National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
Faculty of Public Health, Department of Epidemiology, Universitas Indonesia, Depok, Jawa Barat, Indonesia.
PLoS One. 2020 Dec 3;15(12):e0243097. doi: 10.1371/journal.pone.0243097. eCollection 2020.
Prelacteal feeding (PLF) is a recognised challenge to optimal breastfeeding but remains common in Indonesia. Meanwhile, PLF-related epidemiological research is limited, particularly in this setting. This study examines the prevalence and determinants of overall PLF as well as common PLF types (formula, other milk, and honey) in Indonesia.
Data from 6127 mothers whose last child was ≤23-month-old were drawn from the 2017 Indonesia Demographic and Health Survey. Multivariable modified Poisson regression was used to measure the prevalence ratio (PR) for selected PLF risk factors. PLF was defined as anything to drink other than breast milk within three days after birth, before breastmilk flows. Additional analyses were performed on mothers who gave formula, other milk, and honey.
About 45% babies in Indonesia received PLF with formula being the most frequent (25%), followed by other milk (14%), plain water (5%), and honey (3%). Factors associated with higher prevalence of any PLF were higher wealth quintiles in rural area (PR 1.07; 95% CI 1.03-1.11 per increase in quintile), baby perceived to be small at birth (PR 1.23; 95% CI 1.12-1.35), caesarean deliveries at either public (PR 1.27; 95% CI 1.13-1.44) or private facilities (PR 1.15; 95% CI 1.01-1.31), and not having immediate skin-to-skin contact after birth (PR 1.32; 95% CI 1.23-1.42). PLF was less prevalent among mothers who gave birth to second/subsequent child (PR 0.82; 95% CI 0.76-0.88) and who had an antenatal card (PR 0.89; 95% CI 0.80-0.99). These patterns did not apply uniformly across all PLF types. For example, honey was more common among home births than deliveries at health facilities, but formula and other milk were more common among caesarean deliveries.
Mapping risk factors for PLF, especially by types, could help to design more targeted interventions to reduce PLF and improve breastfeeding practices in Indonesia.
早于母乳喂养开始时间的非母乳喂食（PLF）是母乳喂养的公认挑战，但在印度尼西亚仍然很常见。同时，与 PLF 相关的流行病学研究有限，尤其是在这种情况下。本研究考察了印度尼西亚 PLF 的总体流行率及其常见类型（配方奶、其他奶类和蜂蜜）的决定因素。
从 2017 年印度尼西亚人口与健康调查中抽取了 6127 名最后一个孩子≤23 个月大的母亲的数据。采用多变量校正泊松回归来测量选定的 PLF 风险因素的患病率比（PR）。PLF 定义为出生后三天内除母乳以外的任何饮品，在此之前母乳尚未分泌。对使用配方奶、其他奶类和蜂蜜的母亲进行了额外分析。
印度尼西亚约有 45%的婴儿接受了 PLF，其中配方奶最常见（25%），其次是其他奶类（14%）、白开水（5%）和蜂蜜（3%）。与任何 PLF 患病率较高相关的因素包括农村地区更高的财富五分位数（每增加一个五分位数，PR 为 1.07；95%CI 为 1.03-1.11）、婴儿出生时被认为较小（PR 为 1.23；95%CI 为 1.12-1.35）、在公立或私立机构进行剖宫产（PR 分别为 1.27；95%CI 为 1.13-1.44 和 1.15；95%CI 为 1.01-1.31）以及出生后未立即进行皮肤接触（PR 为 1.32；95%CI 为 1.23-1.42）。与生育第二/多个孩子的母亲（PR 为 0.82；95%CI 为 0.76-0.88）和拥有产前保健卡的母亲（PR 为 0.89；95%CI 为 0.80-0.99）相比，PLF 的发生率较低。这些模式并非在所有 PLF 类型中都适用。例如，与在卫生机构分娩相比，蜂蜜在家庭分娩中更为常见，但配方奶和其他奶类在剖宫产中更为常见。
通过类型映射 PLF 的风险因素，有助于设计更有针对性的干预措施，以减少印度尼西亚的 PLF 并改善母乳喂养实践。
