Prelacteal Feeding Research Articles

Prelacteal feeding practice and maintenance of exclusive breast feeding in Bihar, India - identifying key demographic sections for childhood nutrition interventions: a cross-sectional study.

Background: Exclusive breastfeeding (EBF) during the first six months of life is considered a high impact, but low-cost, measure for improving nutritional status, and reducing morbidity and mortality among children. However, providing prelacteal feed to a newborn, a widely practiced custom in rural India, is a major barrier to the practice of EBF. The present study evaluated the association between provision of prelacteal feeding and continuation of EBF among children up to 3 months age in Bihar, a resource-poor Indian state. Methods: Data from four rounds of a population-based multi-stage sampling survey, conducted in 8 districts of Bihar between 2012 and 2013, was used for the present analysis. Using simple and adjusted logistic regression modelling, we tested the association of providing prelacteal feeding with two outcome measures - 1) giving only breastmilk during the last 24 hours, and 2) exclusively breastfed (EBF) since birth (excluding the first 3 days of life). Results: Among 10,262 children for whom prelacteal feeding data was available, 26% received prelacteal feeding. About 55% mothers reported that their children were exclusively breastfed, whereas 82% mothers provided only breastmilk to their children during the previous 24 hours. Children who received prelacteal feeding had approximately 60% lesser odds of being breastfed exclusively during the previous 24 hours [AOR = 0.39(0.33-0.47)] and 80% lesser odds of receiving continued EBF since birth [AOR = 0.20(0.17-0.24)]. Conclusions: Frontline workers (FLW) provide nutritional counselling to mothers and children of rural India. In order to improve uptake of EBF, the families practicing prelacteal feeding should be identified early and subjected to intensive counselling by FLWs.

Prelacteal feeding practice and its associated factors among mothers of children age less than 24\u2009months old in Southern Ethiopia

BackgroundAlthough Pre-lacteal feeding is a barrier for implementation of optimal breastfeeding practices and increases the risk of neonatal illness and mortality, still it is continued as a deep-rooted nutritional malpractice in developing countries. In Ethiopia pre-lacteal feeding continued as one of the nutritional malpractices in newborns. Therefore the aim of this study was to assess pre-lacteal feeding practice and its determinants among mothers of children less than 24 months of age in Sodo zuria district, Wolaita zone, Southern Ethiopia.MethodsCommunity-based cross-sectional study was conducted from February 15, 2017 to March 12, 2017 in Sodo zuria district, Wolaita zone, Southern Ethiopia. Five hundred five (505) mothers of children aged less than 24 months were selected by multistage randomized sampling technique and the data were collected by using interview based structured questionnaire. Descriptive statistics, binary and multivariable logistic regression analysis were employed to identify the factors associated with pre-lacteal feeding practices. Variables with a p-value < 0.05 were identified as statistically significant factors.ResultsThe prevalence of pre-lacteal feeding practice was 20.6%. The common type of pre-lacteal feeding given was plain water; 38(7.7%) and the major reason was insufficient breast milk 32(6.5%). Mothers living with extended family type (AOR = 10.64, 95% CI: 1.05, 10.71), Lack of breastfeeding counseling (AOR = 5.16, 95% CI: 1.76, 15.13) and mothers who avoid colostrum (AOR = 9.72, 95% CI: 3.46, 27.30) were statistically significant positive predictors of pre-lacteal feeding practice.Conclusion & RecommendationPre-lacteal feeding is commonly practiced in Soddo zuria district. Mothers who live with extended family type, mothers who did not get breastfeeding counseling and mothers who avoid colostrum were statistically significant positive predictors of pre-lacteal feeding practice. Therefore, strengthening breastfeeding counseling about the risks associated with pre-lacteal feeding and colostrum feeding intervention should be integrated. Promotion of intensive nutrition education program, on the benefit of colostrum by giving special emphasis to extended family mothers should be implemented in the community.

