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IJCRR - 4(5), March, 2012

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PREVAILING PRACTICES OF PRELACTEAL FEEDING IN RURAL AREA OF ARATHAWADA
REGION IN MAHARASHTRA STATE OF INDIA

Author: Sonali Gajanan Choudhari, Rajesh N. Lakde, Abhay Bhausaheb Mudey, Deepali S. Deo, Vinod L. Vedpathak, Prashant L. Dahire

Category: Healthcare

Abstract:Title: Prevailing practices of prelacteal feeding in rural area of Marathawada region in
Maharashtra state of India. Objective: To study prevailing practices of prelacteal feeding and
impact of various sociodemographic factors on it. Method \? A community based cross
sectional was conducted in rural area of Marathawada region in Maharashtra State of India. The
study participants were 262 mothers having youngest child in the age group of 0 to 12 months.
Questionnaire included sociodemographic structure of the family, the prelacteal practices
followed in youngest child. Results: Out of total participant mothers, 107 (40.84%) mothers
gave some kind of prelacteal feed to their baby while 155 (59.16%) did not give it. Literacy
status, type of family, socioeconomic status, place of delivery found to have impact on
prelacteal practices. Correlation with mode of delivery found to be non significant.
Conclusion: Ignorance, blindly following generation old beliefs, influence of elderly persons at
home, poverty were found to be various factors leading to prelacteal feeding and thereby
emerging as barriers to appropriate infant feeding practices.

Keywords: prelacteal, literacy, type of family, mode of delivery

Full Text:

INTRODUCTION
Childhood nutrition in most of the countries mostly originates from inadequate and faulty practices of feeding newborn and infant, coupled with exposure to contaminated environment.(1) As per BFHI, no food or drink other than for breast milk is to be given to newborn infant, unless medically indicated. It is now more than 15 years since the launch of BFHI and still the practice of Prelacteal feeds is prevalent in many developing countries and is mainly governed by different cultural norms prevalent.(2) In India also, prelacteal feeding is widely prevalent, since ancient times. Countrywide data from National Family Health SurveyIII (2005-2006) documented that as many as 57% women practiced prelacteal feeding.(3) The common substances used are honey, glucose, sugar water, Ghutti, castor oil, Cow? milk, Goat?s milk, Gangajal, Cow? urine or simply plain water.(2) Prelacteals should not be given to babies because of the following reasons.

1. Giving prelacteal feeds can lead to less frequent, less vigorous and less effective suckling at the breast since the baby feels less hungry. This in turn reduces milk production.

2. The baby is deprived of full benefits of colostrum.

3. Nipple confusion is common if prelacteal feeds are given in a bottle. Nipple confusion interferes with breastfeeding, making failure more likely.

4. Further contaminated feeds or feeding utensils, water and hands may cause infections.(4) Poor infant feeding practices are to a great extent a man made problem, which directly or indirectly contribute to infectious illnesses, malnutrition, and mortality in infants. Knowledge of various cultural practices associated with infant feeding forms an essential first step for any „need felt? intervention programme deigned to bring about positive behavioral change in infant health. (5) Considering this it was decided to study prevailing practices of prelacteal feeding and impact of various sociodemographic factors on it, in a rural area which formed the basis of a „need felt? educational intervention imparted thereafter.

MATERIAL AND METHODS
Study setting:-The present community based cross sectional study was undertaken in five randomly selected villages out of 10 surrounding villages around the rural medical college, in Marathawada region during February to April 2010. Study ParticipantsMothers having a youngest child as infant i.e. up to the age of 1 year were included in the study. Methodology The mothers having youngest child as infant i.e. in the age group of 0-12 months were first enlisted by house to house survey. Initially the pilot study was undertaken in one of the five villages for pretesting the proforma and necessary modifications were made accordingly. For identification, initial contact and to minimize the non-response, the help of medical social worker and anganwadi workers was obtained. All the enlisted mothers were called in „Anganwadi? with their children and were interviewed and interacted with the help of pretested and predesigned proforma. Questions were asked in local language. Out of total population of about 10237 in the selected five villages, 277 mothers were having a child up to 1 year of age. Out of these 277 mothers, 262 mothers were available for the interview. They had been told about the need and objectives of the present study and then only informed consent obtained from them for interview. Thus 262 participant mothers constituted the sample of study. The relevant information regarding the sociodemographic structure of the family, the prelacteal practices & beliefs followed in youngest child was recorded. At the end of interview, health education regarding importance of correct feeding practices was given and an attempt made to solve the problems associated with it. Statistical Analysis – It was done by using descriptive statistics and Chi square test.

