6.7%). Most females (1467, 91.6%) wanted to give colostrum, and 1552 (96.9%) would breastfeed the baby. 1221 (75.2%) wanted to start mother-feed immediately or within 2 hours of birth. Conclusion: The use of prelacteal is common in Pakistan culture. A consistent effort is needed to counter the unsafe prelacteal use.

Barrier of early initiation of breastfeeding among postnatal mothers

Introduction: Early initiation of breastfeeding within one hour of birth decreases infant morbidity and mortality, and it helps promote exclusive breastfeeding. Despite the benefits of early initiation of breastfeeding, the practice is far from adequate. We aim to identify the barriers to the early initiation of breastfeeding among postnatal mothers. Method: A cross-sectional analytical study was carried out among the postnatal ward of Manipal Teaching Hospital from 1 June to 30 August 2017. Consecutive sampling was used. Ethical permission was obtained. Data was collected through face-to-face interviews using a semi-structured questionnaire, including demographics of mother and infant, and time of initiation of feeding. SPSS was used for descriptive analysis of demographics, and the association of factors for the initiation of early breastfeeding was analyzed to draw the inference. Result: Out of 244 postnatal mothers, the early initiation of breastfeeding was done by 19.7%, and 82.4% provided prelacteal feeds of infant formula. Delayed breastfeeding was associated with caesarean section (OR: 21.99; 95% CI 5.55-87.03), prelacteal feeding (OR: 7.49; 95% CI 2.72-20.66), and lack of antenatal checkup visit (OR: 7.38; 95% CI 2.3-23.73). Conclusion: Early initiation of breastfeeding was low (19.7%) in postnatal mothers, with barriers to breastfeeding identified as caesarean delivery, prelacteal feeding, lack of antenatal checkup visits.

Prevalence and associated factors of prelacteal feeding among neonates admitted to neonatal intensive care units, North central Ethiopia, 2019

Background Prelacteal feeding compromises the benefits of exclusive breastfeeding, thereby increasing neonatal malnutrition, infection and mortality. About 26% of the Ethiopian neonates are given prelacteal feeds and nearly 48% of whom are attributed to Amhara region. Besides, prior Ethiopian studies have shown significance of the problem at different community settings in the country. However, the prevalence and associated factors of prelacteal feeding among neonatal admissions has been overlooked in the country in general and in the study area in particular. Therefore, this study was aimed to assess the prevalence and associated factors of prelacteal feeding among neonatal admissions in the study setting. Methods A cross-sectional study was conducted among 321 mother-neonate pairs admitted to Neonatal Intensive Care Unit (NICU) of Debre Tabor General Hospital between September 2018 and February 2019. Every fourth mother neonate pair was included to the study. Multivariable logistic regressions were fitted to find out adjusted odds ratios (AORs) of factors associated with pre-lacteal feeding. Results The prevalence of prelacteal feeding was 20.2% [95% CI: 15.31–26.75%]. Plain water was the most common prelacteal food (32.3%). Factors associated with prelacteal feeding include rural residence (AOR = 4.07, 95% CI: 1.30, 12.81), primiparity (AOR = 4.50, 95% CI: 1.30–12.81), less than four ANC visits (AOR = 4.71, 95% CI: 1.23–17.84), spousal accompany to ANC (AOR = 0.20, 95% CI: 0.05–0.75), home delivery (AOR = 5.94, 95% CI: 1.80–19.67), having twin newborns (AOR = 6.69, 95% CI: 1.25, 35.91) and maternal belief on the purported advantages of prelacteal feeding (AOR = 2.74, 95% CI: 2.09–25.39). Conclusion and recommendation One out of five sick neonates was given prelacteal feeds. Twin neonates, home delivered neonates, rural neonates, neonates born to primiparous mothers, neonates delivered from mothers who had less than four ANC visits, neonates born to mothers who weren’t accompanied by their spouse during ANC and those born to mothers who believe on the purported advantages of prelacteal feeding had higher odds of receiving prelacteal feeds. Therefore, mothers of these vulnerable neonates should be provided with more emphasis about counseling of infant and young child feeding practice during their stay at NICU.

