Prevalence of prelacteal feeding and associated risk factors in Indonesia: Evidence from the 2017 Indonesia Demographic Health Survey

Lhuri D. Rahmartani; Claire Carson; Maria A. Quigley

doi:10.1371/journal.pone.0243097

Peer Review History

Original SubmissionJune 18, 2020
13 Oct 2020 Decision Letter - Jane Anne Scott, Editor PONE-D-20-18812 Prevalence of prelacteal feeding and associated risk factors in Indonesia: evidence from the 2017 Indonesia Demographic Health Survey PLOS ONE Dear Dr. Rahmartani, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. I have reviewed the manuscript as the second reviewer and my comments are below. Please note that the first reviewer and I have both made comments regarding the clarity of the definition of prelacteal feeding. Please submit your revised manuscript by Nov 27 2020 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. 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Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Overall comment: This is a well presented research from the authors and to my knowledge this is the first research that used the national data set from Indonesia to investigate the factors associated with prelacteal feeding. I have only one suggestion that the authors may consider to include in the manuscript. Outcome variables: I request the authors to include actual question from DHS. There is always a debate on ‘first feed’ vs ‘any food other than breast milk in the first three days’ when it comes to DHS survey. Presenting actual question would help comparability of the findings. Reviewer #2: Definition of prelacteal feeding As there are various definitions of PLF used by researchers, I recommend that the definition of prelacteal feeding used in this study be included in the abstract and earlier in the introduction. It is not until page 5 when the authors describe the outcome variables that it is clear that PLF includes anything other than breastmilk in the first 3 days after delivery. Various researchers have defined PLF to be ‘the first feed given’ or ‘feeding any other substance before first breastfeeding’, ‘foodstuff or feed that is given to a newborn infant before the mother has begun to breastfeed’. While the paper for the most part is written in standard English, it would benefit from a careful final proof reading by someone for whom English is their native language. The paper includes a number of minor grammatical errors and several examples of awkward wording. A lack of continuous page numbering made this somewhat annoying to review and comment on. Minor corrections Antenatal card is a noun and needs the indefinite article ‘an’ to be placed before it, i.e. had an antenatal card. There are other cases where the definite (the) or indefinite (a) article is missing from before a noun e.g. had a home birth. Page 3, last para, line 6 should read ‘ used data from the 2017 Indonesia DHS Page 5 line 3 should read ‘… were asked of all mothers’ Page 7 lines 14-16 the first part of this sentence is awkwardly worded. Study population Page 9 line 4 “About 33% of the mothers had the first birth” awkward wording Page 12 Table 2 footnote suggest rewording ‘reported as having ever breastfed’ Page 13 The text needs to stand alone from the tables. The percentages given in the first paragraph are unnecessary and not particularly useful without knowing the percentages of the comparator groups. Page 13 When reporting the aPRs here and for other outcomes it is customary to identify the reference category. For instance, was the reference group for infant size women who perceived that their baby was average size or larger than average. Page 15 Again, the percentages given in the first paragraph are unnecessary and not particularly useful without knowing the percentages of the comparator groups. Page 20 Sociodemographic factors The sentence ‘In contrast, none of the sociodemographic factors were statistically significant honey’ is awkwardly worded, suggest rewriting ”In contrast, none of the sociodemographic factors were significantly associated with giving honey as a PLF.” Page 21 para 1 Strictly speaking your study did not highlight the diversity of PLF risk factors across countries. This wording suggests that you analysed data from a variety of countries. Instead, what you are reporting is that the associations found are not consistent across all countries. Page 21 line 8 should read ‘higher prevalence of any PLF’ Page 21 line 10 should read ‘urban areas’ (plural) Page 22 line 7 should read ‘immediate skin-to-skin contact is one of the Ten Steps…’ (present tense) Page 22 line 10 should read ‘in accordance with…’ Page 24 2nd line from bottom should read ‘educating mothers’ (plural) Page 24 line 4 suggest adding ‘within this practice.’ Reference List Please check the reference list carefully to ensure that all journal titles are abbreviated. You may need to edit the references in your Endnote library. Figure 1 Please check the quality of Figure 1 as it is blurry in the uploaded pdf. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Vishnu Khanal, PhD. Reviewer #2: Yes:** Jane Scott [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0243097.r001
