Pooled Prevalence and Determinants of Prelacteal Feeding Practice in Eastern Africa Evidence from Demographic and Health Survey Data: A Multilevel Study

Abstract

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 lowand 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.

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

“…This study evidenced that the odds of prelacteal feeding practice were higher among mothers who had multiple births as compared to mothers who had single births. This finding is similar to studies conducted in different parts of Ethiopia [ 13 , 14 , 21 , 17 ]. This could be due to the probability of giving preterm birth was higher among women who gave multiple births than those who gave single births [ 30 ].…”

“…Different studies conducted in the country showed that lack of breastfeeding counseling, avoidance of colostrum, birth spacing, Antenatal care (ANC) visit, wealth index, mode of delivery, initiation of breastfeeding, place of delivery, type of residence, and type of birth are factors that affect prelacteal feeding practice [ 8 , 12 , 13 , 16 , 17 ]. In Ethiopia, the prevalence of prelacteal feeding practice was ranged 10.1%-56% [ 7 , 9 , 12 , 13 , 14 , 18 , 19 , 20 ].…”

Prelacteal feeding among infants within the first week of birth in eastern Uganda: evidence from a health facility-based cross-sectional study

“…A multi-level analysis of data from 22 countries in sub-Saharan Africa for risk factors of prelacteal feeding found a 32.2% prevalence of prelacteal feeding, with the likelihood being higher among mothers with a low level of education, preceding birth intervals of less than 24 months, low antenatal care attendance, home delivery, and small-sized baby at birth [ 1 ]. In East Africa, the pooled prevalence of prelacteal feeding is 12% [ 2 ]. One systematic review and meta-analysis conducted in Ethiopia reports a 25.3% pooled prevalence for prelacteal feeding, with the likelihood being lower among mothers that attended antenatal care during the most recent pregnancy, received counseling on infant feeding practices, timely initiated breastfeeding, and resided in an urban setting.…”

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

“…This practice increases the risk of illness among newborns and prevents them from the protective effects and vital nutrients in the colostrum (6). Regardless of its detrimental effects on health, prelacteal feeding is frequently practiced worldwide, particularly in developing countries, including Indonesia (6,7). One of the most crucial feeding practices recommended by The World Health Organization (WHO) in the Global Strategy for Infant and Young Child Feeding is exclusive breastfeeding, defined as the practice of only giving infant breastmilk for the first 6 months of life (8).…”

“…This practice increases the risk of illness among newborns and prevents them from the protective effects and vital nutrients in the colostrum ( 6 ). Regardless of its detrimental effects on health, prelacteal feeding is frequently practiced worldwide, particularly in developing countries, including Indonesia ( 6 , 7 ).…”