Correlates of early initiation of breast feeding and prelacteal feeding: a cross-sectional study in Sindh province of Pakistan

OBJECTIVES: The objective of this study was to determine the prevalence and correlates of early initiation of breast feeding and prelacteal feeding in highly disadvantaged districts in Pakistan. DESIGN: This cross-sectional study design. SETTINGS: This study was carried out in twelve districts of the Sindh province of Pakistan. PARTICIPANTS: A total of 4800 mothers with children under 2 years, selected through a multistage random sampling method. DATA ANALYSIS: Bivariate association, survival analysis (Kaplan-Meier and Cox proportional hazard techniques), multivariate linear regression and the ordinary least square model were used. RESULTS: The results show that the prevalence of early initiation of breast feeding was 68% and prelacteal feeding was 32%. Adequate treatment, proper guidance at antenatal care visits, postpartum health check, normal birth with skilled birth attendants, institutional birth, skin-to-skin contact at birth and birth size were all associated with early breastfeeding initiation (p<0.001). The odds of early initiation of breast feeding after birth are higher if the respondents received proper guidance (OR 2.05; 95% CI 1.02 to 4.11) or made skin-to-skin contact (OR 10.65; 95% CI 6.82 to 16.65). Bivariate association between the prelacteal feeding and a set of correlates suggests that all variables under study were significantly associated with the outcome variable of interest at a 95% or higher significance level. The factors which significantly reduced the odds of prelacteal feeding were adequate treatment (OR 0.29; 95% CI 0.23 to 0.37) and postpartum health check (OR 0.65; 95% CI 0.53 to 0.80). CONCLUSION: Sudy concludes that the correlates like adequate treatment of mothers during labour, postpartum health check-up, normal birth with skilled birth attendants, institutional births and skin-to-skin contact between mother and the baby determine the early initiation of breast feeding and prelecteal feeding. Early initiation of breast feeding needs to be encouraged, and communities must be educated against the use of prelacteal feeding.