Exploring the Factors Associated with Prelacteal Feeds in Papua New Guinea: a Population-based Survey

Overview

Journal BMJ Open

Specialty General Medicine

Date 2024 Dec 26

PMID 39725435

Authors

McKenzie Maviso

Elias Namosha

Georgia S Guldan

Affiliations

Soon will be listed here.

Abstract

Background: Prelacteal feeding disrupts early breastfeeding initiation and exclusive breastfeeding, and increases the risk of childhood illnesses and under-five mortality. Despite its negative health outcomes, newborns are given prelacteal feeds in Papua New Guinea (PNG). This study investigated the factors associated with prelacteal feeding practices among women in PNG.

Design: A population-based cross-sectional study based on Demographic and Health Survey (DHS) data. Multivariable logistic regression using complex sample analysis was performed to control for the effects of potential confounders. Variables with p ≤ 0.05 were considered statistically significant.

Setting: Papua New Guinea.

Participants: A total weighted sample of 4399 women was included in the study.

Outcome Measure: Prelacteal feeds.

Results: About 10% of women provided prelacteal feeds to their infants. The most frequently reported prelacteal feed was plain water (71.7%), followed by grain-based (eg, noodles) (47.1%), dark green leafy vegetables (42.1%) and soup (39.7%). Women with no formal (Adjusted Odds Ratio (AOR) 1.4, 95% CI: 1.0-3.0) or primary (AOR 1.5, 95% CI: 1.0-2.9) education, who had a caesarean section (AOR 4.1, 95% CI: 2.4-7.2), had given birth at home or in the village (AOR 3.7, 95% CI: 2.1-6.8) and from the Islands region (AOR 2.3, 95% CI: 1.5-3.5) had higher odds of providing prelacteal feeds.

Conclusion: Our study revealed that providing prelacteal feeds is common in PNG. Tailored health education and behaviour change communication are necessary to address this harmful infant feeding practice. Furthermore, the promotion of facility-based births and early breastfeeding practices should be prioritised using existing strategies, especially for disadvantaged and rural women.

References

Rollins N, Bhandari N, Hajeebhoy N, Horton S, Lutter C, Martines J . Why invest, and what it will take to improve breastfeeding practices?. Lancet. 2016; 387(10017):491-504. DOI: 10.1016/S0140-6736(15)01044-2. View

Valero-Chilleron M, Mena-Tudela D, Cervera-Gasch A, Gonzalez-Chorda V, Soriano-Vidal F, Quesada J . Influence of Health Literacy on Maintenance of Exclusive Breastfeeding at 6 Months Postpartum: A Multicentre Study. Int J Environ Res Public Health. 2022; 19(9). PMC: 9104596. DOI: 10.3390/ijerph19095411. View

Zong X, Wu H, Zhao M, Magnussen C, Xi B . Global prevalence of WHO infant feeding practices in 57 LMICs in 2010-2018 and time trends since 2000 for 44 LMICs. EClinicalMedicine. 2021; 37:100971. PMC: 8343261. DOI: 10.1016/j.eclinm.2021.100971. View

Li R, Scanlon K, Serdula M . The validity and reliability of maternal recall of breastfeeding practice. Nutr Rev. 2005; 63(4):103-10. DOI: 10.1111/j.1753-4887.2005.tb00128.x. View

Victora C, Bahl R, Barros A, Franca G, Horton S, Krasevec J . Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016; 387(10017):475-90. DOI: 10.1016/S0140-6736(15)01024-7. View

Abdulla F, Hossain M, Karimuzzaman M, Ali M, Rahman A . Likelihood of infectious diseases due to lack of exclusive breastfeeding among infants in Bangladesh. PLoS One. 2022; 17(2):e0263890. PMC: 8849615. DOI: 10.1371/journal.pone.0263890. View

Zakarija-Grkovic I, Segvic O, Vuckovic Vukusic A, Lozancic T, Bozinovic T, Cuze A . Predictors of suboptimal breastfeeding: an opportunity for public health interventions. Eur J Public Health. 2015; 26(2):282-9. DOI: 10.1093/eurpub/ckv203. View

