Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Human Anatomy, University of Gondar, College of Medicine and Health Science, School of Medicine, Gondar, Ethiopia.
Int Breastfeed J. 2021 Sep 8;16(1):68. doi: 10.1186/s13006-021-00414-z.
Prelacteal feeding is a major public health problem that increases the risk of morbidity and mortality in children. It also result delayed breastfeeding initiation and interferes with exclusive breastfeeding. Although numerous studies have been done on prelacteal feeding in individual East African countries, most of them did not consider community-level factors that could affect the likelihood of prelacteal feeding. This study, thus, aimed to assess the pooled prevalence and associated factors of prelacteal feeding practice in East Africa.
We used pooled data from the 12 east Africa countries Demographic and Health Surveys (DHS). A total weighted sample of 33,423 women was included in the final analysis. We employed multilevel logistic regression analysis to assess factors associated with prelacteal feeding practice. Finally, the Adjusted odds ratio (AOR) with 95% Confidence (CI) interval was reported and variables with p value< 0.05, in the multivariable analysis, were declared to be significant predictors of prelacteal feeding practice.
In this study, the pooled prevalence of prelacteal feeding practice was 11.85% (95%CI: 11.50, 12.20) with great variation between countries, ranging from 3.08% (95%CI: 2.35, 3.81) in Malawi to 39.21% (95%CI: 36.36, 42.06) in Comoros. Both individual and community-level factors were associated with prelacteal feeding practice. Of the individual-level factors, home delivery, multiple birth, cesarean delivery, non-exposure to media, delayed initiation of breastfeeding, and being a small-sized baby were associated with higher odds of prelacteal feeding practice. Among the community-level factors, rural residence and higher community-level of media exposure were associated with lower odds of prelacteal feeding practice.
In this study, the pooled prevalence of prelacteal feeding is high. Both individual and community level variables were associated with prelacteal feeding practice. Therefore, individual and community-level interventions that encourage mothers to deliver in the health facility and promoting timely initiation of breastfeeding are needed to reduce prelacteal feeding practices in east Africa. Moreover, media campaigns regarding this harmful traditional practice could be strengthened.
非母乳喂养是一个主要的公共卫生问题，会增加儿童发病和死亡的风险。它还会导致母乳喂养延迟和干扰纯母乳喂养。尽管在东非个别国家进行了许多关于非母乳喂养的研究，但其中大多数没有考虑到可能影响非母乳喂养可能性的社区层面因素。因此，本研究旨在评估东非地区非母乳喂养实践的综合流行率和相关因素。
我们使用来自东非 12 个国家的人口与健康调查（DHS）的汇总数据。最终分析纳入了 33423 名妇女的总加权样本。我们采用多水平逻辑回归分析来评估与非母乳喂养实践相关的因素。最后，报告了调整后的优势比（AOR）和 95%置信区间（CI），并在多变量分析中，将 p 值<0.05 的变量宣布为非母乳喂养实践的显著预测因素。
在这项研究中，非母乳喂养实践的综合流行率为 11.85%（95%CI：11.50，12.20），各国之间存在很大差异，从马拉维的 3.08%（95%CI：2.35，3.81）到科摩罗的 39.21%（95%CI：36.36，42.06）。个人和社区层面的因素都与非母乳喂养实践有关。在个人层面的因素中，家庭分娩、多胎、剖腹产、未接触媒体、母乳喂养延迟和婴儿较小与非母乳喂养实践的可能性较高有关。在社区层面的因素中，农村居住和较高的社区媒体暴露水平与非母乳喂养实践的可能性较低有关。
在这项研究中，非母乳喂养的综合流行率较高。个人和社区层面的变量都与非母乳喂养实践有关。因此，需要在个人和社区层面进行干预，鼓励母亲在医疗机构分娩并促进及时开始母乳喂养，以减少东非的非母乳喂养实践。此外，应该加强关于这种有害传统做法的媒体宣传。