Prelacteal feeding practice and maintenance of exclusive breast feeding in Bihar, India – identifying key demographic sections for childhood nutrition interventions: a cross-sectional study

Background: Exclusive breastfeeding (EBF) during the first six months of life is considered a high impact, but low-cost, measure for improving nutritional status, and reducing morbidity and mortality among children. However, providing prelacteal feed to a newborn, a widely practiced custom in rural India, is a major barrier to the practice of EBF. The present study evaluated the association between provision of prelacteal feeding and continuation of EBF among children up to 3 months age in Bihar, a resource-poor Indian state. Methods: Data from four rounds of a population-based multi-stage sampling survey, conducted in 8 districts of Bihar between 2012 and 2013, were used for the present analysis. Using simple and adjusted logistic regression modelling, we tested the association of providing prelacteal feeding with two outcome measures - 1) giving only breastmilk during the last 24 hours, and 2) exclusively breastfed (EBF) since birth (excluding the first 3 days of life). Results: Among 10,262 children for whom prelacteal feeding data was available, 26% received prelacteal feeding. About 55% mothers reported that their children were exclusively breastfed, whereas 82% mothers provided only breastmilk to their children during the previous 24 hours. Children who received prelacteal feeding had approximately 60% lesser odds of being breastfed exclusively during the previous 24 hours [AOR = 0.39(0.33-0.47)] and 80% lesser odds of receiving continued EBF since birth [AOR = 0.20(0.17-0.24)]. Conclusions: Frontline workers (FLW) provide nutritional counselling to mothers and children of rural India. In order to improve uptake of EBF, the families practicing prelacteal feeding should be identified early and educated on the harmful effects of prelacteal feeding for EBF and subsequently on infant health. Midwives/nurses at the public and private facilities as well as the home birth attendants should also be made aware about the negative effects of prelacteal feed.

Prelacteal feeding practice and maintenance of exclusive breast feeding in Bihar, India – identifying key demographic sections for childhood nutrition interventions: a cross-sectional study

Background: Exclusive breastfeeding (EBF) during the first six months of life is considered a high impact, but low-cost, measure for improving nutritional status, and reducing morbidity and mortality among children. However, providing prelacteal feed to a newborn, a widely practiced custom in rural India, is a major barrier to the practice of EBF. The present study evaluated the association between provision of prelacteal feeding and continuation of EBF among children up to 3 months age in Bihar, a resource-poor Indian state. Methods: Data from four rounds of a population-based multi-stage sampling survey, conducted in 8 districts of Bihar between 2012 and 2013, was used for the present analysis. Using simple and adjusted logistic regression modelling, we tested the association of providing prelacteal feeding with two outcome measures - 1) giving only breastmilk during the last 24 hours, and 2) exclusively breastfed (EBF) since birth (excluding the first 3 days of life). Results: Among 10,262 children for whom prelacteal feeding data was available, 26% received prelacteal feeding. About 55% mothers reported that their children were exclusively breastfed, whereas 82% mothers provided only breastmilk to their children during the previous 24 hours. Children who received prelacteal feeding had approximately 60% lesser odds of being breastfed exclusively during the previous 24 hours [AOR = 0.39(0.33-0.47)] and 80% lesser odds of receiving continued EBF since birth [AOR = 0.20(0.17-0.24)]. Conclusions: Frontline workers (FLW) provide nutritional counselling to mothers and children of rural India. In order to improve uptake of EBF, the families practicing prelacteal feeding should be identified early and subjected to intensive counselling by FLWs.

Prelacteal feeding in newborn: Does demography, antenatal, and intranatal care affect this custom? A study conducted in coastal part of Saurashtra region

Prelacteal feeding in newborn: Does demography, antenatal, and intranatal care affect this custom? A study conducted in coastal part of Saurashtra region

Baby-Friendly Community Initiative-From national guidelines to implementation: A multisectoral platform for improving infant and young child feeding practices and integrated health services.