Asaro T, Gutema B, Weldehawaryat H . Colostrum avoidance practice and associated factors among mothers of infants less than six months in Chencha District: cross-sectional study. BMC Nutr. 2023; 9(1):18. PMC: 9872284. DOI: 10.1186/s40795-023-00674-4. View

Kumar R, Amir-Ud-Din R, Ahmed J, Asim M, Rashid F, Khan S . Correlates of early initiation of breast feeding and prelacteal feeding: a cross-sectional study in Sindh province of Pakistan. BMJ Open. 2023; 13(2):e069902. PMC: 9896234. DOI: 10.1136/bmjopen-2022-069902. View

10.

Maviso M, Pulsan F, Vallely L . Investigation of factors associated with delayed initiation of breastfeeding in Papua New Guinea: a cross-sectional study. BMJ Paediatr Open. 2024; 8(1). PMC: 11474686. DOI: 10.1136/bmjpo-2024-002942. View

11.

Neves P, Armenta-Paulino N, Arroyave L, Ricardo L, Vaz J, Boccolini C . Prelacteal feeding and its relationship with exclusive breastfeeding and formula consumption among infants in low- and middle-income countries. J Glob Health. 2022; 12:04104. DOI: 10.7189/jogh.12.04104. View

12.

Chea N, Asefa A . Prelacteal feeding and associated factors among newborns in rural Sidama, south Ethiopia: a community based cross-sectional survey. Int Breastfeed J. 2018; 13:7. PMC: 5819158. DOI: 10.1186/s13006-018-0149-x. View

13.

Rahmartani L, Carson C, Quigley M . Prevalence of prelacteal feeding and associated risk factors in Indonesia: Evidence from the 2017 Indonesia Demographic Health Survey. PLoS One. 2020; 15(12):e0243097. PMC: 7714248. DOI: 10.1371/journal.pone.0243097. View

14.

Smith E, Hurt L, Chowdhury R, Sinha B, Fawzi W, Edmond K . Delayed breastfeeding initiation and infant survival: A systematic review and meta-analysis. PLoS One. 2017; 12(7):e0180722. PMC: 5528898. DOI: 10.1371/journal.pone.0180722. View

15.

Maviso M, Kaforau L, Hastie C . Influence of grandmothers on breastfeeding practices in a rural community in Papua New Guinea: A critical discourse analysis of first-time mothers' perspectives. Women Birth. 2022; 36(2):e263-e269. DOI: 10.1016/j.wombi.2022.08.001. View

16.

Abdulahi M, Fretheim A, Argaw A, Magnus J . Breastfeeding Education and Support to Improve Early Initiation and Exclusive Breastfeeding Practices and Infant Growth: A Cluster Randomized Controlled Trial from a Rural Ethiopian Setting. Nutrients. 2021; 13(4). PMC: 8067429. DOI: 10.3390/nu13041204. View

17.

Pham B, Silas V, Okely A, Pomat W . Breastfeeding Rate, Food Supplementation, Dietary Diversity Among Children Aged 6-59 Months, and Associated Factors in Papua New Guinea. Front Nutr. 2021; 8:622645. PMC: 7933198. DOI: 10.3389/fnut.2021.622645. View

18.

Neville M, Morton J . Physiology and endocrine changes underlying human lactogenesis II. J Nutr. 2001; 131(11):3005S-8S. DOI: 10.1093/jn/131.11.3005S. View

19.

Raihana S, Alam A, Chad N, Huda T, Dibley M . Delayed Initiation of Breastfeeding and Role of Mode and Place of Childbirth: Evidence from Health Surveys in 58 Low- and Middle- Income Countries (2012-2017). Int J Environ Res Public Health. 2021; 18(11). PMC: 8199672. DOI: 10.3390/ijerph18115976. View

20.

Akello R, Kimuli D, Okoboi S, Komuhangi A, Izudi J . Prelacteal feeding among infants within the first week of birth in eastern Uganda: evidence from a health facility-based cross-sectional study. Int Breastfeed J. 2021; 16(1):77. PMC: 8507326. DOI: 10.1186/s13006-021-00425-w. View