Breastfeeding is considered a proven child survival strategy, and the World Health Organization (WHO) recommends that, the newborns to be put on the breast within an hour after birth [1]. It provides immense immunologic, psychological, social-economic, and environmental benefits [2]. It also significantly reduces a child’s risk of developing obesity, type 2 diabetes mellitus and related chronic non-communicable diseases[3]. Furthermore, breastfeeding promotes a child’s cognitive development [4]. Early initiation of breastfeeding immediately after birth enhances mother-infant bonding [5]. Moreover, it promotes effective suckling, successful establishment, and maintenance of breastfeeding throughout infancy [6]. However, in different countries including Ethiopia, a significant proportion of mothers offer prelacteal feeds to their newborn [7–9].
Colostrum is the first liquid that is produced in the first few hours after delivery. It is thick, sticky and clear to yellowish in color. It contains proteins, vitamin A and maternal antibodies important to the newborn’s nutrition until lactation is fully established [10]. Colostrum establishes important bacteria in the baby’s gut. It also acts as ‘paint’, coating the infant’s gastrointestinal tract. Therefore, colostrum provides natural immunity (baby’s first immunization) against many bacteria and viruses [10, 11]. In contrary to these advantages, colostrum is considered heavy, thick, dirty, toxic and harmful to children’s health and therefore in some societies, a portion of colostrum is discarded. Colostrum avoidance is a common practice in Ethiopia [12, 13]. It is the low-volume concentrated form of nutrient supply system, which suits for newborns with premature digestive system. It has laxative effect which encourages passage of baby’s first stool, meconium. This help to prevent neonatal jaundice by clearing excess amount of bilirubin, which is produced in large quantities at a birth [14, 15].
Colostrum feeding is associated with a reduced risk of otitis media, gastroenteritis, and respiratory illness, necrotizing entero-colitis, obesity, and hypertension [16]. In the developing countries where the rate of communicable diseases is high, timely provision of colostrum is reducing diarrheal disease in the neonates [17].
Globally, more than 4000 infants and young children die because they do not get colostrum within the first hour after birth. Most of the infants are given liquids other than their mother’s milk in the first few days after birth. The rate of breastfeeding varies in communities from almost 70% to a low of 13% as this is culturally influenced [18]. Among women in developing countries who do not give colostrum feeds, most of them avoid colostrum feeding based on cultural beliefs that range from no nutritional value for infants to harmful for the infant’s health. Some women may specify no reason for avoiding colostrum rather than tradition [19].
Globally, colostrum avoidance is practiced in many countries; In Utarkhand, India 92% of mother discarded colostrum, In Nepal 16.5%, In Pakistan 27.9% and in Burkina Faso 16% of mothers deprived colostrum to their infants [20–23]. In Ethiopia, colostrum discarding is the common nutritional malpractice. In Afar 35%, in Debre Tabor 25.6% in Raya kobo 13.5%, in Axum 6.3% and in Motta Town 20.3% of mother reported that they discarded colostrum [24–27] [28].
Every day, 3000–4000 infants die in the developing world from diarrhea and acute respiratory infections because they were receiving inadequate amounts of breast milk in their feeding and were deprived colostrum [29]. In particular, 45% of neonatal infectious deaths, 30% of diarrheal deaths, and 18% of acute respiratory deaths among children aged less than five years are associated with suboptimal breast feeding [30, 31] .Malnutrition is an underlying factor in more than 50% of the major cause of infant mortality and the risk of malnutrition in children during the first 2 years of life is an indication of poor infant feeding practices [32] .A Study carried out in Afambo district, Afar found that children who were colostrum avoided had 2.34 times increased likelihood of being underweight when compared to those children who fed colostrum [33]. Suboptimal breast feeding is also one of the risk factor for childhood stunting [34]. Poor infant feeding practices are chief challenges to the social and economic development of one country [35].
Different factors were noted to affect colostrum avoidance practice; it was mainly related to maternal characteristics. Accordingly, home delivery, failure to attend ANC, lack of post-natal care, late breastfeeding initiation and poor knowledge on optimal breast feeding [26, 27, 36] .
A wide range of harmful new born feeding practices are documented in Ethiopia even after the implementation of infant and young child feeding guideline [37]. In cognizance of the severity as well as the wide spreading practices of inappropriate breastfeeding, the Government of Ethiopia has been devising different strategies including generating of health extension program, and working in collaboration with Non-Governmental Organizations (NGOs) in the areas of IYCF [38, 39]. WHO and UNICEF recommend that children should initiate colostrum within the first hour of birth, However in Ethiopia about 27% of infant had not started colostrum within one hour of birth [40, 41]. Despite the fact that colostrum avoidance has a negative effect on child health, little is known about the extent of the problem and its contributing factors in Southern Ethiopia particularly in study area. As there are diverse cultural practices among Ethiopian communities, evidence generated by this study will assist in developing context specific interventions to halt colostrum avoidance practice and to promote optimal IYCF practice. Therefore, the purpose of this study was to assess the prevalence of colostrum avoidance practices and its associated factors among mothers of children aged less than 12 months in Jinka Town, Southern Ethiopia.
The finding of this study may add knowledge about the magnitude and its determinants of colostrum avoidance and to come up with recommendation on possible intervention for colostrum avoidance and association factors in the study area. This study will also help to health care service provider in their counseling/health education session to strength good breast-feeding practices. It helps Town Health office and Zonal Health department by providing relevant information for future planning and interventions of appropriate strategies to promote colostrum feeding. This in turn, may help to reduce the mortality and morbidity rate of infant in Ethiopia. The finding of this study also helps for local NGOs working in the areas of child health to improve optimal breast feeding practices.