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Original research
Prelacteal and early formula feeding increase risk of infant hospitalisation: a prospective cohort study
  1. Phung Nguyen1,2,
  2. Colin W Binns2,
  3. Anh Vo Van Ha2,3,
  4. Tan Khac Chu2,4,
  5. Luat Cong Nguyen2,5,
  6. Dat Van Duong2,
  7. Dung Van Do1,
  8. Andy H Lee2
  1. 1 Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh, Ho Chi Minh City, Vietnam
  2. 2 School of Public Health, Curtin University Bentley Campus, Perth, Western Australia, Australia
  3. 3 Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
  4. 4 Faculty of Public Health, Hai Phong Medical University, Hai Phong, Vietnam
  5. 5 National Immunization Program, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
  1. Correspondence to Ms Phung Nguyen, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh, Ho Chi Minh City 700000, Vietnam; nthphungytcc{at}


Objective To ascertain the relationship between prelacteal feeding, early formula feeding and adverse health outcomes, especially hospitalisation during the first year of life.

Design Multicentre prospective cohort study.

Setting Six hospitals across three cities in Vietnam.

Patients A total of 2030 pregnant women were recruited at 24–28 weeks of gestation and followed up at hospital discharge, 1, 3, 6 and 12 months post partum.

Main outcome measures Rates of infant hospitalisation, diarrhoea and lower respiratory tract infection during the first 12 months.

Results For the final complete sample (n=1709, 84%), about one-quarter of the infants experienced diarrhoea (25.5%) or were admitted to hospital with at least one episode (24.8%), and almost half (47.6%) the cohort contracted lower respiratory tract infection by 12 months. The prevalence of prelacteal feeding was high (56.5%) while formula feeding was common (79.5%) before hospital discharge, both of which increased the risks of adverse health outcomes particularly hospitalisation by approximately 1.5-fold, with adjusted OR (95% CI) 1.43 (1.09 to 1.88) and 1.48 (1.07 to 2.05), respectively for these infants by 12 months, when compared with others who were exclusively breast fed.

Conclusions Prelacteal feeding and early formula feeding before hospital discharge are associated with higher risks of infection and hospital admission in Vietnamese infants. Support for exclusive breast feeding should be provided to mothers to avoid the adverse consequences of giving formula milk and prelateal foods.

  • Infant feeding
  • prelacteal feed
  • formula feed
  • hospitalisation
  • diarrhoeal disease
  • respiratory infection
  • prospective cohort study
  • Vietnam
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  • Contributors PN: recruited patients, analysed and interpreted data, drafted the manuscript. CWB and AHL: conceptualised and designed the study, supervised the overall study conduct and analysis. AVVH, TKC, LCN: enrolled patients and interpreted data. DaVD and DuVD: provided technical support, supervised the overall study conduct and analysis. All authors critically revised and approved the final manuscript.

  • Funding This study was partially supported by Curtin University, Perth, Western Australia.

  • Competing interests None declared.

  • Patient and public involvement statement Not required.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the Hai Phong University of Medicine and Pharmacy Human Research Ethics Committee (approval no. 05/PHUMPRB), and the Curtin University Human Research Ethics Committee (approval no. HR32/2015).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.

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