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Indian Pediatrics 1999;36: 1069-1070

Is Colostrum Really Discarded by Indian Mothers?

 

Colostrum is bright yellowish thick milk secreted in the first three to six days after birth. It is rich in proteins and immunoglobulins and has anti-infective properties. It is recommended to be given to the newborn baby and should not be discarded. Many studies have previously reported that 30-40% of Indian mothers discard the colostrum(1,2). However, it was not clear whether they totally discard the breast milk for few days or only minor part of it. In contrast some studies have reported that none of the babies were deprived of colostrum(3,4). Further breastfeeding practices have changed over time. Hence to find out the current status of practices related to colostrum we conducted a small prospective study in two parts.

Fifty mother infant pairs delivered in a city hospital catering to all socioeconomic groups were seen daily and feeding practices noted till discharge. Subsequently 50 mothers belonging to different social strata and casts were interviewed in the community on practices related to colostrum feeding they follow.

The following salient observations emerged:

1. No mother in the hospital discarded colostrum. They do discard few drops of breastmilk before initiating feed, which does not amount to `discarding colostrum'. Even those mothers who started breastfeeds after few hours  or one to two days did not discard colostrum but gave breastmilk without discarding any portion when they started breastfeeds.

2. In interviews it was noted that

(a) In Sindhi (24% of interview sample) and Bohra (18% of interview sample) community colostrum is not discarded at all and they were surprised at the querry.

(b) In some communities (38% of interview sample) mothers initiated breastfeeds after two days as they thought that milk is not secreted in the first two days after delivery and hence gave `prelacteal feeds'. However, they started breast feeds after two days without discarding initial milk which actually means that initiation of breast feed is late but colostrum is not discarded really.

(c) Some mothers belonging to Maratha (Dhangar) community (20% of interview sample) reported the practice of discarding breastmilk for first two days. On interaction with them it was observed that due to traditions of this community, mothers were asked to throw away thick yellowish milk which they think is harmful for their babies. The amount of discarded breastmilk for first two days varies largely from few drops to few spoons each time. The discarding is expressed manually two to six times a day for two days and it is thrown after removing it in a bowl. Even if much milk  is not expressed manually in first two days, they resume breastfeeding without any further discarding.

Our study thus indicates that the practice of discarding colostrum is uncommon now and practices differ between communities.

Purnima Bhale,
Shikhar Jain,
Division of Dietetics and
Department of Pediatrics,
Choithram Hospital and Research Center,
Manikbag Road, Indore 452 001,
Madhya Pradesh, India.

References

1. Jethi SC, Shriwastava DK. Knowledge, attitudes and practices regarding infant feeding among mothers. Indian Pediatr 1987; 24: 921-924.

2. Agrawal DK, Agrawal KN, Khare BB. Study on Current Status of infant and childhood feeding practices. Indian Pediatr 1985; 22: 716.

3. Ghosh JB. Colostrum feeding of healthy newborn. Indian Pediatr 1992; 29: 639-640.

4. Bansal RK, Sitharaman S. Colostrum deprivation: A misconception. Indian Pediatr 1988; 25: 396-397.

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