Weaning practices and breast-feeding duration in Northern Thailand.

Current infant feeding guidelines recommend exclusive breast-feeding until the infant is about 4 months old to reduce the risks of early termination of breast-feeding, undernutrition and infection. In many societies, however, supplementary foods are given well before 4 months of age. The present paper describes weaning practices, factors associated with early supplementation and the effects of supplementation on duration of breast-feeding in a random sample of sixty northern Thai breast-fed infants studied prospectively from birth to 2 years of age. Composition of supplementary foods, energy and protein intake from supplements and changes in the supplementary diet with increasing infant age are also described. Rice-based foods were given from soon after birth; 81% of the sample had received supplements by 6 weeks of age. Early supplementary feeding was significantly associated with rural residence, large household size, maternal employment in agriculture and maternal age. Girls and infants with lower birth weights tended to be supplemented earlier. Despite early feeding of supplements, breast-feeding was prolonged, with median duration of 12 months. Early introduction of supplements and quantity of supplements consumed in the first 3 months were not associated with duration of breast-feeding. However, mothers who gave infant formula as the first supplementary food stopped breast-feeding slightly earlier, as did younger mothers living in households with more children.     

Infant feeding practices of the Igbo,Nigeria

The pattern of infant feeding and attitudes of the mothers towards breast feeding, morbidity and mortality of a sample of the Nigerian Igbo tribe was studied. The result showed that:

• Ninety‐four percent of all mothers breast fed their infants for at least six months. The duration was longer among the non‐educated than the educated mothers.

• The size of the family decreased with increases in educational attainment. Eighty percent of the mothers gave their babies supplementary food between 3–7 months of age. A special weaning diet was used by 49 percent of the educated mothers and 27 percent of the non‐educated mothers.

• Twenty percent of the children has at least one attack of diarrhoea before the age of six months. One out of every eleven children was admitted at least once to the hospital before the end of six months.

The prevalence of diarrhoea, malnutrition and possibly death could be attributed to a number of factors. These include: the introduction of supplementary food too early in unsanitary conditions, the ignorance of the mothers of what the weaning diet should constitute, the large number of children in the family, and the unhiegienic environment.     

Breastfeeding and weaning practices in rural communities of Kelantan

A survey of infant-feeding and weaning practices of 566 mothers, systematically sampled from 15 rural villages, randomly selected in the district of Tumpat, Kelantan was carried out. Almost all mothers (97.3%) breastfed their children, reinforcing the previously reported high incidence of breast-feeding among rural Malaysian mothers. One hundred and seventeen (21.3%) of the 551 children breastfed were also given mixed feeding with infant fomulae as well. Weaning started before 4 months of age in 28.3% of the children and after 6 months of age in 12.8% of the children. The 3 most common type of food used in weaning were Nestum (45.0%), rice porridge or paste (42.6%) and wheat porridge or cakes (11.5%). Forty eight children (12.1%) discontinued breastfeeding once weaning was initiated. The main reasons for initiating weaning was mothers' perception that there was insufficient milk and that the child was always hungry (55.7%). Most mothers were also given advice by the health clinic staff on weaning, including the timing and the suitable weaning foods to give. All of the mothers were able to name at least one commercial weaning food product available in their community.     

Carotenoid composition and content of legumes, tubers and roots by HPLC

A survey was carried out in the district of Kemaman, Terengganu, Malaysia to study infant feeding practices in rural and semi-urban communities. A total of 593 mothers were interviewed and their socio-demographic information recorded. Data on infant feeding practices were collected from mothers who had children up to 15 months of age. Among breast-feeding mothers (n =157), 42.0 % fed their babies for less than 3 months and 58.0% bottle fed for more than 6 months. Sixteen children were found to be fed on sweetened condensed milk with 62.5% of them for the first 3 months. Among those who breast fed their babies, 40.1% were found to have bottle fed at one time or another. The majority of breast feeding mothers belonged to the groups having incomplete primary schooling or completed primary education only and household income below RM600 per month. A substantial number of breast fed babies were given weaning foods in the form of porridge mixture (rice + egg, rice + vegetables, rice + meat, rice+ fish and cereals) between the age of 0 - 3 months. The findings of this study concluded that although breast-feeding is widely practiced, however, their duration has dwindled, and early introduction of solid foods is widespread.     

Maternal employment: does it influence feeding practices during infancy?

