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J Hum Lact. 2015 Feb;31(1):89-98. doi: 10.1177/0890334414559074. Epub 2014 Nov 24.

Inequities in milk-based prelacteal feedings in Latin America and the Caribbean: the role of cesarean section delivery.

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Social Nutrition Department, Rio de Janeiro State University, Rio de Janeiro/RJ, Brazil
Yale School of Public Health, New Haven, CT, USA.
Rio Grande do Sul Federal University, Porto Alegre/RS, Brazil.
Rio de Janeiro Federal University, Rio de Janeiro/RJ, Brazil.



Prelacteal feeds (ie, foods other than breast milk offered before the milk comes in) have been identified as a risk factor for shorter breastfeeding duration and neonatal mortality.


This study aimed to test for socioeconomic inequities on the risk of milk-based prelacteal feeding associated with cesarean section delivery.


We conducted secondary cross-sectional data analyses of 7 Demographic and Health Surveys conducted in Latin American and Caribbean countries between 2005 and 2010 (N = 49 253 women with children younger than 3 years of age). Multivariate logistic regression was used to test the association between cesarean section delivery and the risk of milk-based prelacteal feeding in the total samples as well as within the lowest and highest wealth quintile subsamples by country and in the pooled sample.


Almost one-third of newborns received milk-based (22.9%) prelacteal feeds. Prelacteal feeding prevalence varied from 17.6% in Guiana to 55% in Dominican Republic. Cesarean section delivery was associated with significantly higher odds of introduction of milk-based prelacteals in all countries (adjusted odds ratio [AOR] range, 2.34 in Bolivia to 4.50 in Peru). The association between cesarean section delivery and risk of milk-based prelacteal feeds was stronger among the poorest than wealthiest women (AOR [95% confidence interval], 2.94 [2.58-3.67] vs 2.17 [1.85-2.54]).


Women of lower socioeconomic status may need additional breastfeeding support after cesarean section delivery to prevent the introduction of milk-based prelacteals. Reducing the rates of cesarean section deliveries is likely to reduce the prevalence of prelacteal feeding.


Caribbean; Latin America; breastfeeding; cesarean section; prelacteal feeds

[Indexed for MEDLINE]

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