RESULTS
In the present study mothers? age ranged from 19 to 33 years with mean age as 24.91±1.12 years. Out of total 262 participant mothers majority i.e. 139 (53.05%) were from 22 to 25 years age group followed by 58 (22.14%) in the age group 26 to 29 years. The literacy rate among mothers was 172 (65.64%) and majority 145 (55.34%) mothers were housewives. Type of family wise distribution showed 83 (31.68%) mothers belonged to nuclear family, 38 (14.5%) were from joint family and 141 (53.87%) had extended family. Most of the mothers 144 (54.96%) belonged to low socioeconomic class.

(Table I, Figure I) In the present study out of total 262 participant mothers, 107 (40.84%) mothers gave some kind of prelacteal feed to their baby while 155 (59.16%) did not. (Table II) Out of 90 illiterate mothers, 51 (56.67%) gave prelacteal feed to their baby. Among literate, out of 66 mothers educated up to primary, 25 (37.87%) fed prelacteal while out of 74 mothers educated up to secondary, 20 (27.03%) offered prelacteal to their baby. Similarly 7 (33.34%), 3 (42.86%) and 1 (25%) mothers educated up to higher secondary, graduate and post graduate respectively practiced prelacteal feeding. Thus out of 172 literate mothers, 56 (32.56 %) gave prelacteal feed to their baby. Significant association was observed between literacy status and prelacteal feeding (p 0.05).

DISCUSSION
Prelacteal feed is the substance or preparation which is given to the newborn, before he or she is put to breast. This practice of prelacteal feeding probably is a sort of compensation to feed the baby colostrum which is discarded for first few days by some communities.(2) In the present study, it was disheartening to note that in this age of information and communication, a very large number of mothers (40.84%) continue to administer prelacteal feeds to their baby. Fortunately 59.16% mothers did not feed it. Higher percentage of mothers feeding prelacteal to their baby was also observed in the studies by Hiwarkar P A et al (47.73%) (6), Kishore S and Garg B S (45%) (2), Bhale P and Jain S (38%) (7), Pai M et al (43.96%) (8) . Out of 90 illiterate mothers 56.67% gave prelacteal feed to their babies as compared to 32.56% literate mothers (p< 0.01). Kulkarni R N et al (9) also showed that higher percentage i.e. 68.7% of illiterate mothers had given prelacteal to their children as compared to 31.1% of literate

References:

1. Betran AP, de Onis M, lauer J A, Villar J. ecological study of effect of breastfeeding on infant mortality in Latin America. BM 2001; 323:303-6

2. Kishore S and Garg B S: “Practice of Prelacteal Feeding in a Rural Community”, Indian Journal of Public Health, Vol 43, No.4, Oct-Dec, 1999.

3. National Family Health Survey- III (2005-2006), Ministry of Health and Family Welfare, International Institute of Population Sciences, Mumbai, 2007.

4. Jayashree Mondakar, Rhishikesh Thakre, wasundhara Kanbur and Arminda Fernandez: “Lactation and Infant Nutrition”, Pediatrics Clinics of India, page 57-58, July 2001.

5. Sethi V K: “Infant Practices in a Relocated Slum- a Pilot Study”. Indian Pediatrics, Vol. 40:579-580, June 2003.

6. Hiwarkar P A, Aswar N R, Durge P M, Shendre M O : “Breastfeeding and Weaning Practices in Rural Mothers”. The Journal of Obstetrics and Gynecology of India, 1998.

7. Bhale P and Jain S: “Is Colostrum Really Discarded by Indian Mothers?” Indian Pediatrics, Vol. 36, October 1999.

8. Pai M et al: “A High Rate of Caesarean Section in an Affluent section of Chennai: Is It Cause for Concern?” The National Medical Journal of India. Vol. 12, No. 4:156-158, 1999.

9. Kulkarni R N, S Anjenaya, R Gurjar: “Breastfeeding Practices in an Urban Community of Kalamboli, Navi Mumbai”. Indian Journal of Community Medicine, Vol. 24, No. 4, Oct-December 2004, 179-180.

10. Parmar V R, M Salaria, B Poddar, K singh, H Ghotra and Sucharu: “Knowledge, Attitudes and Practice Regarding Breastfeeding at Chandigarh”. Indian Journal of Public Health, Vol.44, No. 4, OctoberDecember 2000.

11. Manju Rahi, D K Taneja, Amrita Mihra, N B Mathur and Suresh Bandhan: “Newborn Care Practices in an Urban Slum of Delhi”. Indian Journal of Medical Science, Vol. 60, No. 12, page 506-513, December 2006.

12. C R Banapurmath and A Selvamuthukumarasamy: “Breastfeeding and the first breastfeeds- correlation of initiation pattern and mode of delivery in 1279 hospital delivered babies”. Indian Pediatrics, Volume 32, page 1299- 1302, December 1995.

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