Colostrum avoidance practice and associated factors among mothers of infants less than six months in Chencha District: cross-sectional study

Abstract

Background Colostrum avoidance is failure to feed first breast milk to a newborn baby for the first 2 to 3 days after delivery. The problem of avoiding colostrum is prevalent in Ethiopia. But it is not adequately addressed yet. Therefore, the purpose of this study was to assess prevalence of colostrum avoidance practices and associated factors among mothers of infants aged less than six months; and to explore barriers for colostrum feeding in ChenchaZuria District. Methods A community-based cross-sectional study supplemented with a qualitative study was conducted in August 2020. The quantitative data were collected from 674 mothers selected by systematic sampling using a structured questionnaire. Both bi-variable and multi-variable binary logistic regression analysis was used to identify factors associated with the colostrum avoidance practices. The statistical significance was declared at a p-value < 0.05. The qualitative data were collected using in-depth interviews from breastfeeding mothers and thematic analysis was done manually. Result The prevalence of the colostrum avoidance practice was 15.3% (95% CI: 11.4%- 18.2%). Late initiation of breastfeeding (AOR 4.15 95% CI 2.51–6.84), giving pre-lacteal feeding (AOR 3.16 95% CI 1.93–5.15), not using of postnatal care (PNC) service (AOR 1.79 95% CI 1.05–3.04), and having poor maternal knowledge regarding colostrum. (AOR 1.88 95% CI 1.14–3.08) were factors significantly associated with the colostrum avoidance practices. And in the qualitative part, cultural beliefs and misconceptions, community influence, and complementary feeding practices were found to be facilitators for the colostrum avoidance. Conclusion About one in seven mothers practiced colostrum avoidance. Factors that contributed to the colostrum avoidance practices were breastfeeding initiation, pre-lacteal feeding, PNC utilization, and maternal knowledge regarding colostrum. Thus, efforts to prevent colostrum avoidance practices should focus on strengthening and promoting PNC services utilization, timely initiation of breastfeeding, and improving awareness creation activities on the importance of colostrum feeding and risks of pre-lacteal feeding.

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

“…Those who practiced prelacteal feeding were 3.16 times more likely to avoid colostrum compared with those who did not. This mirrors findings from previous studies conducted in the North Wollo Zone ( 6 ), Aksum town ( 4 ), and Chencha district in Ethiopia ( 22 ). The aforementioned behavioral characteristics of mothers may stem from the belief that prelacteal foods are beneficial for the health of their infants.…”

“…In Ethiopia, emphasizing key messages about breastfeeding during healthcare visits, rather than solely in the study area, has been shown to positively influence the avoidance of colostrum. This conclusion was supported by research conducted in Chencha district ( 22 ).…”

“…This result is more or less consistent with that of research conducted in Afambo district, Ethiopia ( 20 ), which is that approximately 35% of mothers were discarding colostrum, and also with that of the study conducted in India ( 1 ), where 23% of participating mothers were found to practice colostrum avoidance. The aforementioned rate is notably higher than that of the findings from other regions, such as Aksum town in Ethiopia (6.3%) ( 4 ), Raya Kobo district (13.5%) ( 6 ), Bure district in Ethiopia (14.5%) ( 21 ), and Chencha district in Southern Ethiopia (15.3%) ( 22 ). The observed disparities could stem from variations in sample size, geographical factors, and the age range of children included in the study, potentially introducing recall bias.…”

“…In both the specific area under study and across Ethiopia as a whole, there is a significant requirement for interventions that are focused on exactly when breastfeeding begins. This implies that there may be factors influencing the timing of breastfeeding initiation that need attention, such as cultural practices, healthcare practices, or maternal knowledge and support ( 22 ). By addressing these factors through targeted interventions, the potential to improve breastfeeding practices and, as a consequence, enhance maternal and infant health outcomes, arises.…”

Sociocultural context of exclusive breastfeeding in Africa: A narrative review

“…In Africa, most cultures are said to identify colostrum to be not beneficial to newborns due to the widespread limited knowledge about its health benefits. As Asaro 24 noted, colostrum is regarded as “bad milk” and harmful to the infant in some African cultures and mothers tend to dispose of it. Such practices have been reported among mothers in Ethiopia where the tradition of colostrum avoidance is practised by mothers in the North‐Eastern part of the country because they perceived it as dirty and not good due to its color and consistency.…”