Individual and community-level factors associated with introducing prelacteal feeding in Ethiopia

Summary: Background: The undesirable effect of prelacteal feeding on children's health, growth, and development become a persistent health problem in low-income countries such as Ethiopia. It increases the risk of acquiring respiratory tract infections, diarrhea, and malnutrition. Without identifying and interrupting factors contributing to this practice, it may continue costing the lives of newborn children. Thus, this study to explores the individual and community-level factors that contribute to introducing prelacteal feeding and provides information on future improvement and policy decisions. Methods: We conducted a community-based quantitative cross-sectional study using secondary EDHS 2016 data collected from nine regions and two city administrations. We used 4,128 weighted samples of women with under-five children for this analysis. We applied a multilevel binary logistic regression to know the random, fixed, and mixed effects of prelacteal feeding. We used a P-value of <0.25 for select variables and a P-value of <0.05 to declare final associations. Results: From 4,128 mothers, 328.38 (7.95%) with 95% CI (7.14–8.81%) women reported prelacteal feeding. The highest prevalence was in Afar (43%), Somali (42%), Harari (26%), and Dire Dawa (22%). Factors such as health institutions delivery 0.69 (0.05–0.96), early initiation of breastfeeding 0.21 (0.17–0.28), middle economic status 0.63 (0.42–0.95), and greater than four ANCs 0.63 (0.45–0.90) showed an association with reduced prelacteal feeding, while the caesarian section was associated with increased prelacteal feeding 2.01 (1.17–3.47). Conclusion: Although prelacteal feeding deprives a newborn of vital nutrients and exposes infant to high mortality, women still practice it in Ethiopia. This shows that government commitment, policy intervention, and community mobilization for health education with motivated caregivers on prelacteal feeding are important.