Sundaram, Maria

Public Health

MHS

Bangladesh

The Context of Prelacteal Feeding and its Association with Neonatal Infectious Disease Morbidity in Rural Bangladesh

Prelacteal feeding (PF) describes the practice of introducing food other than breastmilk to a neonate prior to initiation of breastfeeding. Although this practice is common as part of indigenous cultural practices in many areas of the world, its effect on delayed breastfeeding initiation, exclusive breastfeeding, or neonatal infection has not been assessed in detail. Despite this lack of information, there is a widespread assumption that the potential harm of PF is negligible, given the small quantities these represent, over a short period of time in early life Often, PF are not considered when evaluating exclusive breastfeeding (EBF) in a population. However, in a context where low birth weight is extremely common (>50%) and prematurity rates are high (>20%), these exposures (especially to high-risk, potentially infective substances) may be less benign than assumed. For this reason, we propose to study the practice of PF in rural Bangladesh, where the practice is common (>80% of mothers). Using new and existing data from a large ongoing cohort of over 120,000 pregnancies to date, we will characterize PF by type, frequency, timing, maternal factors such as socioeconomic status (SES), and neonatal factors such as gender, gestational age at birth, and birth weight. We will assess the association of PF and delayed breastfeeding initiation, adherence to EBF, and risk of early infant morbidity possibly associated with PF exposure. Comprehensive research of PF is needed, and this preliminary data will help to mount focused epidemiologic studies to inform and, if necessary, modify recommendations regarding PF and EBF.

People

Yukari C. Manabe, MD

Associate Director of Global Health Research and Innovation

Noreen Hynes, MD MPH

Director, Geographic Medicine Center of the Division of Infectious Diseases

Stefan Baral, MD MPH,MBA,MSc

Director, Key Populations Program

Robert Bollinger Jr., MD MPH

Director, Johns Hopkins Center for Clinical Global Health Education (CCGHE); Associate Director, Johns Hopkins Center for Global...

Caitlin Kennedy, PhD MPH,BA

Co-Director, MPH concentration in Social and Behavioral Sciences in Public Health; Associate Director, Center for Qualitative...

Joanne Katz, ScD MS,BSc

Associate Chair, Director of Academic Programs
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September 2017

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