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

Objective: Prelacteal 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 setting A population-based cross-sectional study based on Demographic and Health Survey data Setting: Papua New Guinea Participants A total weighted sample of 4399 women was included in the study. Main outcome measures Prelacteal feeding, modeled using multivariable logistic regression. Results: About 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. Conclusion: Our 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.