Fikree F.F., Rizvi N.

Department of Community Health Sciences, The Aga Khan University.

Colostrum contains high levels of antibodies and immunoglobins, protects the child against neonatal sepsis, diarrhea, respiratory and other diseases. Consequently, scientists have recommended colostrum as the first feed. However, in our sociocultural and religious milieu, honey is the recommended first feed. Our paper reports on the type of first feed given and examines the effect of selected maternal and newborn factors on giving colostrum as the preferential mode for initiating feeding.

The study was conducted in four squatter settlements of Karachi during 1990-1991. Mothers were identified as early in pregnancy as possible and followed to term. Antenatal care was provided by trained workers at home or at the nearby primary health care center. Within three days of delivery trained research workers interviewed each postpartum mother and conducted anthropometirc measurements on the newborn.

994 mothers were followed to term, of which 786 consented to participate in the follow-up study. Breastmilk was the first feed given to only 8.8% [69/786] of the newborns. Other important food items given were honey (62.3%), a combination of rose water and sugar (11.2%) and Ghutti [an herbal concoction] (9.0%). Women delivered by doctors [R.R.=2.0; 95%CI=1.1-3.5] or those delivered in government hospitals [R.R.=2.3; 95%CI=1.4-3.7] were more likely to give colostrum as compared to women who were delivered by traditional birth attendants or at home respectively. However, maternal education, number of antenatal care visits, parity, gender of the newborn, gestational age or birthweight did not influence giving colostrum as the first feed.

In our study colostrum was not the preferred first feed given except when doctors were the obstetric care providers or delivery occurred at hospitals. We suggest that health education targeted to mothers, traditional birth attendants, midwives and lady health providers on the advantages of colostrum be provided.

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