Why healthcare workers give prelacteal feeds

Abstract

Objective: Because prelacteal feeds can adversely affect breastfeeding, UNICEF=WHO discourage their use unless medically indicated. The study was carried out to determine the proportion of healthcare workers who routinely give prelacteal feeds, and their reasons for doing so; further, to determine whether any differences exist between medically and non-medically trained healthcare workers in their administration of prelacteal feeds. Design: Survey. Setting: Primary, secondary and tertiary health facilities in Kaduna township Nigeria. Subjects: Of 1100 healthcare workers sampled, 747 (68%) responded. Of these 80% had received medical training, 20% had not. Methods: Use of a pretested validated questionnaire. Results: Large proportions of both medical and non-medically trained healthcare workers stated they routinely give prelacteal feeds (doctors, 68.2%; nurses, 70.2%; and non-medical, 73.6%). However their reasons for doing so differed significantly (P ¼ 0.00001). Nurses gave mainly for perceived breast milk insufficiency, doctors for prevention of dehydration, hypoglycaemia and neonatal jaundice and non-medical staff to prepare the gastrointestinal tract for digestion and to quench thirst. Conclusions: Most healthcare workers (medical and non-medical) routinely and unnecessarily give prelacteal feeds. Therefore training and retraining programmes in lactation management are necessary and must include non-medical staff. These programmes, while emphasizing the danger of giving prelacteal feeds, must deal with the misconceptions of each group. Deliberate efforts have to be made to incorporate clinical training in breastfeeding in curricula of Schools of Medicine and Nursing.

Factors associated with prelacteal feeding practices in a rural northern Nigerian setting

“…This has been reported in previous studies. [10][11][12] The risks associated with unpasteurised non-human milk from animals like cow, goat and sheep whether prelacteal or not have previously been documented. 21 This finding could be an indication of the level of awareness in the community on the risks associated with consumption of unpasteurised milk.…”

“…Such reasons include cleansing and preparing the baby's gastrointestinal tract for digestion, quenching thirst, flushing the bladder, affording mother enough time to rest, 9 insufficient breastmilk, unclean colostrum, prevention of dehydration and hypoglycaemia. 10 The types of feeds given vary, and can include plain water, glucose water, infant formula, 10,11 'ghee' (refined butter), honey, 12 herbs, black tea and dilute cow milk. 13 Other forms of pre-lacteal feeds documented include dates, sugar and salt.…”

“…13 Other forms of pre-lacteal feeds documented include dates, sugar and salt. 10 Prelacteal feeding is widely practiced alongside breastfeeding. According to the 2013 Nigeria Demographic Health Survey 14 report, 59% of mothers offer a prelacteal feed to their newborns.…”

Prelacteal Feeding Practice and Associated Factors among Mothers Attending Immunization Clinic in Harari Region Public Health Facilities, Eastern Ethiopia

“…Furthermore, prelacteal liquid is given with a finger or a spoon often while the child is asleep or crying, and there is a danger of aspirating the fluid into the air passages and lungs. Thus, this feeding process reduces the practice of exclusive breast feeding which can be dangerous to the child and may even result in death [2]- [4].…”

Factors associated with exclusive breastfeeding in the first six months of life in Northern India

“…27,33 Studies have shown that it could be due to reason of insufficient milk supply. 34,35 In present study 105 (52.5%) babies were given pre-lacteal feed in the form of a honey 57(54.28%) followed by ghutti 27 (25.71%).…”