Background: Although at least 30% of women with young children participate in the labour force, there has been very little research into the effect of maternal employment on the diets of young children. Increasingly it is being recognized that early feeding practices affect future health and may have a part to play in the development of eating disorders. Therefore it was decided to conduct a study in Sheffield to determine whether maternal employment influences infant feeding practices.
Methods: Mothers from social classes I and II (employed n =27; unemployed n =28) with infants aged 10–12 months were interviewed in their homes. Information was collected on past and present food and drink consumption, weaning practices, and progression to independent feeding.
Results: Employed mothers stopped breast-feeding earlier. This difference became evident after 2 months of age and reached significance at 4 months ( P < 0.05). Employed mothers introduced foods earlier and relied more on commercial baby foods, with significantly more spending over ú7–12 per week at the time of the survey ( P < 0.05).
Conclusions: Maternal employment does influence infant feeding practices and consequently may have repercussions on future health. Further studies are needed to investigate the long-term effects of maternal employment on infant feeding practices, particularly amongst lower socio-economic class families.     

The reasons for early weaning among mothers in Teheran.

In order to identify the reasons for early weaning in Teheran, we interviewed 900 mothers using a systematic randomized sampling method. A total of 15% of the mothers were illiterate, 93% were housewives, and 97% had given birth in hospitals. Only 3% of the newborns benefited from rooming-in facilities in hospital, and 68% were bottle-fed while still in hospital. In 3.1% of cases the mother had not breast-fed her newborn at all. Of those who had breast-fed their infant, 38% used only their own milk, whereas 62% used a combination of breast milk and infant formula. The median duration of breast-feeding was 16 months (mean, 14 months). A total of 74% of mothers who used supplementary formula and 39% of those who had completely stopped breast-feeding blamed milk insufficiency, although 67% of these mothers had reached this conclusion only because their infants cried or were irritable. The following factors had a negative influence on the duration of breast-feeding: use of supplementary formula and of estrogen-containing oral contraceptives; fathers with high incomes; and mothers with a high educational level. In contrast, the mother''s religious motive to breast-feed and her insistence on breast-feeding had a positive impact. Unfortunately, 21% of the mothers started using supplementary formula during the first month postpartum, and two-thirds before the end of the fourth month. Every month that bottle-feeding was started prematurely shortened the duration of breast-feeding by 20 days.(ABSTRACT TRUNCATED AT 250 WORDS)     

Maternal Control of Child Feeding During the Weaning Period: Differences Between Mothers Following a Baby-led or Standard Weaning Approach

A controlling maternal feeding style has been shown to have a negative impact on child eating style and weight in children over the age of 12 months. The current study explores maternal feeding style during the period of 6–12 months when infants are introduced to complementary foods. Specifically it examines differences between mothers who choose to follow a traditional weaning approach using spoon feeding and pureés to mothers following a baby-led approach where infants are allowed to self feed foods in their solid form. Seven hundred and two mothers with an infant aged 6–12 months provided information regarding weaning approach alongside completing the Child Feeding Questionnaire. Information regarding infant weight and perceived size was also collected. Mothers following a baby-led feeding style reported significantly lower levels of restriction, pressure to eat, monitoring and concern over child weight compared to mothers following a standard weaning response. No association was seen between weaning style and infant weight or perceived size. A baby-led weaning style was associated with a maternal feeding style which is low in control. This could potentially have a positive impact upon later child weight and eating style. However due to the cross sectional nature of the study it cannot be ascertained whether baby-led weaning encourages a feeding style which is low in control to develop or whether mothers who are low in control choose to follow a baby-led weaning style.     

Breast-feeding patterns in a rural village in Giza, Egypt.

In a longitudinal study of infant feeding in rural Giza, Egypt, we found that 68.8% of the recruited mothers initiated early suckling of colostrum, but only 51.2% of the infants were exclusively breast-fed in the first week. Solid foods were introduced much earlier than at the recommended age of 4 to 6 months. Sixty percent of the mothers who participated in the study considered breast-feeding plus regular or irregular complementary feeding to be exclusive breast-feeding.     

