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Promotion and prelacteal feeding of breastmilk substitutes among mothers in Kathmandu Valley, Nepal.
Matern Child Nutr. 2016 Apr; 12 Suppl 2:8-21.MC

Abstract

In 1992, Nepal passed the Mother's Milk Substitutes (Control of Sale and Distribution) Act in order to regulate the sale, distribution and promotion of substitutes for breastmilk within Nepal, in an effort to protect and promote breastfeeding. Helen Keller International, in collaboration with Nepal's Ministry of Health and Population's Child Health Division, implemented a study to assess mothers' exposure to promotions for and utilization of breastmilk substitutes in Kathmandu Valley, Nepal. A health facility-based, cross-sectional survey was conducted among 304 mothers being discharged after delivery. Prelacteal feeding of breastmilk substitutes is prevalent (55.9% of mothers, n = 170). Reported recommendations during antenatal checks and after delivery from health professionals to use breastmilk substitutes were prevalent, occurring among 47.4% (n = 144) of mothers; rates of these recommendations were significantly higher for mothers that delivered in private health facilities, as compared with public (67.7% vs. 38.0%, P < 0.001). Mothers that received a recommendation to use a breastmilk substitute from a health worker were 16.7 times more likely to provide a prelacteal feed of a breastmilk substitute, as compared with mothers that did not receive a recommendation (P < 0.001). Few mothers reported observation of commercial advertisements for breastmilk substitutes inside a health facility (reported by 3.6% of mothers). No mothers reported receiving a sample of a breastmilk substitute, bottle or teat from a health professional. More information is needed to determine why there is such a high rate of health worker recommendations for breastmilk substitute use in the first few days after delivery.

KEY MESSAGES

While utilization of breastmilk substitutes is low among mothers of young children in Nepal, prelacteal feeding of breastmilk substitutes is highly prevalent in Kathmandu Valley. Reported recommendations from health professionals to use breastmilk substitutes are common (over 40%) and are associated with prelacteal feeding among Nepal mothers included in this study. Provision of lactation management training to health workers and monitoring their practices regularly could strengthen breastfeeding counselling, aid in reducing high rates of prelacteal feeding and contribute to improved infant feeding practices.

Authors+Show Affiliations

Helen Keller International, Asia Pacific Regional Office, Phnom Penh, Cambodia.Consultant to Helen Keller International.Helen Keller International, Kathmandu, Nepal.Ministry of Health and Population, Kathmandu, Nepal.Helen Keller International, Kathmandu, Nepal.Helen Keller International, Washington, DC, USA.Helen Keller International, Washington, DC, USA.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27061953

Citation

Pries, Alissa M., et al. "Promotion and Prelacteal Feeding of Breastmilk Substitutes Among Mothers in Kathmandu Valley, Nepal." Maternal & Child Nutrition, vol. 12 Suppl 2, 2016, pp. 8-21.
Pries AM, Huffman SL, Adhikary I, et al. Promotion and prelacteal feeding of breastmilk substitutes among mothers in Kathmandu Valley, Nepal. Matern Child Nutr. 2016;12 Suppl 2:8-21.
Pries, A. M., Huffman, S. L., Adhikary, I., Upreti, S. R., Dhungel, S., Champeny, M., & Zehner, E. (2016). Promotion and prelacteal feeding of breastmilk substitutes among mothers in Kathmandu Valley, Nepal. Maternal & Child Nutrition, 12 Suppl 2, 8-21. https://doi.org/10.1111/mcn.12205
Pries AM, et al. Promotion and Prelacteal Feeding of Breastmilk Substitutes Among Mothers in Kathmandu Valley, Nepal. Matern Child Nutr. 2016;12 Suppl 2:8-21. PubMed PMID: 27061953.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Promotion and prelacteal feeding of breastmilk substitutes among mothers in Kathmandu Valley, Nepal. AU - Pries,Alissa M, AU - Huffman,Sandra L, AU - Adhikary,Indu, AU - Upreti,Senendra Raj, AU - Dhungel,Shrid, AU - Champeny,Mary, AU - Zehner,Elizabeth, PY - 2015/02/03/received PY - 2015/04/08/revised PY - 2015/05/05/accepted PY - 2016/4/11/entrez PY - 2016/4/12/pubmed PY - 2017/1/4/medline KW - Nepal KW - breastfeeding KW - breastmilk substitutes KW - prelacteal feeding SP - 8 EP - 21 JF - Maternal & child nutrition JO - Matern Child Nutr VL - 12 Suppl 2 N2 - UNLABELLED: In 1992, Nepal passed the Mother's Milk Substitutes (Control of Sale and Distribution) Act in order to regulate the sale, distribution and promotion of substitutes for breastmilk within Nepal, in an effort to protect and promote breastfeeding. Helen Keller International, in collaboration with Nepal's Ministry of Health and Population's Child Health Division, implemented a study to assess mothers' exposure to promotions for and utilization of breastmilk substitutes in Kathmandu Valley, Nepal. A health facility-based, cross-sectional survey was conducted among 304 mothers being discharged after delivery. Prelacteal feeding of breastmilk substitutes is prevalent (55.9% of mothers, n = 170). Reported recommendations during antenatal checks and after delivery from health professionals to use breastmilk substitutes were prevalent, occurring among 47.4% (n = 144) of mothers; rates of these recommendations were significantly higher for mothers that delivered in private health facilities, as compared with public (67.7% vs. 38.0%, P < 0.001). Mothers that received a recommendation to use a breastmilk substitute from a health worker were 16.7 times more likely to provide a prelacteal feed of a breastmilk substitute, as compared with mothers that did not receive a recommendation (P < 0.001). Few mothers reported observation of commercial advertisements for breastmilk substitutes inside a health facility (reported by 3.6% of mothers). No mothers reported receiving a sample of a breastmilk substitute, bottle or teat from a health professional. More information is needed to determine why there is such a high rate of health worker recommendations for breastmilk substitute use in the first few days after delivery. KEY MESSAGES: While utilization of breastmilk substitutes is low among mothers of young children in Nepal, prelacteal feeding of breastmilk substitutes is highly prevalent in Kathmandu Valley. Reported recommendations from health professionals to use breastmilk substitutes are common (over 40%) and are associated with prelacteal feeding among Nepal mothers included in this study. Provision of lactation management training to health workers and monitoring their practices regularly could strengthen breastfeeding counselling, aid in reducing high rates of prelacteal feeding and contribute to improved infant feeding practices. SN - 1740-8709 UR - https://www.unboundmedicine.com/medline/citation/27061953/Promotion_and_prelacteal_feeding_of_breastmilk_substitutes_among_mothers_in_Kathmandu_Valley_Nepal_ L2 - https://doi.org/10.1111/mcn.12205 DB - PRIME DP - Unbound Medicine ER -