Prelacteal and early formula feeding increase risk of infant hospitalisation: a prospective cohort study

Abstract

ObjectiveTo ascertain the relationship between prelacteal feeding, early formula feeding and adverse health outcomes, especially hospitalisation during the first year of life.DesignMulticentre prospective cohort study.SettingSix hospitals across three cities in Vietnam.PatientsA total of 2030 pregnant women were recruited at 24–28 weeks of gestation and followed up at hospital discharge, 1, 3, 6 and 12 months post partum.Main outcome measuresRates of infant hospitalisation, diarrhoea and lower respiratory tract infection during the first 12 months.ResultsFor the final complete sample (n=1709, 84%), about one-quarter of the infants experienced diarrhoea (25.5%) or were admitted to hospital with at least one episode (24.8%), and almost half (47.6%) the cohort contracted lower respiratory tract infection by 12 months. The prevalence of prelacteal feeding was high (56.5%) while formula feeding was common (79.5%) before hospital discharge, both of which increased the risks of adverse health outcomes particularly hospitalisation by approximately 1.5-fold, with adjusted OR (95% CI) 1.43 (1.09 to 1.88) and 1.48 (1.07 to 2.05), respectively for these infants by 12 months, when compared with others who were exclusively breast fed.ConclusionsPrelacteal feeding and early formula feeding before hospital discharge are associated with higher risks of infection and hospital admission in Vietnamese infants. Support for exclusive breast feeding should be provided to mothers to avoid the adverse consequences of giving formula milk and prelateal foods.

Determinants of Breastfeeding Duration in Shiraz, Southwest Iran

“…3 Adjusted for the mother's education, the mother's pre-pregnancy employment status, birth weight, pacifier used, delivery method, parity, the mother's pre-pregnancy body mass index (BMI), time until the first breastfeed, mother taught how to position and attach, prelacteal feed given, formula given in hospital, infant demand fed at 3 months, infant demand fed at 4 months. 4 Adjusted for the mother's age, the mother's education, the mother's pre-pregnancy employment status, birth weight, pacifier used, delivery method, parity, time until the first breastfeed, mother taught how to position and attach, formula given in hospital, infant demand fed at 1 month, infant demand fed at 3 months, infant demand fed at 4 months. AHR, adjusted hazards ratio; CI, confidence interval; NS, not significant in the adjusted model.…”

“…The explanatory variables examined as potential determinants were derived from the literature and included maternal and infant characteristics such as maternal age, the mother's level of education, the mother's employment status, infant weight, the use of a pacifier; and biomedical and hospital practices, including the method of delivery, parity, body mass index (BMI) before pregnancy, antenatal class attendance, time since birth of the first breastfeed, whether the mother was taught how to attach, whether the infant was given a prelacteal feed of formula while in hospital, and 'feeding on demand' at one, three, and four months [4][5][6] (Supplementary Materials Table S1).…”

“…Exclusively breastfed infants experience better health than those who are minimally breastfed or exclusively formula fed [1][2][3]. Infants who are not exclusively breastfed for the first months of their lives and are given other foods are more likely to be admitted to hospital with infections [4][5][6]. The World Health Organization (WHO), United Nations Children's Fund (UNICEF), the American Academy of Pediatrics, and other international authorities recommend exclusive breastfeeding for the first six months, followed by the introduction of appropriate complementary foods.…”

Associations between infant and young child feeding practices and acute respiratory infection and diarrhoea in Ethiopia: A propensity score matching approach

“…Evidence from sub-Saharan African [11,13,15] and Asian [10,16] countries have indicated that inappropriate introduction of complementary foods and bottle feeding were associated with the onset of diarrhoea among infants and young children. This is potentially due to the replacement of irreplaceable human milk by complementary foods and contamination of the food and/or teat/nipple of the bottle [17,18].…”

Improving Breastfeeding by Empowering Mothers in Vietnam: A Randomised Controlled Trial of a Mobile App

“…In a large cohort study ( n = 1709), the prevalence of prelacteal feeding was high (56.5%) and formula feeding was common (79.5%) before hospital discharge. This increased the risks of hospitalisation by 2 months for prelacteal feeds and infant formula use [ 48 ].…”