Study of knowledge and attitude towards breastfeeding in antenatal mothers at Chamarajanagara Institute of Medical Sciences, Chamarajanagar, India

Background: exclusive breast feeding practice is major pillar in preventing infant mortality. This study was undertaken to know the knowledge and attitude of antenatal mothers towards breast feeding.Methods: this is a cross sectional study in our hospital in which 264 antenatal mothers were included after verbal consent. Antenatal mothers were explained about the study, their knowledge and attitude regarding breast feeding is assessed by questionnaire. Study will be analysed by appropriate statistical analysis.Results: In total of 264 antenatal mothers, most of them were between 20-25 years, majority in third trimester. Among them 68.2% knows breast feeding should be initiated within first hour of delivery, 90.2% is for no prelacteal feeds and 95.8% wants to feed colostrum. Only 42.4% wants to continue breastfeeding for two years. About 62.9% of antenatal mothers wants to supplement the child with food after six months.81.8% knows breast feeding is not only helpful to the baby but also it prevents breast cancer in mother later in life. 21.2% wants to feed complimentary feeds as early as 3 months.Conclusions: our study on knowledge of breast feeding among antenatal mothers shown most of them are against prelacteal feeds and wants to feed colostrums, but initiation of breast feeding within first hour of birth and weaning after six months and continuation of breast milk up to two years is lagging. Multiple educational sessions, visual aids, pamphlets, electronic media, counseling during antenatal period and in early post natal period is necessary to inculcate appropriate knowledge on breast feeding.

Prelacteal Feeding Practices of Mothers Attending Infant Welfare Clinic in a Tertiary Hospital in Port Harcourt, Nigeria

Background: Breastfeeding pattern established in the immediate neonatal period is a determinant of long term breastfeeding behaviour. Objectives: To determine prelacteal feeding practices of mothers attending the Infant Welfare Clinic of a tertiary hospital in Port Harcourt, Nigeria. Subjects and Methods: This was a cross sectional hospital based study carried out over a 3 month period. A structured, self-administered questionnaire was distributed to mothers whose babies were 0 to 6 months old, who visited the infant welfare clinics of the hospital for any of the child health services such as immunization, nutrition counselling, weighing and vitamin A supplementation. Questions asked included socio-demographics, the first feeds given immediately after birth, how long it took to commence breastfeeding and reasons for giving any feeds other than breast milk. Results: A total of 207 mothers participated in this study, mean age 30.73±4.129SD. 146 (70.5%) mothers gave breast milk as the first feeds to their babies while 61(29.5%) gave prelacteal feeds. Fifty eight (28%) of the babies were put to breast within 2-12 hours after delivery. There was a significant positive relationship between time to first breast feed and administration of prelacteal feeds (p = 0.000). Reasons for giving substances other than breast milk included poor or no lactation and caesarian section delivery. The commonest reason for not giving breast milk as the first feed was because breast milk did not flow. Factors which positively influenced giving breastmilk as the first feed included maternal level of education (p=0.018), delivery in government health facilities (p=0.00) and having vaginal delivery (p=0.008). Conclusion: Prelacteal feeding practice is common among mothers in Port Harcourt. Time to first breast feed, mode of delivery and place of delivery were some of the factors that influenced use of prelacteal feeds.

