Prelacteal feeding practices in Pakistan: a mixed-methods study.

Area of Science:

• Public Health
• Maternal and Child Health
• Sociology

Background:

• Prelacteal feeding, administering substances before breastfeeding, is prevalent in Pakistan.
• This practice is linked to increased neonatal morbidity and mortality due to delayed breastfeeding initiation.

Purpose of the Study:

• To investigate the social and cultural factors influencing prelacteal feeding practices in Pakistan.

Main Methods:

• A mixed-method approach combining data from the Pakistan Demographic and Health Survey (PDHS) 2012-13 with qualitative interviews.
• Quantitative analysis involved logistic regression on a subset of 1361 dyads (children 0-23 months).
• Qualitative data were gathered through in-depth interviews with six mothers and six healthcare providers, analyzed using NVivo.

Main Results:

• A majority of children (64.7%) received prelacteal feeding, commonly milk other than breast milk, honey, or sugar water.
• Factors associated with prelacteal feeding included maternal primary education and deliveries in private health facilities.
• Conversely, birth at public health facilities and delayed breastfeeding initiation were associated with lower rates of prelacteal feeding.

Conclusions:

• Prelacteal feeding is an established social norm in Pakistan, influenced by cultural traditions and access to substances.
• Effective breastfeeding promotion policies must consider these deeply ingrained customs to drive behavioral change.