The Baby‐Friendly Community Initiative (BFCI) is an extension of the 10th step of the Ten Steps of Successful Breastfeeding and the Baby‐Friendly Hospital Initiative (BFHI) and provides continued breastfeeding support to communities upon facility discharge after birth. BFCI creates a comprehensive support system at the community level through the establishment of mother‐to‐mother and community support groups to improve breastfeeding. The Government of Kenya has prioritized community‐based programming in the country, including the development of the first national BFCI guidelines, which inform national and subnational level implementation. This paper describes the process of BFCI implementation within the Kenyan health system, as well as successes, challenges, and opportunities for integration of BFCI into health and other sectors. In Maternal and Child Survival Program (MCSP) and UNICEF areas, 685 community leaders were oriented to BFCI, 475 health providers trained, 249 support groups established, and 3,065 children 0–12 months of age reached (MCSP only). Though difficult to attribute to our programme, improvements in infant and young child feeding practices were observed from routine health data following the programme, with dramatic declines in prelacteal feeding (19% to 11%) in Kisumu County and (37.6% to 5.1%) in Migori County from 2016 to 2017. Improvements in initiation and exclusive breastfeeding in Migori were also noted—from 85.9% to 89.3% and 75.2% to 92.3%, respectively. Large gains in consumption of iron‐rich complementary foods were also seen (69.6% to 90.0% in Migori, 78% to 90.9% in Kisumu) as well as introduction of complementary foods (42.0–83.3% in Migori). Coverage for BFCI activities varied across counties, from 20% to 60% throughout programme implementation and were largely sustained 3 months postimplementation in Migori, whereas coverage declined in Kisumu. BFCI is a promising platform to integrate into other sectors, such as early child development, agriculture, and water, sanitation, and hygiene.

Assessment of breast feeding practices and its contributing factors in slums of Amritsar city (Punjab), India

Introduction: Feeding practices in a community directly affect the nutritional status of infants. The current study was conducted with the objective of assessing the breast feeding practices and factors contributing to it in slums of Amritsar city.Materials and Method: It was a cross-sectional study conducted in a slum of Amritsar city. Mothers who have delivered within the past one year were taken as study subjects. Sample size of 235 was calculated. Mothers were interviewed by using predesigned, pretested proforma. Breast feeding practices were studied. Sociodemographic factors were studied in relation to breast feeding practices. The data was collected, compiled and analyzed by using SPSS evaluation version 19.0. Results: It was observed that 90.6% infants were put to the breast milk after birth. But inappropriate early neonatal feeding practices were common. Prelacteal feed in the form of honey, sugar water or saline water was given to 86% of infants. Colostrum was discarded by 45.7% of women. Only 17% of women started breast feeding within one hour and 62.5% infants were put on exclusive breast feeding. Place of delivery was found to be a significant factor affecting exclusive breast feeding practice. Conclusion: Though majority of infants were put on breast milk, inappropriate feeding practices are prevalent. As place of delivery affects the breast feeding practice, institutional deliveries should be promoted.

Perspectives on maternal, infant, and young child nutrition and family planning: Considerations for rollout of integrated services in Mara and Kagera, Tanzania.

In Lake Zone, Tanzania, low contraceptive prevalence, closely spaced births, and child stunting are common. Synergies exist between postpartum family planning (PPFP) and maternal, infant, and young child nutrition (MIYCN), yet health services are often provided in silos. This qualitative formative research study aimed to identify barriers and facilitating factors for optimal nutrition and PPFP practices in Mara and Kagera, Tanzania. Results informed the program design of an integrated nutrition and family planning (FP) implementation approach. The study involved in‐depth interviews with mothers of infants under 1 year (n = 24), grandmothers (n = 12), health providers (n = 6), and traditional birth attendants (n = 12), and 14 focus group discussions with community health workers, fathers, and community leaders. Findings reveal that breastfeeding initiation was often delayed, and prelacteal feeding was common. Respondents linked insufficient breast milk to inadequate maternal nutrition—in terms of the quality of the diet and small quantities of food consumed by mothers. Breast milk insufficiency was addressed through early introduction of foods and liquids. Mothers believed that breastfeeding prevents pregnancy, regardless of the frequency or duration of breastfeeding, yet were generally not aware of the lactational amenorrhea method (LAM) of FP. Joint decision‐making on FP was viewed as important, and women often discussed it with their partner. Future programming should address misconceptions about return to fecundity1 knowledge gaps and concerns about FP methods including LAM; and perceptions regarding insufficient breast milk and early introduction of foods which are impediments to optimal MIYCN and FP practices.