Knowledge and awareness of breastfeeding, weaning practices and newborn care in pregnant women in urban areas

Background: Breastfeeding, proper weaning practices, and newborn care play a crucial role in the health of a child. The objective of the study is to determine the availability of information regarding breastfeeding, newborn care and immunization and to find out about the attitude of women towards newborn care practices.Methods: A cross-sectional observational study was conducted in a tertiary health care centre in an urban area in Navi Mumbai, on primigravidae in their third trimester of pregnancy. The data was collected by a questionnaire, results were analysed by EpiInfo7.Results: 93% women knew the benefits of breastfeeding, 92% knew of exclusive breastfeeding. 90% would initiate breastfeeding immediately after delivery, 83% would not give prelacteal feeds. 75% would practise skin-to-skin contact and 95% would practise rooming-in technique. 44% would delay bathing the newborn. 95% women received TT immunisation. All agreed to vaccinate their child. 19% believed traditional practices like applying kajal to eyes, prelacteal feeds etc. to be hazardous.Conclusions: The knowledge pregnant women have about breastfeeding and newborn care is inadequate. There is a need for intervention measures such as behavior-change-communication and better health services, to equip mothers so they may provide optimal care to their babies.

Knowledge and factors affecting initiation of breast feeding in post-natal mothers in a tertiary care center

Background: The study was planned to evaluate awareness of breast feeding among mother, institutional quality indicators of early breast feeding. The objective was to know factors causing delay in breast feeding initiation, to assess knowledge, cultural practices, and quality indicators of hospital regarding breast feeding initiative.Methods: The observational study was conducted over a period of 3months from July 2017-Sept 2017 in a tertiary care centre of India. 118 postnatal mothers were interviewed for time of first breast feeding (dependent variable or outcome), and independent variables age, education , religion, parity, occupation of mother, antenatal visits, prelacteal feeds, customs of not breast feeding, duration of labour, mode of delivery, sedation, pain after delivery, baby over mother abdomen after birth, institutional quality indicators-knowledge of breast feeding given by doctor /nurses, relatives, self reading, mothers with correct attachment and position of baby during breast feeding and separation of mother and baby post delivery.Results: Mean time of initiation of breast feeding was 1340.262min after birth. Prelacteal feeds, lack of education, cesarean deliveries, parity of mother, sedation, anesthesia during cesarean and lack of counselling by staff nurses were found to have early increased time of initiation of breast feeding.Conclusions: Great lacuna in knowledge, attitude and practice of early breast feeding of mother.

Overview of Optimal Breast-feeding Practices and a Study of Breast-feeding Practices among Suburban Mothers in South India

Background: The status of breast milk practices is dismal in India in spite of specialized nutrient to newborns by way of breast milk. Culture influences breastfeeding decisions of mothers which have an influence on overall growth, development, health and nourishment of infants and children. Objectives: Assessing the maternal information, approach, and practices towards breastfeeding among mothers. Breastfeeding correlation with a number of antenatal visits, hospital education, maternal education, parity, mode of delivery, holding the baby after delivery, socioeconomic status, employment, religion and sex of the child, and prelacteal feeds. Methods: In a study, 400 mothers with children up to 2 years attending hospitals over a one year period. Data was collected using a self-administered standardized questionnaire. Statistical Analysis: The data was analysed regarding mean, frequencies, percentages, Chi-Square test and Spearman’s correlation test. Results: Breast feeding was deferred in mothers who delivered by Caesarean section due to mothers being kept for observation. Forty-three point eight % of mothers initiated first breast feeds within an hour. Eighty-eight point six % had initiated breastfeeds within one to four hours, however, it was. Prelacteal feeds were given by twenty-seven % mothers. Most mothers fed colostrum to the infants. Mean duration of exclusive breastfeeding was four and a half months. There was no association between duration of exclusive breastfeeding with parity, hospital education, holding of baby socioeconomic status and sex of the child. 34% of mothers administered in addition to breast feeding bottle-feeding. The mean age of starting complementary foods was 6 and half months. Conclusion: Due to cultural factors and other social promotional activities, the majority of the mothers had adequate knowledge and a positive attitude towards infant breastfeeding practice. Delay in the initiation of breastfeeding will impact education programs and neonatal feeding practices.

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

ObjectiveTo examine the risk factors of prelacteal feeding (PLF) among mothers in sub-Saharan Africa (SSA).DesignWe 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.SettingDemographic and Health Surveys in twenty-two SSA countries.SubjectsMother–baby pairs (n 95348).ResultsPrevalence 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.ConclusionsTo 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.