Prevalence of and factors associated with early initiation of breastfeeding and prelacteal feeding among infants aged 6-12 months in Chitwan district, central Nepal

Breastfeeding is crucial for optimum growth and development of a child and is recognized as the most cost-effective intervention to reduce infant and child mortality. The World Health Organization (WHO) recommends initiation of breastfeeding within the first hour of childbirth and avoiding any prelacteal feeding. This study aimed to examine the prevalence of and factors associated with early initiation of breastfeeding and prelacteal feeding among infants aged 6–12 months in Chitwan district of central Nepal. A community-based cross-sectional study was conducted among 297 randomly selected mothers using face-to-face interviews. The prevalence of early initiation of breastfeeding and prelacteal feeding was assessed using frequency distribution, and their association with socio-demographic factors was examined using Chi-squared tests followed by multiple logistic regression at a 5% level of significance. The prevalence of early initiation of breastfeeding was 51.5% and prelacteal feeding was 40.06%.Prelacteal feeding was nearly universal (97.05%) among those who were born by cesarean section. The likelihood of early initiation was higher among the infants who were male child (adjusted odds ratio (AOR): 1.83; 95% confidence interval (CI): 1.12, 2.99), born to a family size > 4 (AOR: 2.03; 95% CI: 1.16, 3.55), and born to mothers who had received counseling on breastfeeding (AOR: 1.78; 95% CI: 1.08, 2.92); conversely, those born to non-Hindu family (AOR: 0.35; 95% CI: 0.16, 0.74) and born to primiparous mothers (AOR: 0.36; 95% CI: 0.20, 0.64). On the other hand, those born to non-Hindu families (AOR: 2.05; 95% CI: 1.01, 4.13), primiparous mothers (AOR: 1.78; 95% CI: 1.03, 3.07), and mothers with low decision-making authority (AOR: 1.94; 95% CI: 1.18, 3.20) had increased likelihood of prelacteal feeding. This study found that only about one in two infants received the recommended early initiation of breastfeeding, and the prevalence of prelacteal feeding was much higher than the national average. These results highlight the need for improved, culturally sensitive lactation support programs in health facilities and community-based interventions to promote the recommended breastfeeding practices. Stronger support is also needed for mothers who undergo caesarean sections to help them establish breastfeeding.