PREVALENCE OF PRELACTEAL FEEDING PRACTICE IN WARDHA AND THE EFFECT OF ANTENATAL EDUCATION ON IT
Tushar Jagzape, Amol Lohkare, Jayant Vagha, Bhavana B. Lakhkar
Department of Pediatrics, Sawangi, Wardha, Maharashtra. India
Address for Correspondence
Dr Bhavana B. Lakhkar, Professor and HOD, Dept of Pediatrics, Sawangi (m), Wardha, Maharashtra. India
Abstract
The study aims at determining the prevalence of prelacteal feed in patients presenting at AVBRH, to study the effect of breast feeding education and to see whether sex of child has any influence over it. Mothers with babies below 6 months who presented to outpatient of AVBRH were interrogated about their place of delivery, feeding education during antenatal period, whether they gave prelacteal feed and if yes, what feed was given. Details of baby and mothers responses were noted. One hundred and eighty mothers were included in study. Total of 82 (43.2%) babies were given prelacteal feeds of which 63% were females. The practice of prelacteal feed was compared in babies born in AVBRH and outside as feeding education is given in our hospital which is not so commonly in given in other hospitals. Among those given prelacteal feeds, only 26.8% were inborn whereas the rest were outborn babies. Also female babies received prelacteal feed more as compared to boys. Thus, feeding education especially during antenatal period can reduce the prevalence of prelacteal feeds.
Introduction
In recent years, importance of breast-feeding has tremendously increased due to its advantages to both mother and baby. The hospitals, which promote breast-feeding, are recognized as Baby Friendly Hospitals and AVBRH, Sawangi is one of them. Ten steps of successful lactation have been given by WHO and UNICEF in their joint statement of 1988 (1). All baby friendly hospitals are supposed to follow these steps. In AVBRH mother's education about breast-feeding starts during antenatal period and is executed by Medical and Nursing students. These students attend antenatal clinic and are trained to provide structured feeding education. Following advices are given: Breast milk is best for your baby. It is best started within ½ an hour of birth as it gives a protective umbrella to baby right at birth. Any thing like honey, sugar water, milk or even warm water given before breast milk can harm the baby as it can cause infection specially diarrhea. Baby should be exclusively breast fed till 6 months of life till then not even water or vitamin drops are needed. Any kind of milk other than breast milk, bottle, nipple, poopse are harmful to baby. Baby should always be kept in the same bed as mother as it helps in establishing milk formation. Baby should be fed on demand that means whenever she/he cries breast milk should be offered. The practice of giving prelacteal feeds like glucose water, sugar water, honey etc is widely prevalent in rural areas. It is an unhealthy practice as it can cause infection in baby and also delays establishment of lactation. This study was done to see the effect of feeding education to mother on the practice of prelacteal feed to newborns.
Methods & Materials
All the mothers with babies less than 6 months who presented to OPD over 3 months period from 1st April 2007 to 31st June 2007 were included in the study. Mothers were asked whether they received breast-feeding advice during antenatal period specially about prelacteal feeding. Then they were asked about their education and delivery details. If prelacteal feed was given to the baby, it was noted and content of this feed also was asked and response was noted. Babies who were low birth weight or preterm or were admitted in NICU due to some reason after birth were excluded from study. Prevalence of prelacteal feeds in these babies and factors such as mother's education, antenatal feeding advice, baby's gender were analyzed. Statistical method used was SPSS.
Results
Total 214 mothers were interrogated. Male:Female babies were 106:108. Prelacteal feed was not given in 56.8% babies. Female babies were given more prelacteal feeds as compared to male babies as depicted in Table 1. The most common prelacteal feed was honey followed by boiled water, glucose water and sugar water.

Table 1: Factors associated with Prelacteal feeds

Babies with no prelacteal feed Babies with prelacteal feed Don't know P value
Males
Females
63 (58.3%)
45 (41.7%)
30 (36.6%)
52 (63.4%)
13 (54.2%)
11 (45.8%)
<0.05
Inborn babies
Outborn babies
89 (82.4%)
19 (17.6%)
22 (26.8%)
50 (73.2%)
12 (35.3%)
22 (64.7%)
<0.05
Antenatal feeding education 73 (67.6%) 20 (24.4%)   <0.01
Educated mother 88 (81.4%) 48 (58.5%)   <0.01
Total 108 82    


Discussion
The practice of giving prelacteal feed to baby is a traditionally accepted culture in India. In the report of nationwide study by Breast Feeding Promotion Network of India (BPNI), prevalence of prelacteal feed was found to be 49% (2) which is almost same as our study. Other study done in Wardha rural population also found prevalence to 45% (3), in Chandigarh urban slums was 40% (4) and in a study in 1997, it was 100 % in Cuttack mothers (5). However BPNI study was in 2002, Kumar et al study is in 2005 and present study is in 2007 (2,4), it is possible that practices are changing for better, over the years. Regional differences may also account for this change. In our study, about double the number of females as compared to males received prelacteal feed. This may be due to mothers being more eager to give breast milk to boys than girls.

Honey was most common prelacteal feed in our study similar to the BPNI study (2). Other studies also found gur water and cow's milk as common prelacteal feeds(3).

In the present study, 72.35% of inborn babies did not get prelacteal feed which is similar to the Chandigarh study (4). This again emphasizes the importance of health education and also institutional delivery. Once again this study proves benefits of formal education to mother. Similar positive effect of maternal literacy was found in the Chandigarh study.

Study by Diwakar et al (6) scientifically proves that prelacteal feeds are not required as in term AGA babies blood sugar is well maintained without any other feed than breast milk. If we have to discontinue prelacteal feeding practice from society, health education during antenatal care is a must.

Thus to conclude, education of mothers during antenatal care can lead to successful exclusive breast feeding practices.
Funding
None
Conflict of Interest
None
References :
  1. World Health Organization (WHO). Bridging the gaps - The world health report 1995.
  2. Gupta A, Gupte YP. Status of infant and young child feeding in 49 districts of India-A national report of quantitative study. Breast Feeding Promotion Network of India (BPNI) 2003.
  3. Kishore S, Garg BS. Practice of prelacteal feeding in a rural community. Indian J Public Health. 1999; 43: 144-7.
  4. Kumar D, Agarwal N, Swami HM. Socio-demographic correlates of breast-feeding in urban slums of Chandigarh. Indian J Med Sci. 2006; 60: 461-6.
  5. Mishra S, Mishra BK, Tandon J. Prelacteal feeding practices of children : a case study on mothers of Cuttack (Orissa). Indian J Preventive & Social Med. 1997; 28: 74-8.
  6. Diwakar KK, Sasidhar MV. Plasma glucose levels in term infants who are appropriate size for gestation and exclusively breast fed. Arch Dis Child Fetal Neonatal Ed. 2002; 87: F46-8.
Last Updated : Tuesday, December 01, 2009 Vol 6 Issue 12 Art #56
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Jagzape T, Lohkare A, Vagha J, Lakhkar B B. PREVALENCE OF PRELACTEAL FEEDING PRACTICE IN WARDHA AND THE EFFECT OF ANTENATAL EDUCATION ON IT . Pediatric Oncall [serial online] 2009[cited 2009 December 1];6. Art #56. Available From : http://www.pediatriconcall.com/Journal/Article/FullText.aspx?artid=265&type=J&tid=&imgid=&reportid=150&tbltype=
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