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Factors Associated With Prelacteal Feeding of Commercial Milk Formula: An Analysis of Cohort Data From the BADUTA Study in Indonesia
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Factors Associated With Prelacteal Feeding of Commercial Milk Formula: An Analysis of Cohort Data From the BADUTA Study in Indonesia
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Factors Associated With Prelacteal Feeding of Commercial Milk Formula: An Analysis of Cohort Data From the BADUTA Study in Indonesia
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Journal Article
Factors Associated With Prelacteal Feeding of Commercial Milk Formula: An Analysis of Cohort Data From the BADUTA Study in Indonesia
2025
Overview
Introducing commercial milk formula (CMF) as prelacteal feeds can disturb exclusive breastfeeding and shorten breastfeeding duration. However, the prelacteal feeding of CMF has been growing alongside its increasing sales in Indonesia. This study examined predictors of the CMF feeding in the Malang and Sidoarjo districts of Indonesia. This analysis used post‐delivery data collected from 676 mothers in a cohort evaluation of a cluster randomised controlled trial (Baduta study). Multivariate random effects logistic models were employed to assess factors associated with the CMF feeding. A total of 467 (69.1%) respondents reported giving CMF to their infants during the first 3 days after delivery. Mothers with low breastfeeding self‐efficacy (BFSE) were at a higher risk of providing CMF within 3 days of birth compared to those with medium or high BFSE (adjusted odds ratio (aOR) 8.12; 95% confidence interval (CI) (4.26–15.48). Receiving explanations to solve breastfeeding problems from health professionals (aOR: 1.87; 97% CI: 1.12–3.11) and primipara parity (aOR: 1.71; 95% CI: 1.12–3.04) were positively associated with the CMF feeding. Early initiation of breastfeeding (EIBF) was protective against CMF feeding (aOR: 0.40; 95% CI: 0.22–0.58). There was an interaction between EIBF and BFSE. EIBF was protective among mothers with high or medium BFSE, but had no effect among those with low BFSE. CMF feeding was prevalent in Indonesia. Future strategies should focus on improving health‐staff capacity to strengthen BFSE during pregnancy and provide adequate counselling for mothers with breastfeeding problems. Prelacteal feeding of commercial milk formula was prevalent in Indonesia. Future strategies should focus on improving health‐staff capacity to strengthen breastfeeding self‐efficacy during pregnancy and provide adequate counselling for mothers with breastfeeding problems as both factors are the important determinants of this harmful practice. Summary Nearly 7 in 10 newborns received commercial milk formula during the first 3 days of their life. Parity, breastfeeding self‐efficacy, early initiation of breastfeeding and receiving explanations to solve breastfeeding problems were the predictors of this practice. Mothers with medium and high breastfeeding self‐efficacy who performed early initiation of breastfeeding were less likely to introduce early commercial milk formula. However, this practice was not influenced by early initiation of breastfeeding among those with low breastfeeding self‐efficacy. Support from healthcare providers regarding breastfeeding difficulties was positively associated with the outcome indicating the need to improve the quality of the service.
