title: Initiation of Breastfeeding and Factors Associated with Prelacteal Feeds in Central Nepal.
abstract: BACKGROUND
  Prelacteal feeds and delayed initiation of breastfeeding may lead to undernutrition of the infant but are still prevalent in many countries.
  
  
  OBJECTIVE
  A prospective cohort community-based study was conducted in central Nepal to ascertain the rate of early breastfeeding initiation and factors associated with the introduction of prelacteal feeds.
  
  
  METHODS
  Breastfeeding information was collected from 639 women who recently gave birth in the Kaski district of central Nepal. Backward stepwise logistic regression analysis was performed to determine factors associated with the use of prelacteal feeds.
  
  
  RESULTS
  The incidence of prelacteal feeds was 9.1%, with infant formula being the most common prelacteal food. Approximately 67% and 90% of mothers breastfed within 1 hour and 4 hours of delivery, respectively. Women who reside in urban areas (odds ratio [OR] = 2.68; 95% confidence interval [CI], 1.35-5.39), first-time mothers (OR = 2.15; 95% CI, 1.15-4.02), and those who underwent cesarean section (OR = 10.10; 95% CI, 5.47-18.67) were more likely to give prelacteal feeds to their infants.
  
  
  CONCLUSIONS
  The early initiation of breastfeeding with colostrum as the first feed was common in the study area. The introduction of prelacteal feeds was associated with urban residency, first-time motherhood, and cesarean delivery.
authors.affiliation: School of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal School of Public Health, Curtin University, Perth, Western Australia, Australia.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Karkee
authors.affiliation: School of Public Health, Curtin University, Perth, Western Australia, Australia Andy.Lee@curtin.edu.au.
authors.forename: Andy H
authors.initials: AH
authors.lastname: Lee
authors.affiliation: School of Public Health, Curtin University, Perth, Western Australia, Australia.
authors.forename: Vishnu
authors.initials: V
authors.lastname: Khanal
authors.affiliation: School of Public Health, Curtin University, Perth, Western Australia, Australia.
authors.forename: Colin W
authors.initials: CW
authors.lastname: Binns
keywords: Nepal; breastfeeding; initiation; prelacteal feeds