Prelacteal feeding, the feeding a newborn substances or liquids before breastfeeding, is a common cultural practice in Pakistan, but is associated with neonatal morbidity and mortality because it delays early initiation of breastfeeding. In this study, we sought to examine the social and cultural factors associated with prelacteal feeding in Pakistan. This mixed-method study used data from the Pakistan Demographic and Health Survey (PDHS) 2012–13. Findings from the survey were complemented by qualitative interviews with mothers and healthcare providers. In a subset of PDHS dyads (n = 1361) with children (0–23 months), descriptive statistics and bivariate and multivariable logistic regression analysis examined factors associated with prelacteal feeding. The qualitative study included in-depth interviews with six mothers and six health care providers, which were analyzed using NVivo software version 10. In PDHS, a majority of children (64.7%) received prelacteal feeding. The most common prelacteal food was milk other than breast milk (24.5%), while over a fifth (21.8%) of mothers reported giving honey and sugar water. Factors associated with prelacteal feeding included: birth at public health facilities (AOR 0.46, 95% CI 0.02, 0.95), maternal primary education (AOR 2.28, 95% CI 1.35, 3.85), and delayed breastfeeding initiation (AOR 0.03, 95% CI 0.01, 0.61). In our qualitative study, the major themes found associated with prelacteal feedings included: easy access to prelacteal substances at health facilities, deliveries in private health facilities, prelacteals as a family tradition for socialization, insufficient breast milk, Sunna of Holy Prophet, and myths about colostrum. These data indicate that prelacteal feeding is a well-established practice and social norm in Pakistan. Policies and interventions aimed at promoting breastfeeding need to take these customs into consideration to achieve the desired behavioral changes.

中文翻译：

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巴基斯坦的哺乳前喂养实践：混合方法研究。

哺乳前喂养，即母乳喂养前给新生儿喂食物质或液体，是巴基斯坦常见的文化习俗，但与新生儿发病率和死亡率相关，因为它会延迟母乳喂养的早期开始。在这项研究中，我们试图研究巴基斯坦与哺乳前喂养相关的社会和文化因素。这项混合方法研究使用了 2012-13 年巴基斯坦人口和健康调查 (PDHS) 的数据。调查结果还得到了对母亲和医疗保健提供者的定性访谈的补充。在有儿童（0-23 个月）的 PDHS 双人组（n = 1361）子集中，描述性统计以及双变量和多变量逻辑回归分析检查了与哺乳前喂养相关的因素。该定性研究包括对六名母亲和六名医疗保健提供者的深入访谈，并使用 NVivo 软件版本 10 进行分析。在 PDHS 中，大多数儿童 (64.7%) 接受了哺乳前喂养。最常见的哺乳前食物是母乳以外的牛奶（24.5%），而超过五分之一（21.8%）的母亲表示给予蜂蜜和糖水。与哺乳前喂养相关的因素包括：在公共卫生机构出生（AOR 0.46，95% CI 0.02，0.95）、母亲初等教育程度（AOR 2.28，95% CI 1.35，3.85）和延迟母乳喂养（AOR 0.03，95% CI） 0.01、0.61）。在我们的定性研究中，发现与哺乳前喂养相关的主要主题包括：在卫生设施中容易获得哺乳前物质、在私人卫生设施中分娩、哺乳前作为家庭社交传统、母乳不足、神圣先知的圣行以及有关神话的神话。初乳。这些数据表明，哺乳前喂养在巴基斯坦是一种既定的做法和社会规范。旨在促进母乳喂养的政策和干预措施需要考虑这些习俗，以实现预期的行为改变。