Determinants of given anything other than breast milk for neonates in Ethiopia: a multilevel modeling complex sample

Nigusie Selomon Tibebu1, Tigabu Desie Emiru2, Chalie Marew Tiruneh2

  • 1Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Po-Box: 272, Debre Tabor, Ethiopia. dtu@dtu.edu.et.

BMC Pediatrics
|June 16, 2025
PubMed

Insights

Prelacteal feeding, giving non-breast milk items to newborns, impacts exclusive breastfeeding rates. This study identified Catholic religion, timely breastfeeding initiation, Cesarean delivery, and pastoralist regions as key predictors in Ethiopia.

Area of Science:

  • Public Health
  • Maternal and Child Health
  • Epidemiology

Background:

  • Prelacteal feeding, defined as administering non-breast milk substances within the first three days postpartum, poses a significant challenge to optimal infant nutrition.
  • This practice negatively affects the initiation and exclusivity of breastfeeding, particularly in developing nations.

Purpose of the Study:

  • To investigate the individual and community-level determinants of prelacteal feeding practices among neonates in Ethiopia.

Main Methods:

  • A multilevel, population-based, cross-sectional study utilizing data from the 2019 Ethiopian Demographic and Health Survey.
  • A weighted sample of 24,252 participants was analyzed using multilevel modeling to account for data hierarchy.
  • Statistical significance was determined using a p-value threshold of < 0.05 in multivariable analyses.

Main Results:

  • Catholic religion affiliation was associated with lower odds of prelacteal feeding (Adjusted Odds Ratio [AOR] = 0.05).
  • Timely initiation of breastfeeding (AOR = 4.44) and Cesarean delivery (AOR = 3.94) were significantly associated with increased odds of prelacteal feeding.
  • Living in pastoralist regions was a strong predictor, with higher odds of prelacteal feeding (AOR = 6.39).

Conclusions:

  • Prelacteal feeding in Ethiopia is influenced by a complex interplay of individual characteristics (religion, delivery method, breastfeeding initiation) and community-level factors (region type).
  • Strengthening maternal health services and promoting early and exclusive breastfeeding are crucial interventions.
  • Equitable distribution of maternal health services across regions, with a specific focus on pastoralist areas, is recommended to reduce prelacteal feeding rates.
Abstract