{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:10:06Z","timestamp":1789841406426,"version":"4.0.1"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Breastfeeding Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Prelacteal feeding (PLF) is influenced by sociocultural factors and may disrupt exclusive breastfeeding while increasing the risk of neonatal infections. This study aimed to elucidate PLF practices among geographically isolated and culturally distinct communities in the Hindukush ranges of Chitral, northwestern Pakistan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A community-based cross-sectional study was conducted among 345 mothers with infants aged less than 24 months in Chitral. Data were collected using a structured, interviewer-administered questionnaire. PLF practices were assessed through descriptive statistics, and associated factors were examined using logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Overall, 26% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 91) of mothers reported practicing PLF. PLF was significantly more common among Kho mothers (31%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 91) than Kalash mothers (0%) (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.0001). The most commonly used prelacteal substances were infant formula (41%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 37), Zamzam water (30%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 27), butter (18%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 16), and honey (12%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 11). The primary reasons cited for PLF were perceived health benefits for the infant, insufficient breast milk production, and cultural or religious beliefs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Approximately one-quarter of mothers practiced PLF, with a marked disparity between Kho and Kalash communities. Ethnicity emerged as the principal determinant of PLF, highlighting the influence of cultural practices. Targeted breastfeeding counseling, maternal education, and community-based awareness interventions are urgently needed to promote exclusive breastfeeding and reduce PLF practices in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15568253261490310","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T20:38:01Z","timestamp":1789677481000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Determinants of Prelacteal Feeding Among Mothers in the Remote Communities of Chitral, Pakistan"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3146-6260","authenticated-orcid":false,"given":"Saif","family":"Ullah","sequence":"first","affiliation":[{"name":"Department of Zoology, University of Chitral, Chitral, Pakistan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tashrifa","family":"Bibi","sequence":"additional","affiliation":[{"name":"Department of Zoology, University of Chitral, Chitral, Pakistan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahzadi","family":"Rahim","sequence":"additional","affiliation":[{"name":"Department of Zoology, University of Chitral, Chitral, Pakistan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaina","family":"Bibi","sequence":"additional","affiliation":[{"name":"Department of Zoology, University of Chitral, Chitral, Pakistan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajid","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Zoology, Quaid-i-Azam University, Islamabad, Pakistan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-024-04660-y"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.12.04104"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12871"},{"key":"e_1_3_3_5_1","volume-title":"Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: The Baby-friendly Hospital Initiative: monitoring manual","author":"World Health Organization","year":"2025","unstructured":"4.World Health Organization. Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: The Baby-friendly Hospital Initiative: monitoring manual. World Health Organization: Geneva; 2025. Available from: https:\/\/iris.who.int\/server\/api\/core\/bitstreams\/b7967990-bca4-4770-a16d-ee25d17549c7\/content"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu17081326"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tifs.2021.09.021"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-020-00295-8"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/2333794X211018321"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-069902"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.51846\/jucmd.v2i2.2380"},{"key":"e_1_3_3_12_1","volume-title":"Pakistan demographic and health survey 2017\u201318: key findings","author":"National Institute of Population Studies (NIPS) [Pakistan], ICF","year":"2019","unstructured":"11.National Institute of Population Studies (NIPS) [Pakistan], ICF. Pakistan demographic and health survey 2017\u201318: key findings. National Institute of Population Studies and ICF: Islamabad (Pakistan) and Rockville, MD; 2019."},{"issue":"4","key":"e_1_3_3_13_1","first-page":"152","article-title":"Breastfeeding practices and knowledge in semi-urban area of Pakistan","volume":"27","author":"Hina A","year":"2022","unstructured":"12.Hina A, , Riaz M, , Athar T, et al. Breastfeeding practices and knowledge in semi-urban area of Pakistan. 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Citizen report card study. Transparency International Pakistan: Islamabad; 2018. Available from: http:\/\/www.transparency.org.pk\/documents\/crc-health-chitral.pdf"},{"key":"e_1_3_3_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006238"},{"key":"e_1_3_3_26_1","unstructured":"25.Aga Khan Foundation Pakistan. Role of Community Based Savings Groups (CBSGs) in enabling greater utilisation of community midwives in Chitral district of Pakistan. 2013. Available from: https:\/\/assets.publishing.service.gov.uk\/media\/57a08a1fed915d622c00058b\/CBSG\u2013enabling-community-midwives-chitral-district-pakistan.pdf [Last accessed: March15 2026]."},{"key":"e_1_3_3_27_1","volume-title":"Biostatistics: a foundation for analysis in the health sciences","author":"Daniel WW","year":"1999","unstructured":"26.Daniel WW. Biostatistics: a foundation for analysis in the health sciences, 7th ed. 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Bashalini: A place for biological gender impurities segregating women during menstruation in Kalash. 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