Sako Sewunet
Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Heliyon. 2022 Apr 26;8(4):e09339. doi: 10.1016/j.heliyon.2022.e09339. eCollection 2022 Apr.
Prelacteal feeding is the main obstacle for exclusive breastfeeding and the major causes of neonatal morbidity and mortality. The practice is one of a deep-rooted public health problem of Ethiopia that needs further investigation. Therefore, this study aimed to assess the prevalence and independent predictors of prelacteal feeding practice in Ethiopia.
This study used data from the 2019 Ethiopia Mini Demographic and Health Survey. A two-stage multilevel mixed-effects logistic regression model was conducted to identify individual and community-level predictors of prelacteal feeding practice of mothers. In the multivariable analysis, variables with a p-value less than 5% and an adjusted odds ratio with a 95% confidence interval were reported as statistically significant variables with prelacteal feeding practice.
The prevalence of prelacteal feeding practice among mothers of children less than 2 years old in Ethiopia was 16.31% (95% CI: 14.7%, 17.9%). Women who had multiple births [AOR = 4.62; 95%CI: 1.63, 13.08], delivered through cesarean section [AOR = 2.66; 95%CI: 1.63, 4.33], initiated breastfeeding after 1 hour of delivery [AOR = 3.16; 95%CI: 2.25, 4.47] and mothers who were from pastoralist region [AOR = 2.12; 95%CI: 1.22, 3.68] were more likely to practice prelacteal feeding than their counterparts.
This study revealed that the prevalence of prelacteal feeding practice remained a great public health concern of the country. Type of birth, mode of delivery, initiation of breastfeeding and geographic region where the mothers reside were factors that were positively associated with prelacteal feeding practice. Therefore, behavior change communication need to be applied using a variety of communication channels to halt this harmful traditional practice. In addition, promotion of institutional delivery and early initiation of breastfeeding practice using the existing strategies need to be strengthened with special emphasis given to marginalized women in order to diminish the practice in Ethiopia.
初乳前喂养是纯母乳喂养的主要障碍，也是新生儿发病和死亡的主要原因。这种做法是埃塞俄比亚一个根深蒂固的公共卫生问题，需要进一步调查。因此，本研究旨在评估埃塞俄比亚初乳前喂养行为的患病率及其独立预测因素。
本研究使用了2019年埃塞俄比亚小型人口与健康调查的数据。采用两阶段多水平混合效应逻辑回归模型来确定母亲初乳前喂养行为的个体和社区层面预测因素。在多变量分析中，p值小于5%且调整后的比值比及其95%置信区间的变量被报告为与初乳前喂养行为具有统计学显著意义的变量。
埃塞俄比亚2岁以下儿童母亲的初乳前喂养行为患病率为16.31%（95%置信区间：14.7%，17.9%）。多胞胎产妇[AOR = 4.62；95%置信区间：1.63，13.08]、剖宫产分娩产妇[AOR = 2.66；95%置信区间：1.63，4.33]、分娩后1小时后开始母乳喂养的产妇[AOR = 3.16；95%置信区间：2.25，4.47]以及来自游牧地区的母亲[AOR = 2.12；95%置信区间：1.22，3.68]比其他母亲更有可能进行初乳前喂养。
本研究表明，初乳前喂养行为的患病率仍然是该国一个重大的公共卫生问题。分娩类型、分娩方式、母乳喂养的开始时间以及母亲居住的地理区域是与初乳前喂养行为呈正相关的因素。因此，需要通过各种沟通渠道应用行为改变沟通来制止这种有害的传统做法。此外，需要加强利用现有策略促进机构分娩和尽早开始母乳喂养的做法，并特别关注边缘化妇女，以减少埃塞俄比亚的这种做法。
