Prelacteal feeding: influencing factors and relation to establishment of lactation

Abstract

This study was carried out with a view to finding out factors influencing prelacteal feeding and its relation to establishment of lactation in rural Bangladesh. 420 mothers in early post-partum period were interviewed at home. Prelacteal feeding was given to 77% of the babies, and honey was given to 72% of them. The common methods of prelacteal feeding were by finger (41%) and spoon (40%). Twelve socio-demographic and health care variables were studied for their probable influence on prelacteal feeding. Nine of them accounted for 22% of the variability in giving prelacteal feeding. Reasons of giving prelacteal feeding and the time of first breast feeding influenced the practice significantly (P < 0.05). Type and duration of prelacteal feeding had significant negative influence on "coming in" of milk (P < 0.05). Prelacteal feeding accounted for 44% of variations in coming in of milk. Prelacteal feeding and coming in of milk formed a vicious cycle: the former delayed initiation of lactation and on the other hand delay in coming in of milk encouraged prelacteal feeding. These observation emphasized the need for coordinated efforts for promotion of proper infant feeding practices in our rural community.

PIP: Prelacteal feeding was investigated in a retrospective, community-based study of 420 new mothers from Bangladesh's rural Chittagong district. The majority (80%) of these mothers were from poor or lower-middle class households. 324 infants (77%) received prelacteal feeds, primarily honey (72%). The most common feeding methods were by finger (41%) or by spoon (40%). Mothers cited the following reasons for prelacteal feeding: social custom (55%), insufficient breast milk (14%), to keep the mouth and throat moist (9%), to keep the body warm (9%), rapid growth (7%), and to clear the bowel (5%). The strong impact of social custom is confirmed by the finding that 55% of these mothers were aware that exclusive breast feeding is sufficient to support infant growth for the first 4-6 months of life. Only 9% of mothers initiated breast feeding within 30 minutes of delivery. Prelacteal feeding accounted for 44% of the variation in the "coming in" of breast milk. A cycle was established in which prelacteal feeding delayed the initiation of lactation and the delay in lactation encouraged further prelacteal feeding. Since prelacteal feeding is a significant predictor of the establishment of lactation, there is a need for community education on the promotion of more appropriate infant feeding practices.