Do Differences in Prelacteal Feeding Explain Differences in Subsequent Breastfeeding Between Haiti and the Dominican Republic?

OBJECTIVE

Although Haiti and the Dominican Republic (DR) share the same island of Hispaniola, exclusive breastfeeding is much higher in Haiti. As prelacteal feeding also differs between the two countries, it was hypothesize that prelacteal feeding would account for the subsequent differences in breastfeeding exclusivity between the two countries, while controlling for other potentially influencing differences.

METHODS

Data for infants under 6 months of age were extracted from the cross-sectional Demographic and Health Surveys from Haiti (2012) and the DR (2013). Bivariate analysis and ordered logistic regression models were used.

RESULTS

Data were available for 686 Haitian infants [mean age: 2.9 (SD: 1.6) months] and 264 Dominican infants [mean age: 2.6 (SD: 1.6) months]. Haitian infants were more likely to be exclusively breastfed than Dominican infants, 41.3% versus 8.0%, at the time of the survey, and less likely to have been exposed to any prelacteal feeds, 20.1% versus 69.8%, respectively. Furthermore, Dominican infants were more likely to have been exposed to milk-based prelacteal feeds. Dominican status, any prelacteal feeds, and milk-based prelacteal feeds significantly and independently reduced the odds of breastfeeding exclusivity.

CONCLUSIONS FOR PRACTICE

Identification of factors beyond prelacteal feeding are necessary to explain the substantially lower breastfeeding exclusivity in the DR compared to Haiti and to determine why so many Dominican infants are exposed to milk-based prelacteal feeds.