The custom of providing prelacteal feeds is a long-held tradition throughout many parts of China. Prelacteal
feeds are not recommended because they can interfere with the establishment of breastfeeding, increase the risk of infection
and change the composition of the human microbiome. The objective of this paper is to review the rate of offering
prelacteal feeds in different areas in China and the influence this custom has on breastfeeding outcomes.
Electronic databases were systematically searched to identify studies reporting on prelacteal feeds in China. In total eight
papers (three retrospective cohort studies, one prospective cohort study, one case-control study and three cross-sectional
studies) published in the Chinese language and six papers (one Systematic Literature Review (SLR), four prospective cohort
studies and one cross-sectional study) published in the English language were retrieved.
The prevalence of prelacteal feeding varies widely in China. The highest rates are seen in Shandong Province in Eastern
China, with as many as 72.4% of infants receiving a prelacteal feed before the initiation of breastfeeding. Xinjiang-
Province in the west of China reported alower prevalence of prelacteal feeding; with 23%, 2% and 6% of infants receiving
water, cow’s milk and solid food, respectively, before discharge from hospital. In comparison to western developed countries
prelacteal feeding rates in China were found to be substantially higher. Five out of the seven studies that measured the
effect of prelacteal feeds on breastfeeding outcomes found that prelacteal feeding was associated with reduced breastfeeding
Due to the potentially deleterious effect of prelacteal feeding on breastfeeding, every effort should be made to reduce
prelacteal feeding throughout China.