Assessment of infant and young child feeding practices in a rural area

Background: Breastfeeding is an ideal and effective ways to provide and nourish children everywhere with the best start to life. Breastfeeding is also a newborn’s first vaccine, providing vital antibodies, and an immunity boost. Objectives: The objectives of the study were to describe the sociodemographic profile and to determine the breastfeeding practices in the lactating mothers. Materials and Methods: A descriptive study was conducted in community health center, Bellur, for 4 months. An Institutional Ethical Committee clearance was obtained. Around 100 lactating mothers were the study subjects. The inclusion and exclusion criteria of the study were met. The data were collected using pre-tested semi-structured pro forma. Results: The study findings revealed that initiation of breastfeeding within 1 h was practiced among 64% of mothers, on-demand breastfeeding among 54%, and complementary feeding at 6 months was started by 76% subjects. The most commonly used pre-lacteal feed is honey. Conclusion: It was observed that the infant and young child feeding practices were not satisfactory in the study subjects, so focused and sustained information, education and communication campaign is necessary to promote breastfeeding.

A population-based cross-sectional study to determine the practices of breastfeeding among the lactating mothers of Patiala city.

Introduction:The present study was undertaken to study the breastfeeding practices and the influence of literacy and prevailing cultural factors on different aspects of breastfeeding.Materials and Methods:A community-based cross-sectional study was conducted at Badungar, a semi-urban area in Patiala city including a total of 370 mothers. Mothers were interviewed using pre-formed, semi-structured Performa. The participant's demographic information, awareness and practices regarding breastfeeding were recorded by paying house to house visits. Data were analyzed using SPSS ver. 21.Results:Only 27.30% of the mothers knew that breastfeeding should be initiated within 1 hour of birth. A total of 51.62% mothers considered prelacteal feed to be the right practice while 55.95% considered colostrum bad for the baby. Only 53.78% of the lactating mothers knew the correct meaning of exclusive breastfeeding. Only 24.86% mothers started breastfeeding within an hour after birth. Colostrum was not given by 57.29% of the lactating mothers while Prelacteal feeds were given by 50.81% mothers. Exclusive breastfeeding till 6 months was given by 45.67% mothers. A significant association was observed in high mother's education, high socio-economic status, nuclear status of family, history of antenatal care registration, and hospital delivery with exclusive breastfeeding (P < 0.01).Conclusion:Study concluded that breastfeeding practices were not optimum; hence promotion of knowledge regarding the right practices of breastfeeding and focus on the factors affecting them is highly warranted in this area.

A cross-sectional study to investigate factors related to the time of initiation of breastfeeding in Jamnagar district of Gujarat, India

Background: Early initiation of breastfeeding (EIBF) and exclusive breastfeeding for the first 6 months of life prevents around 20% newborn deaths and 13% under-five deaths. EIBF is predominately associated with socioeconomic, health related, and individual factors. Very few studies in Gujarat and probably none in Jamnagar district have been conducted to know factors related to the timing of initiation of breastfeeding. Objectives: This study was carried out with the objective to find out the prevalence of EIBF and association of demographic, antenatal, and intranatal factors with prelacteal feeding practice in Jamnagar district of Gujarat. Materials and Methods: This study was carried out in 2015–2016 in four talukas of Jamnagar district with a sample size of 426 mother-infant pairs calculated with appropriate formula using prevalence of EIBF. Out of this, 400 samples with adequate response were analyzed. Multistage sampling was done and mothers who gave valid consent were taken as respondent. Chi-square, Fisher exact, and Pearson correlation tests were used for statistical analysis. Results: The prevalence of EIBF was 62% in Jamnagar district. About 94.8% newborn of 15–19 years aged mothers, 96.4% newborns of mothers of Class-V socio-economic class, 87.5% newborns of illiterate mothers, 96.5% newborns of farmer mothers, and 77.4% of 1st birth order newborns received breastfeeding within 1 h of their birth. The proportion of newborn receiving breastfeeding within 1–4 h after birth increased significantly with increasing number of antenatal care (ANC) visits (P < 0.01). Among mothers with prolonged labor, 43.5% could initiate breastfeeding early. Mode of delivery and health facility for delivery were a significant determinant for the time of initiation of breastfeeding. Conclusion: EIBF decreased with increasing age of mothers, increasing socio-economic class and increasing the education level of mothers. The practice of EIBF is also low among employed mothers, among newborn with high birth order and among mothers of general caste. EIBF is high in mothers with fewer ANC visits, among mothers with prolonged labor, in case of normal delivery, delivery at primary health care, and delivery assisted by female health staff.