Revision 1
9 Nov 2020 Author Response RESPONSE TO COMMENTS FROM REVIEWER 1 Overall comment: This is a well presented research from the authors and to my knowledge this is the first research that used the national data set from Indonesia to investigate the factors associated with prelacteal feeding. I have only one suggestion that the authors may consider to include in the manuscript. Outcome variables: I request the authors to include actual question from DHS. There is always a debate on ‘first feed’ vs ‘any food other than breast milk in the first three days’ when it comes to DHS survey. Presenting actual question would help comparability of the findings. Response: We thank Reviewer 1 for raising this issue so that we can clarify. We were aware that there was a slight wording difference between the English and Indonesian versions of 2017 IDHS. In the Indonesian version, the question translates to "In the first three days after delivery, before your milk began flowing regularly, was (NAME) given anything to drink other than breast milk?", while in the English version, the question does not have the part about milk flowing regularly and it was exactly the question that we have previously included in our manuscript i.e. “In the first three days after delivery, was (NAME) given anything to drink other than breast milk?". In our initial submission, we only included the English version because this is the standard definition used by DHS Guidelines, other DHS reports from other countries, and DHS-based studies. We also had confirmed with the DHS Team that this was the correct approach. However, after carefully considering your feedback, we agree that adding the question as worded in the Indonesian version is more accurate. Therefore, in the revised manuscript, the translated Indonesian question has been added into the methods (please refer to Manuscript with Track Changes, page 5, line 92-94). The impact of the slightly different definitions is addressed in the discussion (page 19-20, line 282-285). RESPONSE TO COMMENTS FROM REVIEWER 2 1. Definition of prelacteal feeding. As there are various definitions of PLF used by researchers, I recommend that the definition of prelacteal feeding used in this study be included in the abstract and earlier in the introduction. It is not until page 5 when the authors describe the outcome variables that it is clear that PLF includes anything other than breastmilk in the first 3 days after delivery. Various researchers have defined PLF to be ‘the first feed given’ or ‘feeding any other substance before first breastfeeding’, ‘foodstuff or feed that is given to a newborn infant before the mother has begun to breastfeed’. Response: In addition to our response to the comment from Reviewer 1, we have now included the definition of prelacteal feeding (PLF) in the abstract (Manuscript with Track Changes, page 2, line 8-11) and introduction (page 3, line 27) and hope it will improve clarity. 2. While the paper for the most part is written in standard English, it would benefit from a careful final proof reading by someone for whom English is their native language. The paper includes a number of minor grammatical errors and several examples of awkward wording. Response: Two of the authors have English as their native language and we have revised these minor errors. 3. A lack of continuous page numbering made this somewhat annoying to review and comment on. Response: We have page numbers in the manuscript, but we apologise for not including continuous line numbers. They have now been added into the manuscript. For the rest of corrections where line numbers are indicated, please refer to the Manuscript with Track Changes. Minor corrections 1. Antenatal card is a noun and needs the indefinite article ‘an’ to be placed before it, i.e. had an antenatal card. There are other cases where the definite (the) or indefinite (a) article is missing from before a noun e.g. had a home birth. Response: Thank you for your detailed comments on the text. All the grammatical and typographical errors listed above have been corrected. 2. Page 3, last para, line 6 should read ‘used data from the 2017 Indonesia DHS Response: Correction has been made. 3. Page 5 line 3 should read ‘… were asked of all mothers’ Response: Correction has been made. 4. Page 7 lines 14-16 the first part of this sentence is awkwardly worded. Study population Response: Correction has been made. It now says, “In this study, possession of an antenatal card was considered as a potential associated factor because it is designed as an educative intervention for pregnancy and birth preparedness. Antenatal cards contain information on breastfeeding including PLF avoidance and colostrum benefit” (line 133-136). 5. Page 9 line 4 “About 33% of the mothers had the first birth” awkward wording Response: Correction has been made. It now says, “One-third of the study population reported that the cohort member was their first baby” (line 170-173). 