Breastfeeding and pre-lacteal feeding practices in Nepal: A review article

 A national study conducted in Nepal found that pre-lacteal feeding is mostly observed in Terai areas of Nepal. Promotion of ANC visit and Infant and Young Child Feeding (IYCF) practices are required for reducing pre-lacteal feeding practices. IYCF and breastfeeding practices are highly influenced by the knowledge and believe of people. Pre-lacteal feeding is mostly observed among women who had delivery in their home. In Nepal, beside inadequate frequency of breast feeding, too early or too late complementary feeding is also observed. Bottle feeding is detrimental even though it is on the phase of increasing. In the study carried within tertiary level hospitals of Nepal, exclusive breastfeeding was found to be lower among mothers. The main reason behind it was lack of time since the mother had to leave for their job. Breastfeeding was discontinued earlier leading to early initiation of complementary feeding. Hence, supportive environment is required for increasing the breastfeeding practices for a longer duration. As the postpartum is associated with significant stressors, and excessive stress poses a threat to maternal, child, and family well-being, stress is found to be higher among non- Breastfeeding mothers (BF) as compared to exclusive BF mothers. A need for early recognition, diagnosis and intervention in postpartum non-breastfeeding women of Nepal is required so that the future complications can be avoided.

 In a study carried out in Kirtipur Municipality, a majority of the mothers were found to breastfeed their children at least four times a day. The study suggests conducting an intervention within educated mothers and illiterate employed mothers during office hours and daytime at their job respectively. Similarly, in a study carried out in Rural Southern Nepal, rates of exclusive initial breastfeeding, exclusive breastfeeding was found to be lower in Nepal as a comparison to other developing nations. In the Muslim community of Parsa district, exclusive breastfeeding practice among the Muslim community was found to be good. 99.08% of mothers were found to breastfeed their babies whereas 0.91% of mothers did not breastfeed at all. Out of which, 83.87% followed the criteria of exclusive breastfeeding i.e. they provided no other food or drink (not even water), except breast milk which included milk expressed. A study in Chitwan found that initiation of breastfeeding was found to be statistically significant with determinants like age of respondents, age at childbirth, and the types of delivery. A study in Nepal found that in spite of having a positive perception regarding breastfeeding, the practices of early initiation and pre-lacteal feeding were not satisfactory among mothers. The study suggests providing counseling to mothers during the ANC period regarding breastfeeding and its advantages. Breastfeeding promotion and education need to be targeted within families, peer groups who may influence infant feeding decisions along with the mothers giving birth. Breastfeeding support in health facilities and peer mobilization strategies can be the pathway to improve breastfeeding rates especially in an urban areas like Kathmandu valley.

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