A study to assess the knowledge and practice of nursing staff posted in postnatal ward about immediate care of newborn and breast feeding in selected hospital of Bhopal district, Madhya Pradesh

Background: High rate of infancy deaths is largely attributed to very high share of neonatal deaths i.e 66% of infant deaths in 2007, in India. It can be largely attained by providing quality care to the newborn immediately after birth and Breast-feeding which is the standard way of feeding all infants. Objectives of the study were to assess the knowledge and practices of nurses regarding Immediate Care of Newborn and assess the knowledge of nurses of postnatal ward regarding Breast feeding.Methods: This was a hospital based cross-sectional study carried out in selected hospital of Bhopal district. 32 nurses involved in the immediate care of the newborn were identified. Data was collected about Immediate Care of Newborn and breast feeding. Analysis was done using MS Excel and EpiInfo-7.Results: 81.3% nurses knew how to prevent the new born from bleeding and 71.9% knew the correct dose of Vit K at birth. 78.1% put delivered baby on to mother’s abdomen, 84.4% dried and covered the baby correctly, 90.6% tied cord correctly and 96.9 weighted the baby. 75% said initiation should be done within first hour of birth. 90.6% said feeding should be done for more than 8 times a day and 87.5% believed hand washing should be done before every feed. 59.4% said Pre-lacteal feeding should not be given, 87.5% adhered to colostrum feeding.Conclusions: Nurses have knowledge about the immediate care of the newborn and breast feeding but there are some lacunas despite the continuous efforts of training. Much still needs to be done.

Infant feeding practices of a tribal community in a mandal of Khammam district, Telangana

Background: Breast milk is the best, safest and most nutritious food for infants. Though breast feeding is almost universal, there are yet some myths and false beliefs surrounding the practice due to various cultures and traditions in India. In the present study an attempt was made to understand various aspects of infant feeding practices among the Sugali tribes of Khammam district, Telangana state.Methods: A cross sectional study was conducted among Sugali community in Khammam mandal of Khammam district in Telangana from March to June 2010. In which 314 families with pre-school children were interviewed using a pre–designed semi-structured questionnaire.Results: Nearly 80% (251) of the mothers had said that they initiate breast feeding after one hour of delivery, while only 6% initiated breastfeeding within one hour delivery. About 54% of the mothers were giving colostrum to their newborns, while others (45.86%) were giving pre-lacteal feeding to the infants including jaggery water and honey. It was observed that most (71.65%) of the mothers were continuing to breastfeed their children more than 18 months. Only 11.78% of the mothers started weaning before 6 months of age. Socio-economic status, literacy rate and working status of the mothers were some of the influencing factors.Conclusions: The study identified the practices of infant feeding, their determinants among the sugali tribes and recommendations to improve their practices. False beliefs and difficulties regarding breast feeding need to be addressed through heath education and family support.

Gestational Diabetes Mellitus Reduces Breastfeeding Duration: A Prospective Cohort Study.