6. Page 12 Table 2 footnote suggest rewording ‘reported as having ever breastfed’ Response: Correction has been made. 7. Page 13 The text needs to stand alone from the tables. The percentages given in the first paragraph are unnecessary and not particularly useful without knowing the percentages of the comparator groups. Response: Correction has been made. It now says, “However, giving any PLF was more common among mothers who lived in rural area, had their first child, perceived their babies as smaller than average, had a caesarean delivery at public facilities, and did not have an antenatal card” (line 197-200). 8. Page 13 When reporting the aPRs here and for other outcomes it is customary to identify the reference category. For instance, was the reference group for infant size women who perceived that their baby was average size or larger than average. Response: Correction has been made here and elsewhere. A reference group is mentioned when reporting PRs. For example, in paragraph starting at line 201, it now says “Table 3 shows the final models after mutual adjustment for all factors. The prevalence of any PLF was higher among mothers who perceived their baby to be smaller (aPR 1.23; 95% CI1.12-1.35) than among mothers who perceived their baby to be of average size”. 9. Page 15 Again, the percentages given in the first paragraph are unnecessary and not particularly useful without knowing the percentages of the comparator groups. Response: Correction has been made here. It now says, “Table 4, formula was more common among mothers who gave birth for the first time, perceived their baby to be smaller, and had a caesarean delivery (in either public or private facilities)” (line 220-223). 10. Page 20 Sociodemographic factors The sentence ‘In contrast, none of the sociodemographic factors were statistically significant honey’ is awkwardly worded, suggest rewriting “In contrast, none of the sociodemographic factors were significantly associated with giving honey as a PLF.” Response: We agree that this is clearer and have amended the manuscript with the suggested text (line 301-302). 11. Page 21 para 1 Strictly speaking your study did not highlight the diversity of PLF risk factors across countries. This wording suggests that you analysed data from a variety of countries. Instead, what you are reporting is that the associations found are not consistent across all countries. Response: The sentence has been reworded, and now reads “Our findings were not consistent with those observed from research in different settings, suggesting that PLF risk factors are not consistent across all countries” (line 314-316). 12. Page 21 line 8 should read ‘higher prevalence of any PLF’ Response: Correction has been made. 13. Page 21 line 10 should read ‘urban areas’ (plural) Response: Correction has been made. 14. Page 22 line 7 should read ‘immediate skin-to-skin contact is one of the Ten Steps…’ (present tense) Response: Correction has been made. 15. Page 22 line 10 should read ‘in accordance with…’ Response: Correction has been made. 16. Page 24 2nd line from bottom should read ‘educating mothers’ (plural) Response: Correction has been made. 17. Page 24 line 4 suggest adding ‘within this practice.’ Response: Correction has been made. 18. Reference List Please check the reference list carefully to ensure that all journal titles are abbreviated. You may need to edit the references in your Endnote library. Response: Thank you for highlighting this, we have checked the list and amended as needed. There are some Indonesian language texts that it is not appropriate to abbreviate, for example “Penelitian Gizi dan Makanan” in reference no.13. 19. Figure 1 Please check the quality of Figure 1 as it is blurry in the uploaded pdf. Response: The image for Figure 1 has been uploaded to and previewed on https://pacev2.apexcovantage.com/ and this version has been resubmitted. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0243097.r002
16 Nov 2020 Decision Letter - Jane Anne Scott, Editor Prevalence of prelacteal feeding and associated risk factors in Indonesia: evidence from the 2017 Indonesia Demographic Health Survey PONE-D-20-18812R1 Dear Dr. Rahmartani, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Jane Anne Scott, PhD, MPH Grad Dip Dietetics, BSc Academic Editor PLOS ONE Additional Editor Comments (optional): Please check that your references are up to date. References 16 and 53 have been published and full volume and page number details are available. Reviewers' comments: https://doi.org/10.1371/journal.pone.0243097.r003
Formally Accepted
20 Nov 2020 Acceptance Letter - Jane Anne Scott, Editor PONE-D-20-18812R1 Prevalence of prelacteal feeding and associated risk factors in Indonesia: evidence from the 2017 Indonesia Demographic Health Survey Dear Dr. Rahmartani: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Jane Anne Scott Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0243097.r004

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