title: Factors associated with prelacteal feeding and timely initiation of breastfeeding in hospital-delivered infants in India.
abstract: BACKGROUND
  Early initiation of breastfeeding continues to remain uncommon in India, and the practice of giving prelacteal feeding is still prevalent.
  
  
  OBJECTIVE
  We determined the rates of timely initiation of breastfeeeding and prelacteal feeding, factors associated with these practices, and the association between the 2.
  
  
  METHODS
  Five hundred women who delivered live infants at a tertiary care hospital in India were included. The study outcomes were timely initiation of breastfeeding and prelacteal feeding. Multiple logistic regression was used to estimate the odds ratios (OR) of both timely initiation and prelacteal feeding.
  
  
  RESULTS
  Timely initiation and prelacteal feeding rates were 36.4% and 16.9%, respectively. Factors associated with timely initiation were higher maternal education (adjusted OR 2.00, 95% confidence interval [CI] 1.10, 3.60), counseling on breastfeeding during antenatal visits (adjusted OR 3.60, 95% CI 2.00, 6.20); absence of obstetric problems (adjusted OR 3.48, 95% CI 1.68, 7.23); vaginal deliveries (adjusted OR 37.57, 95% CI 17.40, 81.11); and increasing gestational age of newborn (adjusted OR 1.20, 95% CI 1.00, 1.40). Factors significantly associated with higher rates of prelacteal feeding were lower maternal education (adjusted OR 2.13, 95% CI 1.06, 4.35), Muslim religion (adjusted OR 2.27, 95% CI 1.18, 4.36), and delivery by cesarean section (adjusted OR 2.56, 95% CI 1.56, 4.19). There was a significant association between delayed initiation and prelacteal feeding (P < .001).
  
  
  CONCLUSIONS
  The rates of timely initiation of breastfeeding were undesirably low, and the practice of prelacteal feeding existed even in tertiary care hospitals. Identifying factors associated with these practices might be a strategy for optimizing timely initiation and discouraging prelacteal feeding in hospital-delivered babies.
authors: 1Masters Clinical Epidemiology, University of Pennsylvania.
authors: Archana
authors: A
authors: Patel
authors: Anita
authors: A
authors: Banerjee
authors: Amol
authors: A
authors: Kaletwad
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric; D005260:Female; D006266:Health Education / Q000458:organization & administration; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D011295:Prenatal Care; D012959:Socioeconomic Factors; D062606:Tertiary Care Centers / Q000458:organization & administration*; D013997:Time Factors
keywords: India; breastfeeding; infant feeding; prelacteal; timely initiation