Gestational diabetes mellitus (GDM) and its complications are major concerns because of the negative effects of GDM during antenatal period and on the future health of mothers and infants. Breastfeeding is beneficial for GDM mothers and their babies to reduce future health risks. Little is known about the link between GDM and the duration of "any" breastfeeding. Therefore, the aim of this study was to investigate the relationship between GDM and the duration for which Vietnamese women breastfeed their babies postpartum. A prospective cohort of 2,030 pregnant women between 24 and 28 weeks of gestation was recruited. GDM status was determined using a 75 g oral glucose tolerance test. Included mothers were then followed up from discharge after childbirth until 12 months postpartum to determine their breastfeeding duration. Kaplan-Meier estimates, log-rank tests, logistic and Cox regression models were used to examine the association between GDM and breastfeeding outcomes. In our cohort, 94.4% of all women reported "any" breastfeeding at discharge and 72.9% of women were still breastfeeding at 12 months postpartum. The risk of early breastfeeding cessation was higher in GDM women than their non-GDM counterparts after adjustment for demographic factors (hazard ratios [HR] = 1.39, 95% confidence intervals [CI] = 1.13-1.71, p = 0.002), and all potential confounding factors (HR = 1.38, 95% CI = 1.12-1.70, p = 0.002). There were no significant differences in breastfeeding outcomes at discharge (early initiation, prelacteal feeding, and "any" breastfeeding rate) between GDM and non-GDM mothers. GDM was associated with shorter breastfeeding duration. Women with GDM require ongoing support after hospital discharge to maintain long-term breastfeeding.

Trends and predictors of optimal breastfeeding among children 0-23 months, South Asia: Analysis of national survey data.

Optimal breastfeeding practices, including early initiation of breastfeeding (EIBF) within 1 hr of birth, exclusive breastfeeding (EBF) for the first 6 months of age, and continued breastfeeding (CBF) for 2 years of age or beyond with appropriate complementary foods, are essential for child survival, growth, and development. Breastfeeding norms differ within and between countries in South Asia, and evidence is needed to inform actions to protect, promote, and support optimal practices. This study examines time trends and predictors of EIBF, avoidance of prelacteal feeding (APF), EBF, and CBF to 2 years using survey data from Afghanistan, Bangladesh, India, Nepal, and Pakistan since 1990. EIBF, APF, and EBF increased in Bangladesh, India, and Nepal from 1990 to 2016. EIBF and EBF increased in Pakistan from 1990 to 2013, but both EIBF and APF decreased in recent years. In Afghanistan, EIBF, APF, and EBF decreased from 2010 to 2015. CBF remained fairly constant across the region although prevalence varied by country. Significant (p < 0.05) predictors of suboptimal practices included caesarian delivery (4–25%), home delivery, small size at birth, and low women's empowerment. Wealth, ethnic group, and caste had varied associations with breastfeeding. Progress towards optimal breastfeeding practices is uneven across the region and is of particular concern in Afghanistan and Pakistan. There are some common predictors of breastfeeding practices across the region, however country‐specific predictors also exist. Policies, programs, and research should focus on improving breastfeeding in the context of women's low empowerment and strategies to support breastfeeding of infants born small or by caesarian section, in addition to country‐specific actions.

Evaluation of Breast-Feeding Promotion Policy in Cipto Mangunkusumo Hospital Jakarta

The purpose of this prospective cohort study was to evaluate the breastfeeding promotion program m Dr. C1pto Mangunkusumo general hospital which we started m 1991. The study was done from July 1992 until March 1993. During that time. We could follow 249 mother-infant pairs every month for 4 months. Results: 1. Babies who received only breast milk during hospital stay did not lose more weight if compared to babies who got some formula. 2. Not a single baby lost weight more ~10% during hospital stay· Prelacteal feeding delayed the adequacy of breastmilk; 4. Though prelacteal feeding once or twice by spoon did not interfere with full breast feeding at the age of 4 months, yet mothers whose babies were given prelacteal feeding started to give supplementary food earlier; 5. Family income places a role in the decision to give early food supplement.

