Exploring the factors associated with prelacteal feeding in Papua New Guinea: a population-based cross-sectional study

ObjectivePrelacteal feeds disrupt early breastfeeding initiation and exclusive breastfeeding and increase the risk of childhood illnesses and under-five mortality. Despite its negative health outcomes, prelacteal feeding prevails in Papua New Guinea (PNG). This study aimed to investigate the factors associated with prelacteal feeding among women in PNG. Design and settingA population-based cross-sectional study based on Demographic and Health Survey data SettingPapua New Guinea ParticipantsA total weighted sample of 4399 women was included in the study. Main outcome measuresPrelacteal feeding, modeled using multivariable logistic regression. ResultsAbout 10% (95% CI: 9 to 11) of women provided prelacteal feeds to their infants in PNG. The most frequently reported prelacteal feed was plain water (71.7%), followed by grains (eg, noodles) (47.1%), dark green leafy vegetables (42.1%), and soup (39.7%). Women with no formal (AOR 1.4, 95% CI: 1.0 to 3.0) or primary education (AOR 1.5, 95% CI: 1.0 to 2.9), from the Islands region (AOR 2.3, 95% CI: 1.5 to 3.5), who had a cesarean section (AOR 4.1, 95% CI: 2.4 to 7.2), and who had given birth at home or in the village (AOR 3.7, 95% CI: 2.1 to 6.8) had higher odds of providing prelacteal feeds. No statistically significant association was found between immediate newborn skin-to-skin contact after birth and prelacteal feeding. ConclusionOur study underscores the role of sociodemographic and healthcare system factors in prelacteal feeding. Strengthening healthcare providers capacity to increase mothers awareness of optimal breastfeeding and promote more health facility births is warranted. Comprehensive breastfeeding education should also be promoted at antenatal clinics and during outreach healthcare activities. Strengths and limitations of the studyO_LIThe rigor of the methodological approach and representativeness of the survey render its results and recommendations generalisable to the country. C_LIO_LIThe studys findings, based on appropriate estimation adjustments and sample design, are representative of female population in PNG; thus could guide policy development and design for effective infant and child feeding interventions. C_LIO_LIThe studys cross-sectional nature means that a temporal relationship cannot be established between the outcome and independent variables. C_LIO_LIPrelacteal feeding was assessed based on the maternal self-report, which might have resulted in desirability bias; mothers may be less likely to report that they have provided prelacteal feeds while knowing its adverse outcomes. C_LIO_LIThe DHS did not collect some important information, such as maternal beliefs, misconceptions, knowledge, attitudes, and practices towards breastfeeding, which could impact prelacteal feeding in this context. C_LI