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Background <p>Pre-lacteal feeding is a significant barrier to exclusive breastfeeding and a leading cause of morbidity and mortality among children under 24 months worldwide. In Ethiopia, it remains a deeply rooted public health concern influenced by socio-demographic, maternal, and geographical factors. This study aimed to assess the prevalence and determinants of pre-lacteal feeding practices among Ethiopian children under 24 months.</p> Methods <p>The data used for this study was from the 2019 Ethiopia Mini Demographic and Health Survey, including a weighted sample of 2,051 mothers with children under 24 months. A Bayesian Geo-additive model was applied to determine the risk factors and spatial variations of pre-lacteal feeding practices among Ethiopian zones.</p> Results <p>The prevalence of pre-lacteal feeding was 12.2% in Ethiopia. The potential predictors of pre-lacteal feeding were multiple births [OR = 3.28, 95% CI: (1.35, 7.71)], cesarean delivery [OR = 2.32, 95% CI: (1.42, 3.73) ], starting breastfeeding after one hour [OR = 3.61, 95% CI (2.72, 4.97)], and living in pastoralist [OR = 5.21, 95%CI (2.41, 11.04) ] or urban regions [OR = 2.4595%CI: (1.08, 5.35) ], protective factors included 1–3 antenatal care visits [OR = 0.67, 95%CI: (0.47, 0.96)] and facility-based delivery [OR = 0.61, 95% CI: (0.40, 0.96)] and the continuous variables such as maternal age, age at first birth, child’s age, and birth interval were also significant. Spatial analysis revealed there exist regional disparities with positive and negative influences on pre-lacteal feeding.</p> Conclusions <p>Pre-lacteal feeding was higher and continues to be a significant practice in Ethiopia, shaped by maternal characteristics, sociodemographic factors, and geographic location. Mothers in pastoralist regions are more likely to practice pre-lacteal feeding which needs the implementation of mobile maternal health services. The spatial analysis identified potential hotspots areas where interventions are urgently needed. To reduce pre-lacteal feeding rates, public health efforts should prioritize increasing antenatal care attendance, ensuring timely breastfeeding initiation, and strengthening exclusive breastfeeding education. Additionally, tailored strategies addressing regional disparities must be implemented to enhance child health outcomes across the country.</p>

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Pre-lacteal feeding practices and associated factors among mothers of children under 24 months age in Ethiopia: A geo-additive model approach

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月12日

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  • Addisu Dessie,
  • Melkamu A. Zeru,
  • Dereje Tesfaye Zike,
  • Aweke A. Mitku

摘要

Background

Pre-lacteal feeding is a significant barrier to exclusive breastfeeding and a leading cause of morbidity and mortality among children under 24 months worldwide. In Ethiopia, it remains a deeply rooted public health concern influenced by socio-demographic, maternal, and geographical factors. This study aimed to assess the prevalence and determinants of pre-lacteal feeding practices among Ethiopian children under 24 months.

Methods

The data used for this study was from the 2019 Ethiopia Mini Demographic and Health Survey, including a weighted sample of 2,051 mothers with children under 24 months. A Bayesian Geo-additive model was applied to determine the risk factors and spatial variations of pre-lacteal feeding practices among Ethiopian zones.

Results

The prevalence of pre-lacteal feeding was 12.2% in Ethiopia. The potential predictors of pre-lacteal feeding were multiple births [OR = 3.28, 95% CI: (1.35, 7.71)], cesarean delivery [OR = 2.32, 95% CI: (1.42, 3.73) ], starting breastfeeding after one hour [OR = 3.61, 95% CI (2.72, 4.97)], and living in pastoralist [OR = 5.21, 95%CI (2.41, 11.04) ] or urban regions [OR = 2.4595%CI: (1.08, 5.35) ], protective factors included 1–3 antenatal care visits [OR = 0.67, 95%CI: (0.47, 0.96)] and facility-based delivery [OR = 0.61, 95% CI: (0.40, 0.96)] and the continuous variables such as maternal age, age at first birth, child’s age, and birth interval were also significant. Spatial analysis revealed there exist regional disparities with positive and negative influences on pre-lacteal feeding.

Conclusions

Pre-lacteal feeding was higher and continues to be a significant practice in Ethiopia, shaped by maternal characteristics, sociodemographic factors, and geographic location. Mothers in pastoralist regions are more likely to practice pre-lacteal feeding which needs the implementation of mobile maternal health services. The spatial analysis identified potential hotspots areas where interventions are urgently needed. To reduce pre-lacteal feeding rates, public health efforts should prioritize increasing antenatal care attendance, ensuring timely breastfeeding initiation, and strengthening exclusive breastfeeding education. Additionally, tailored strategies addressing regional disparities must be implemented to enhance child health outcomes across the country.