Effectiveness of weekly cell phone counselling calls and daily text messages to improve breastfeeding indicators

BackgroundEvery year, nearly one million deaths occur due to suboptimal breastfeeding. If universally practiced, exclusive breastfeeding alone prevents 11.6% of all under 5 deaths. Among strategies to improve exclusive breastfeeding rates, counselling by peers or health workers, has proven to be highly successful. With growing availability of cell phones in India, they are fast becoming a medium to spread information for promoting healthcare among pregnant women and their families. This study was conducted to assess effectiveness of cell phones for personalized lactation consultation to improve breastfeeding practices.MethodsThis was a two arm, pilot study in four urban maternity hospitals, retrained in Baby Friendly Hospital Initiative. The enrolled mother-infant pairs resided in slums and received healthcare services at the study sites. The control received routine healthcare services, whereas, the intervention received weekly cell phone counselling and daily text messages, in addition to counselling the routine healthcare services.Results1036 pregnant women were enrolled (518 - intervention and 518 - control). Rates of timely initiation of breastfeeding were significantly higher in intervention as compared to control (37% v/s 24%, p < 0.001). Pre-lacteal feeding rates were similar and low in both groups (intervention: 19%, control: 18%, p = 0.68). Rate of exclusive breastfeeding was similar between groups at 24 h after delivery, but significantly higher in the intervention at all subsequent visits (control vs. intervention: 24 h: 74% vs 74%, p = 1.0; 6 wk.: 81% vs 97%, 10 wk.: 78% vs 98%, 14 wk.: 71% vs 96%, 6 mo: 49% vs 97%, p < 0.001 for the last 4 visits). Adjusting for covariates, women in intervention were more likely to exclusively breastfeed than those in the control (AOR [95% CI]: 6.3 [4.9–8.0]).ConclusionUsing cell phones to provide pre and postnatal breastfeeding counselling to women can substantially augment optimal practices. High rates of exclusive breastfeeding at 6 months were achieved by sustained contact and support using cell phones. This intervention shows immense potential for scale up by incorporation in both, public and private health systems.Trial registrationThis study was retrospectively registered with Clinical Trial Registry of India (http://www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=3060) Trial Number: CTRI/2011/06/001822 on date 20/06/2011.

Magnitude of prelacteal feeding practice and its association with place of birth in Ethiopia: a systematic review and meta-analysis, 2017

BackgroundPrelacteal feeding is one of the commonest inappropriate child feeding practice which exposes to malnutrition, infection, and neonatal mortality. However, there is no systematic review and meta-analysis that estimates the pooled prevalence of prelacteal feeding and its association with place of birth in Ethiopia. Therefore, this study aimed at investigating the magnitude of prelacteal feeding practice and its association with home delivery in the country.MethodsPrimary studies were accessed through, HINARI and PubMed databases. Additionally, electronics search engines such as Google Scholar, and Google were used. The Joana Briggs Institute quality appraisal checklist was used to appraise the quality of studies. Data were extracted using Microsoft Excel spreadsheet. Heterogeneity between the studies was examined using the I2 heterogeneity test. The DerSimonian and Liard random-effect model was used. The random effects were pooled after conducting subgroup and sensitivity analyses. Publication bias was also checked.ResultsA total of 780 primary studies were accessed. However, about 24 studies were included in the qualitative description and quantitative analysis of the prevalence of prelacteal feeding. To examine the association between home delivery and prelacteal feeding practice, only six studies were included. The prevalence of prelacteal feeding ranged from 6.1–75.8%. The pooled prevalence of prelacteal feeding among Ethiopian children was 26.95% (95% CI: 17.76%, 36.14%). The highest prevalence was observed in the Afar region. The pooled odds of prelacteal feeding among women who gave birth at home was increased by 5.16 (95% CI: 3.7, 7.2) folds as compared to those who gave birth at Health institutions.ConclusionPrelacteal feeding practice in Ethiopia was found to be high. Home delivery was strongly associated with prelacteal feeding practice. Therefore, promoting institutional delivery and strengthening of the existing child nutrition strategies are recommended.

