Prelacteal feeding and its relationship with exclusive breastfeeding and formula consumption among infants in low- and middle-income countries.

Autor:	Neves PA; Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada.; International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil., Armenta-Paulino N; Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.; Surgery and Medical and Social Sciences Department, University of Alcalá de Henares, Alcalá de Henares (Madrid), Spain., Arroyave L; International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil., Ricardo LI; International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil., Vaz JS; Faculty of Nutrition, Universidade Federal de Pelotas, Pelotas, Brazil., Boccolini CS; Institute of Scientific and Technological Communication and Information in Health, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil., Richter L; DSI-NRF Centre of Excellence in Child Development, University of the Witwatersrand, Johannesburg, South Africa., Peréz-Escamilla R; Yale School of Public Health, Yale University, New Haven, Connecticut, USA., Barros AJ; International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil.
Jazyk:	angličtina
Zdroj:	Journal of global health [J Glob Health] 2022 Dec 23; Vol. 12, pp. 04104. Date of Electronic Publication: 2022 Dec 23.
DOI:	10.7189/jogh.12.04104
Abstrakt:	Background: Early feeding practices are important determinants of optimal feeding patterns later in life. We aimed to investigate if giving any fluids or foods other than breast milk during the first three days after birth (prelacteal feeds) affects exclusive breastfeeding and consumption of formula among children under six months of age in low and middle-income countries (LMICs). Methods: We conducted a retrospective cohort study using data from 85 nationally representative Demographic Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) in LMICs (2010-2019). We considered three exposures: any prelacteal feeding (PLF), milk-based only prelacteal feeding (MLK), and water-based only prelacteal feeding (WTR), according to the DHS/MICS definition. The outcomes were exclusive breastfeeding, based on the World Health Organization definition, and consumption of formula among infants under six months of age. We used Poisson models adjusting for sociodemographic indicators, antenatal care, birth assistance, and early initiation of breastfeeding to estimate the effects of the exposures on the outcomes. Findings were grouped by each country, as well as by regions of the world and national income classification. Results: We included data from 91 282 children. PLF, MLK, and WTR had a prevalence of 33.9% (95% confidence interval (CI) = 33.6-34.2), 22.2% (95% CI = 21.9-22.4), and 9.4% (95% CI = 9.2-9.6), respectively. Exclusive breastfeeding and consumption of formula had a prevalence of 35.2% (95% CI = 34.9-35.5) and 27.7% (95% CI = 27.4-28.0), respectively. In the crude analysis, children who were given PLF were 40% less likely to be exclusively breastfed (prevalence ratio (PR) = 0.60; 95% CI = 0.56-0.64) and nearly twice more likely to receive formula (PR = 1.89; 95% CI = 1.72-2.08); the direction of the associations was the same across income groups and regions of the world. In the adjusted analysis, the observed crude effects were only slightly reduced (exclusive breastfeeding - PR = 0.62; 95% CI = 0.59-0.66, consumption of formula - PR = 1.72; 95% CI = 1.59-1.85). MLK showed a stronger impact on the outcomes than PLF, especially for formula consumption (adjusted PR = 1.81; 95% CI = 1.67-1.97) and in low-income countries. WTR was only negatively associated with exclusive breastfeeding (adjusted PR = 0.69; 95% CI = 0.63-0.75), but not with formula consumption (adjusted PR = 1.09; 95% CI = 0.99-1.20). Conclusions: Feeding babies prelacteal foods shortens exclusive breastfeeding duration and increases the likelihood of formula consumption in children under six months of age in LMICs. Pro-breastfeeding interventions must be prioritized during antenatal care and throughout the stay in the maternity facility to properly protect, support, and promote exclusive breastfeeding since birth. Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests. (Copyright © 2022 by the Journal of Global Health. All rights reserved.)
Databáze:	MEDLINE
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