Pre-Lacteal Feeding Practices Of Doctors And Nurses In A State And Teaching Hospital In Western Nigeria: A Cause For Concern

摘要

Background: Pre-lacteal feeding of healthy new born babies by the health workers in the neonatal and post-natal wards of many non-baby friendly hospitals is a common practice. A study of these pre-lacteal feeding practices may generate information on the nature and the extent of these practices in the main non-baby friendly hospitals and provide ideas on the necessary adjustment in feeding practices. Aim: To determine the prelacteal feeding practices of Nigerian doctors and nurses in charge of the newborns and their mothers at the 2 major none baby friendly hospitals in a state capital.Materials and Methods: The doctors and nurses in charge of the newly delivered mothers and their babies at 2 Nigerian hospitals were interviewed by means of a pre-tested questionnaire regarding their usual practice concerning the giving of prelacteal feeds. Information such as the departments and assigned wards of duty of the respondents, the reasons why they give prelacteal feeds to the newborn babies and the details of the types and timing of feeds were obtained. Results: Sixty two respondents (30 doctors and 32 nurses) were studied. All the respondents identified mothers own breast milk as the best food for the newborn. However, 60 (96.8%) respondents (29 doctors and 31 nurses) routinely prescribed prelacteal feeds for healthy babies whose mothers were considered to have delay in lactation. The prelacteal feeds prescribed by 29 doctors were infant formula 15(51.7%), glucose drinks 11(37.9%) and plain water 3 (10.3%) respectively. Also infant formula16 (51.6%), glucose drinks 13(41.9%) and plain water 2(6.5%) were prescribed by the 31 nurses respectively. Twenty-one (35.0%) of the total 60 subjects giving prelacteal feeds usually advised giving prelacteal feeds within the first 2 hours of delivery.Conclusion: Pre-lacteal feeding is a common practice among the health workers studied. It should be discouraged by the means of educational seminars and update courses. Introduction The UNICEF/WHO baby friendly hospital initiative program is based on the recognition that breast feeding activities in the hospital are important to the success of later breastfeeding.1 In spite of the official acceptance of the Baby Friendly Hospital Initiative (BFHI) policy and practices by the Nigerian ministry of health, many hospitals in the land are yet to adopt and implement the 10 steps to successful breastfeeding. Such hospitals may encourage the prelacteal use of breast milk substitutes, such as infant formula, glucose drinks and water. The zeal and the enthusiasm demonstrated by the UNICEF/WHO and many stakeholders at the inception of the BFHI led to the expectations that the principles and the practice of the initiative would spread from the designated to non-designated hospitals and health units. 2 This study was conducted to determine to which extent the BFHI practices had influenced the early feeding of newborn in the 2 non-designated major hospitals in the Osun state capital. The State Specialist Hospital and the Ladoke Akintola University Teaching Hospital in which this study was conducted are both situated in Osogbo, the capital of a Western Nigeria state. Both hospitals are specialist and referral hospitals. None of the two hospitals has so far being designated baby friendly by the UNICEF and WHO. Subjects And Methods The subjects were the 62 doctors and nurses in the newborn and postnatal wards of the State Specialist Hospital, and the Ladoke Akintola University Teaching hospital, Osogbo, who responded to the questionnaire. All the subjects were interviewed to obtain information regarding their practices on prelacteal feeding of the newborn between the 1st and 31st of August 2006. Information elicited with the questionnaire included the designation and assigned wards of duty of the respondents, the details of the types of feeds, the times of feeding and the reasons for prescribing the feeds. The doctors and nurses in the newborn unit were classified as