Although Haiti and the Dominican Republic (DR) share the same island of Hispaniola, exclusive breastfeeding is much higher in Haiti. As prelacteal feeding also differs between the two countries, it was hypothesize that prelacteal feeding would account for the subsequent differences in breastfeeding exclusivity between the two countries, while controlling for other potentially influencing differences.
Data for infants under 6 months of age were extracted from the cross-sectional Demographic and Health Surveys from Haiti (2012) and the DR (2013). Bivariate analysis and ordered logistic regression models were used.
Data were available for 686 Haitian infants [mean age: 2.9 (SD: 1.6) months] and 264 Dominican infants [mean age: 2.6 (SD: 1.6) months]. Haitian infants were more likely to be exclusively breastfed than Dominican infants, 41.3% versus 8.0%, at the time of the survey, and less likely to have been exposed to any prelacteal feeds, 20.1% versus 69.8%, respectively. Furthermore, Dominican infants were more likely to have been exposed to milk-based prelacteal feeds. Dominican status, any prelacteal feeds, and milk-based prelacteal feeds significantly and independently reduced the odds of breastfeeding exclusivity.
Conclusions for Practice
Identification of factors beyond prelacteal feeding are necessary to explain the substantially lower breastfeeding exclusivity in the DR compared to Haiti and to determine why so many Dominican infants are exposed to milk-based prelacteal feeds.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Balogun, O. O., Kobayashi, S., Anigo, K. M., Ota, E., Asakura, K., & Sasaki, S. (2016). Factors influencing exclusive breastfeeding in early infancy: A prospective study in north central Nigeria. Maternal and Child Health Journal,20(2), 363–375.
Boccolini, C., & Pérez-Escamilla, R. (2014). Risk factors for prelacteal feedings in seven Latin America and Caribbean countries: A multilevel analysis. FASEB Journal,28(S1), 131.
Cayemittes, M., Busangu, M. F., De Dieu Bizimana, J., Barrère, B., Sévère, B., Cayemittes, V., et al. (2013). Enquête Mortalité, Morbidité et Utilisation des Services, Haïti, 2012. Calverton, MD: Ministère de la Santé Publique et de la Population, Institut Haïtien de l’Enfance, and ICF International.
Centro de Estudios Sociales y Demográficos (CESDEM), & ICF International. (2014). Encuesta Demográfica y de Salud 2013. CESDEM and ICF International: Santo Domingo, Dominican Republic.
Corsi, D. J., Neuman, M., Finlay, J. E., & Subramanian, S. V. (2012). Demographic and health surveys: A profile. International Journal of Epidemiology,41(6), 1602–1613.
Demographic and Health Survey Program. (2015). The DHS Program. What we do. Survey types. DHS methodology. Retrieved January 1, 2020 from https://www.dhsprogram.com/What-We-Do/Survey-Types/DHS-Methodology.cfm.
Frankema, E., & Masé, A. (2014). An island drifting apart. Why Haiti is mired in poverty while the Dominican Republic forges ahead. Journal of International Development,26(1), 128–148.
Gupta, A., Holla, R., Dadhich, J. P., Suri, S., Trejos, M., & Chanetsa, J. (2013). The status of policy and programmes on infant and young child feeding in 40 countries. Health Policy & Planning,28(3), 279–298.
Haider, R., Ashworth, A., Kabir, I., & Huttly, S. R. (2000). Effect of community-based peer counsellors on exclusive breastfeeding practices in Dhaka, Bangladesh: A randomised controlled trial. Lancet,356(9242), 1643–1647.
Hajeebhoy, N., Nguyen, P. H., Mannava, P., Nguyen, T. T., & Mai, L. T. (2014). Suboptimal breastfeeding practices are associated with infant illness in Vietnam. International Breastfeeding Journal,9(1), 1–7. https://doi.org/10.1186/1746-4358-9-12.
Heidkamp, R., Ayoya, M. A., Teta, I. N., Stoltzfus, R. J., & Marhone, J. P. (2015). Breastfeeding practices and child growth outcomes in Haiti: An analysis of data from Demographic and Health Surveys. Maternal & Child Nutrition,11(4), 737–748.
Jaupart, P. (2018). Divided island: Haitian immigration and electoral outcomes in the Dominican Republic. Journal of Economic Geography,18(4), 951–999. https://doi.org/10.1093/jeg/lby030.
Lamberti, L. M., Fischer Walker, C. L., Noiman, A., Victora, C., & Black, R. E. (2011). Breastfeeding and the risk for diarrhea morbidity and mortality. BMC Public Health,11(S3), S15.
Lesorogol, C., Bond, C., Dulience, S. J. L., & Iannotti, L. (2018). Economic determinants of breastfeeding in Haiti: The effects of poverty, food insecurity, and employment on exclusive breastfeeding in an urban population. Maternal and Child Nutrition,14(2), 1–9. https://doi.org/10.1111/mcn.12524.
Lok, K. Y. W., Bai, D. L., & Tarrant, M. (2015). Predictors of breastfeeding initiation in Hong Kong and Mainland China born mothers. BMC Pregnancy and Childbirth,15(1), 1–11.
