Pre-lacteal Feeding Among Infants Within the First Week of Birth in Eastern Uganda: Evidence From a Health Facility-based Cross-sectional Study

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Abstract Background: Pre-lacteal feeding hinders early initiation of breastfeeding and exclusive breastfeeding but is understudied in Uganda. We examined the prevalence and factors associated with pre-lacteal feeding among postpartum mothers in Kamuli district in rural eastern Uganda.Methods: We conducted a cross-sectional study at four large healthcare facilities and randomly sampled mother-baby pairs attending postnatal care clinics. Pre-lacteal feeding was defined as giving anything to eat or drink to a newborn other than breast milk within the first 0-3 days of life. Data were collected using a researcher-administered questionnaire and summarized using frequencies and percentages. The Chi-squared, Fisher’s exact, and Student’s t-tests were used for comparison while the factors independently associated with pre-lacteal feeding were determined using modified Poisson regression analysis, reported as adjusted prevalence risk ratio (aPRR) with corresponding 95% confidence intervals (CI). Results: Of 875 participants enrolled, 319 (36.5%) practiced pre-lacteal feeding. Pre-lacteal feeding was associated with being unemployed (aPRR, 0.70; 95% CI, 0.50-0.91), married (aPRR, 0.71; 95% CI, 0.58-0.87), receiving health education on infant feeding practices (aPRR, 0.72; 95% CI, 0.60-0.86), spontaneous vaginal delivery (aPRR, 0.76; 95% CI, 0.61-0.95), health facility delivery (aPRR, 0.73; 95% CI, 0.60-0.89), knowing that pre-lacteal feeding could lead to difficulties in breathing (aPRR, 0.70; 95% CI0.57-0.86), attendance of antenatal care at public health facility (aPRR, 2.41; 95% CI, 1.71-3.39), and a travel distance of 5 km or beyond from home to health facility (aPRR, 1.46; 95% CI, 1.23-1.72).Conclusion: We observed a high prevalence of pre-lacteal feeding among postpartum mothers in rural eastern Uganda. Pre-lacteal feeding is less likely among the unemployed and married mothers, those who received health education on infant feeding practices, had a spontaneous vaginal delivery, had delivered in a health facility, and knew that pre-lacteal feeding could lead to breathing difficulties in the newborn. Conversely, pre-lacteal feeding is more likely among mothers who attend antenatal care visits at public health facilities and those who travel 5 km or beyond to access health facilities.

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