Asaro TekleBuche, Gutema Befikadu Tariku, Weldehawaryat Haymanot Nigussie
Health Office of Bursa District, Sidama, Ethiopia.
School of Public Health, Arba Minch University, Arba Minch, Ethiopia.
BMC Nutr. 2023 Jan 23;9(1):18. doi: 10.1186/s40795-023-00674-4.
Colostrum avoidance is failure to feed first breast milk to a newborn baby for the first 2 to 3 days after delivery. The problem of avoiding colostrum is prevalent in Ethiopia. But it is not adequately addressed yet. Therefore, the purpose of this study was to assess prevalence of colostrum avoidance practices and associated factors among mothers of infants aged less than six months; and to explore barriers for colostrum feeding in ChenchaZuria District.
A community-based cross-sectional study supplemented with a qualitative study was conducted in August 2020. The quantitative data were collected from 674 mothers selected by systematic sampling using a structured questionnaire. Both bi-variable and multi-variable binary logistic regression analysis was used to identify factors associated with the colostrum avoidance practices. The statistical significance was declared at a p-value < 0.05. The qualitative data were collected using in-depth interviews from breastfeeding mothers and thematic analysis was done manually.
The prevalence of the colostrum avoidance practice was 15.3% (95% CI: 11.4%- 18.2%). Late initiation of breastfeeding (AOR 4.15 95% CI 2.51-6.84), giving pre-lacteal feeding (AOR 3.16 95% CI 1.93-5.15), not using of postnatal care (PNC) service (AOR 1.79 95% CI 1.05-3.04), and having poor maternal knowledge regarding colostrum. (AOR 1.88 95% CI 1.14-3.08) were factors significantly associated with the colostrum avoidance practices. And in the qualitative part, cultural beliefs and misconceptions, community influence, and complementary feeding practices were found to be facilitators for the colostrum avoidance.
About one in seven mothers practiced colostrum avoidance. Factors that contributed to the colostrum avoidance practices were breastfeeding initiation, pre-lacteal feeding, PNC utilization, and maternal knowledge regarding colostrum. Thus, efforts to prevent colostrum avoidance practices should focus on strengthening and promoting PNC services utilization, timely initiation of breastfeeding, and improving awareness creation activities on the importance of colostrum feeding and risks of pre-lacteal feeding.
初乳回避是指在分娩后的头2至3天未能给新生儿喂哺初乳。在埃塞俄比亚，回避初乳的问题很普遍，但尚未得到充分解决。因此，本研究的目的是评估6个月以下婴儿母亲中初乳回避行为的发生率及其相关因素；并探讨陈查祖里亚区初乳喂养的障碍。
2020年8月进行了一项基于社区的横断面研究，并辅以定性研究。定量数据通过系统抽样从674名母亲中收集，使用结构化问卷。采用双变量和多变量二元逻辑回归分析来确定与初乳回避行为相关的因素。当p值<0.05时具有统计学意义。定性数据通过对母乳喂养母亲进行深入访谈收集，并手动进行主题分析。
初乳回避行为的发生率为15.3%（95%置信区间：11.4%-18.2%）。母乳喂养开始时间晚（调整后比值比4.15，95%置信区间2.51-6.84）、进行开奶前喂养（调整后比值比3.16，95%置信区间1.93-5.15）、未使用产后护理（PNC）服务（调整后比值比1.79，95%置信区间1.05-3.04）以及母亲对初乳的知识匮乏（调整后比值比1.88，95%置信区间1.14-3.08）是与初乳回避行为显著相关的因素。在定性部分，发现文化信仰和误解、社区影响以及辅食喂养习惯是初乳回避的促成因素。
约七分之一的母亲存在初乳回避行为。导致初乳回避行为的因素包括母乳喂养开始时间、开奶前喂养、PNC服务的利用以及母亲对初乳的知识。因此，预防初乳回避行为的努力应集中在加强和促进PNC服务的利用、及时开始母乳喂养以及提高关于初乳喂养重要性和开奶前喂养风险的宣传活动。
