title: Prevalence and factors associated with prelacteal feeding in Western Nepal.
abstract: BACKGROUND
  Newborn infants are often given prelacteal feeds in Nepal despite government policies encouraging exclusive breastfeeding for the first six months of life.
  
  
  OBJECTIVE
  This study investigated the prevalence, reasons, types and factors associated with prelacteal feeding in the south-western region of Nepal.
  
  
  METHODS
  Information on prelacteal feeding was obtained from 735 recently delivered women who were recruited for a prospective community-based cohort study conducted during 2014 in the Rupandehi district of Nepal. Factors associated with prelacteal feeding were assessed using logistic regression analysis.
  
  
  RESULTS
  A total of 225 (30.6%) mothers reported giving prelacteal feeds to their infants. The most popular prelacteal food was formula milk (41.7%), followed by cow or buffalo milk (26.6%), and sugar/glucose water (12.4%). Caesarean delivery (17.3%), cultural preference (16.4%) and being tired after childbirth (10.6%) were the most commonly cited reasons. Almost half (48%) of the mothers were advised by their mother/mother-in-law on prelacteal feeding method. Higher parity (adjusted odds ratio (OR) 2.05; 95% confidence interval (CI) 1.18-3.54), low birthweight (OR 1.97; 95% CI 1.23-3.16), caesarean delivery (OR 3.70; 95% CI 2.37-5.80) and wealthy status (OR 2.49; 95% CI 1.52-4.06) were associated with prelacteal feeding.
  
  
  CONCLUSIONS
  Nearly one-third of the infants in this study were given prelacteal feeds. Future breastfeeding promotion programmes should focus on the mothers with low birthweight infants, of high parity, from a wealthy family and those who had caesarean delivery.
authors.affiliation: School of Public Health, Curtin University, Perth, Australia. Electronic address: khanal.vishnu@gmail.com.
authors.forename: Vishnu
authors.initials: V
authors.lastname: Khanal
authors.affiliation: School of Public Health, Curtin University, Perth, Australia.
authors.forename: Andy H
authors.initials: AH
authors.lastname: Lee
authors.affiliation: School of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Karkee
authors.affiliation: School of Public Health, Curtin University, Perth, Australia.
authors.forename: Colin W
authors.initials: CW
authors.lastname: Binns
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001903:Bottle Feeding / Q000706:statistics & numerical data*; D001942:Breast Feeding / Q000706:statistics & numerical data*; D002417:Cattle; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007223:Infant; D007225:Infant Food; D007407:Interviews as Topic; D008423:Maternal Age; D009035:Mothers / Q000523:psychology*; D009390:Nepal / Q000453:epidemiology; D036801:Parturition; D049590:Postpartum Period; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Breastfeeding; Cohort study; Infant feeding; Nepal; Prelacteal feeds