Lutter, C. K., & Morrow, A. L. (2013). Protection, promotion, and support and global trends in breastfeeding. Advances in Nutrition,4(2), 213–219.
McLennan, J. D. (2016). Changes in caesarean section rates and milk feeding patterns of infants between 1986 and 2013 in the Dominican Republic. Public Health Nutrition,19(15), 2688–2697.
McLennan, J. D. (2017). Changes over time in early complementary feeding of breastfed infants on the island of Hispaniola. Revista Panamericana de Salud Pública,41, e39.
Neville, M., & Morton, J. (3008S). Physiology and endocrine changes underlying human lactogenesis II. The Journal of Nutrition,131, 3005S–3008S.
Nguyen, T. T., Withers, M., Hajeebhoy, N., & Frongillo, E. A. (2016). Infant formula feeding at birth is common and inversely associated with subsequent breastfeeding behavior in Vietnam. The Journal of Nutrition,146(10), 2102–2108. https://doi.org/10.3945/jn.116.235077.
Nguyen, P., Binns, C. W., Van Ha, A. V., Chu, T. K., Nguyen, L. C., Van Duong, D., … Lee, A. H. (2019). Prelacteal and early formula feeding increase risk of infant hospitalisation: A prospective cohort study. Archives of Disease in Childhood. https://doi.org/10.1136/archdischild-2019-316937.
Oakley, L., Benova, L., Macleod, D., Lynch, C. A., & Campbell, O. M. R. (2017). Early breastfeeding practices: Descriptive analysis of recent Demographic and Health Surveys. Maternal & Child Nutrition,14(2), e12535. https://doi.org/10.1111/mcn.12535.
Patil, C. L., Turab, A., Ambikapathi, R., Nesamvuni, C., Chandyo, R. K., Bose, A., … Williams, A. (2015). Early interruption of exclusive breastfeeding: Results from the eight-country MAL-ED study. Journal of Health, Population and Nutrition,34(1), 10. https://doi.org/10.1186/s41043-015-0004-2.
Pérez-Escamilla, R., Segura-Millán, S., Canahuati, J., & Allen, H. (1996). Prelacteal feeds are negatively associated with breast-feeding outcomes in Honduras. The Journal of Nutrition,126(11), 2765–2773.
Rivera-Pasquel, M., Escobar-Zaragoza, L., & de Cosío, TG. (2015). Breastfeeding and maternal employment: Results from three national nutritional surveys in Mexico. Maternal and Child Health Journal,19(5), 1162–1172.
Rustein, S. O., & Johnson, K. (2004). The DHS Wealth Index. DHS Comparative Reports No. 6. Calverton, Maryland: ORC Macro.
Rustein, S. O., & Rojas, G. (2006). Guide to DHS Statistics: Demographic and Health Survey methodology. Calverton, MA: Demographic and Health Surveys, ORC Marco.
Stough, C. O., Khalsa, A. S., Nabors, L. A., Merianos, A. L., & Peugh, J. (2019). Predictors of exclusive breastfeeding for 6 months in a national sample of US children. American Journal of Health Promotion,33(1), 48–56. https://doi.org/10.1177/0890117118774208.
Taylor, L., & McLennan, J. D. (2016). Differences in prelacteal feeding on the island of Hispaniola: The Dominican Republic and Haiti. American Journal of Tropical Medicine and Hygiene,95(5S), 452.
Turcksin, R., Bel, S., Galjaard, S., & Devlieger, R. (2014). Maternal obesity and breastfeeding intention, initiation, intensity and duration: A systematic review. Maternal and Child Nutrition,10(2), 166–183. https://doi.org/10.1111/j.1740-8709.2012.00439.x.
UNICEF. (2019). UNICEF data: Monitoring the situation of children and women/Infant and young child feeding. Retrieved January 9, 2020 from https://data.unicef.org/topic/nutrition/infant-and-young-child-feeding/.
United Nations. (2018). United Nations/DESA/Population Division/World Population Prospects 2017. Retrieved June 30, 2018 from https://esa.un.org/unpd/wpp/.
Victora, C. G., Bahl, R., Barros, A. J. D., França, G. V. A., Horton, S., Krasevec, J., … Richter, L. (2016). Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. The Lancet,387(10017), 475–490. https://doi.org/10.1016/S0140-6736(15)01024-7.
WHO. (1998). Evidence for the ten steps to successful breastfeeding. Geneva: World Health Organization. Retrieved January 1, 2020 from https://apps.who.int/iris/bitstream/10665/64877/1/WHO_CHD_98.9.pdf?ua=1.
World Bank. (2018a). Countries and economies. Retrieved June 30, 2018, from https://data.worldbank.org/country.
World Bank. (2018b). World Bank country and lending groups. Retrieved May 6, 2018, from https://datahelpdesk.worldbank.org/knowledgebase/articles/906519
Thanks to the DHS program for making available the datasets used in this study and the women who participated in the original surveys.
No funding was received for this study.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
McLennan, J.D., Sampasa-Kanyinga, H. Do Differences in Prelacteal Feeding Explain Differences in Subsequent Breastfeeding Between Haiti and the Dominican Republic?. Matern Child Health J (2020). https://doi.org/10.1007/s10995-020-02891-w
- Breast feeding
- Prelacteal feeding
- Dominican Republic