Prelacteal feeding practices and associated factors among mothers of children aged less than 24 months in Raya Kobo district, North Eastern Ethiopia: A cross-sectional study

Background: The harmful infant feeding practices of prelacteal feeding is widely practiced in Ethiopia. Hence, it is vital to appreciate the cultural basis and potential factors on infant feeding practices in different parts of Ethiopia. This study aimed to investigate prelacteal feeding practices and associated factors among mothers of children aged less than 24 months in Raya Kobo district, North Eastern Ethiopia. Methods: A quantitative community-based cross-sectional study supplemented by qualitative methods was employed. Sixty hundred thirty (630) mothers of children aged less than 24 months were selected by systematic random sampling technique. Descriptive statistics, bivariate and multivariable logistic regression analysis were employed to identify the factors associated with prelacteal feeding practices. Variables with a p-value < 0.05 were identified as statistically significant factors. Qualitative data was collected by focus group discussion and in-depth interview and analyzed using thematic frameworks. Results: The prevalence of prelacteal feeding was 38.8% (95% CI: 35.00%, 43.00%). Home delivery was a risk factor for practicing prelacteal feeding. Those mothers who gave birth at home were seven times more likely to practice prelacteal feeding as compared to mothers who delivered at health institutions (Adjusted Odd Ratio (AOR):7.10; 95% CI: 3.91, 12.98). Mothers who were not aware of the risks associated with prelacteal feeding were nearly four times more likely to practice prelacteal feeding as compared to knowledgeable mothers (AOR: 3.70; 95% CI: 2.44, 5.53). Late initiation of breastfeeding (after one hour of delivery) was also associated with prelacteal feeding practice (AOR: 2.70; 95% CI: 1.78, 3.99). The major reasons stated for providing prelacteal feeding were to prevent "evil eye" and illness and to "clean infant's stomach". Conclusion: Prelacteal feeding was commonly practiced in Raya Kobo district. Home delivery, delayed commencement of breastfeeding after birth and lack of awareness about the risks associated with prelacteal feeding were predictors of prelacteal feeding. Therefore, strengthening infant feeding counseling about the risks associated with prelacteal feeding, promoting institutional delivery and timely initiation of breastfeeding are important measures for preventing prelacteal feeding in Raya Kobo district.