Essential newborn care practices and associated factors among home delivered mothers in Damot pulasa Woreda, southern Ethiopia

BackgroundGlobally 3.1 million children die each year in their neonatal period (first 28 days of life) according to World Health Organization (WHO) 2011 report. Half of these surprisingly occur within the first 24 h of delivery and 75% occur in the early neonatal period.MethodsA community based cross-sectional study design was carried out from March 2016 to April, 2016 in Damot Pulasa district, Wolaita zone, Southern Ethiopia to assess selected essential newborn care practices and associated factors among home delivered mothers in Damot pulasa district. Data were entered into Epi Info version 3.5.1 and exported to SPSS version 20 software for analysis. Multiple logistic analyses were done to control possible confounding variable. A P-value less than 0.05 was taken as a significant association.ResultThe study showed that the prevalence of essential newborn care practice was 24%. Multivariate logistic regression analysis revealed that variables like ANC visit (AOR =0.213,P = 0.015,CI = 0.102–0.446),PNC visit (AOR = 0.209, P = 0.00,CI = 0.110–0.399), advice about essential newborn care practice (AOR =0.114,P = 0.0001, CI = 0.058–0.221),urban areas women (AOR =2,P = 0.042, CI = 1.024–3.693), planned pregnancy (AOR = 7, P = 0.00, CI =3.732–11.813), and knowledge about newborn danger signs (AOR = 0.277, P = 0.006, CI = 0.110–0.697) were the independent predictors of ENBC practices.ConclusionGenerally, coverage of essential newborn care practices was low. ANC visit, advice about ENBC, PNC visit, residence, planned pregnancy and knowledge about newborn danger signs were predictors of essential newborn care practice in the study area. Therefore, Health facilities should enhance linkage with health posts to increase ANC and PNC service utilization. Health extension workers should also promote and give health education about pre-lacteal feeding, early bathing, planned pregnancy, newborn danger signs and application of materials on the newborn stump.

Uncovering the barriers to exclusive breastfeeding for mothers living in Dhaka\u2019s slums: a mixed method study

BackgroundDespite the substantial impact on child and maternal health, breastfeeding practices for infants remain at the suboptimum level in Bangladesh. Yet the understanding of why these practices are suboptimal, especially surrounding urban slum dwelling mothers, is unclear. The purpose of this study was to assess early infant feeding practices, examine associations with maternal factors, and uncover the facilitators and barriers to early feeding practices in selected slums of Dhaka, Bangladesh.MethodsA mixed method study was conducted from June to September 2016 using both quantitative and qualitative methods among mothers with children under the age of 6 months. The survey included 342 mother-infant pairs and 18 in-depth interviews were conducted. Univariate and multiple logistic regression was used to determine status of early infant feeding practices and factors associated with exclusive breastfeeding (EBF) within the previous 24 h. Transcripts were coded to uncover the facilitators and barriers surrounding early infant feeding practices.ResultsSixty four percent (220/342) of mothers initiated breastfeeding within 1 h, 96.5% (330/342) reported feeding colostrum, and 36.3% (124/342) infants were EBF in the last 24 h. After adjusting for child gender, maternal age, education, diet and household income; infant’s age (adjusted odds ratio (AOR) for 61–120 days 6.42; 95% CI 3.42, 12.1; AOR for 121–180 days 45.6; 95% CI 18.33, 113.45), prelacteal feeding (AOR 2.53; 95% CI 1.14, 4.58), lack of planning for EBF during pregnancy (AOR 4.06; 95% CI 1.09, 15.12) and infants delivered by cesarean section (AOR 2.76; 95% CI 1.34, 5.67) were negatively associated with EBF. During the 18 interviews, eight mothers reported a cesarean delivery and none of these mothers initiated breastfeeding within 1 h or exclusively breastfed. Moreover, all eight mothers gave their infants prelacteal feeds.ConclusionsThe status of early infant feeding practices in Dhaka’s slums was poor. The negative impact of cesarean section on all early infant feeding practices was evident in both quantitative and qualitative analysis.