Infant feeding practices of Pakistani mothers in England and Pakistan

Objectives To investigate infant feeding practices followed by Pakistani mothers in Pakistan and in England. To establish if practices conform to current guidelines and to investigate reasons for adherence and nonadherence. Methods Ninety mothers of weaning age children were interviewed; 45 were in England and 45 in Pakistan. A questionnaire available in English and Urdu sought to find out about the methods of milk feeding and weaning used and the advice received, together with general beliefs about weaning. Results Characteristics of the infants in terms of current age, gender distribution, birth order of baby and age of weaning showed no significant differences between the two groups. Thus, differences between the two groups could be attributed to cultural differences rather than any of these factors. Chi‐square analysis showed that the initial method of feeding chosen was significantly different (P < 0.001, d.f. = 2) with 73% of mothers in Pakistan breast‐feeding compared with 24% in England. Similar proportions of mothers in both groups commenced weaning between 3 and 4 months. Common weaning foods included rice, cereals and eggs with progression to fruit and vegetables and family food in Pakistan, and fruit, vegetables, meat and convenience foods (especially sweet options) in England. Both groups of mothers wanted more information about infant feeding practices. Conclusion Mothers in Pakistan demonstrated more confidence in weaning practices than in England because of experiences with other siblings and advice from relatives. More advice from health professionals was requested and is needed by all mothers in order to improve weaning practices of the infants.     

2002年北京市2岁以内婴幼儿营养与喂养状况调查

目的了解北京市2岁以内婴幼儿出生时营养、母乳喂养与辅食添加状况,为政府制定儿童营养政策提供依据。方法采取分层整群随机抽样方法,于2002年8至11月在北京市18个区县进行抽样调查。在取得知情同意的情况下,对422名2岁以内婴幼儿的家长进行面对面询问调查。结果北京市平均婴儿出生体重为3325g,低体重出生率和巨大儿出生率分别为2．8％和13．0％;4月龄内婴儿母乳喂养率、混合喂养率和人工喂养率分别为56．6％、33．9％和9．5％,城区混合喂养率明显高于郊区;婴幼儿平均断奶月龄为7．4个月;6月龄及以上婴幼儿的辅食添加率为99．4％,城区和郊区婴幼儿各类辅食的添加顺序一致,但郊区婴幼儿的辅食添加时间晚于城区,且蔬菜水果、水产品、食用油的添加频率低于城区。结论北京地区新生儿体格发育良好,应在社区加强婴幼儿喂养的健康教育,提高母乳喂养率,适当延长母乳喂养时间,并适时添加各类辅食。     

Breast feeding and weaning practices of urban housewives in Srinagar

Researchers interviewed 125 mothers in Srinagar, India about breast feeding and weaning practices. Overall the mothers were generally illiterate (52%), housewives (67.2%), Muslim (76%), and from a nuclear family (56%). 39% were in the low income group. Most of the children (48%) ranged for 6-12 months old. 96% of the children had been breast fed. Some of the reasons for breast feeding included nutritional quality, economical, pleased the mother, and made the infant feel secure. 65.8% breast fed their infants on demand. 65.7% weaned their infants between 7-9 months yet 52% believed breast feeding should continue to 18 months. 96% breast fed their infants while ill with diarrhea. 57% believed colostrum to be unhygienic and did not feed it to their infants. 72% decided to breast feed before becoming pregnant while 36% decided to bottle feed before pregnancy. 89% of illiterate mothers breast fed while only 45% of literate mothers did. Further, only 11.8% of the mothers whose family income was 1500 rupees/month breast fed whereas 47% in the lower and 41.2% in the middle income groups did. At 7-9 months, 69.8% of illiterate and 69.5% of literate mothers had already introduced semi solid foods. 78.3% of literate mothers gave semi solid foods to their infants 2 times/day, but only 11.6% of the illiterate mothers did so. Moreover 81.4% of illiterate mothers only fed their infants semi solid foods once a day. Literate mothers were more likely than literate mothers to feed their infants solid foods (75% vs. 46.2%), introduce them at an earlier age (22.2% vs 10%, 7-9 months), and feed them more often (55.5% vs 16.6%; twice a day). In conclusion, the higher the educational status the more likely mothers were likely to breast feed.     

Weaning practices in Kaduna, Northern Nigeria

A standardized questionnaire was administered to 65 mothers attending the Nutrition Clinic of the Ahmadu Bellow University Teaching Hospital, Kaduna, Northern Nigeria, over the October-December 1978 period to determine at what age the 1st supplementary diet was introduced, the age the child was weaned, and the weaning practices. The questionnaire dealt with various aspects of weaning knowledge, attitudes, and practices. The mothers were referred to the Nutrition Clinic because their babies already were suffering from protein energy malnutrition, had failed to thrive, or had severe infections, e.g., measles, gastroenteritis, or respiratory diseases. 58 (89.2%) of the families were of low socioeconomic status. 36 mothers (55.4%) introduced supplementary feeds to their babies between 4-6 months of life; 27 (41.5%) mothers introduced supplementary feeds when their children were between 7-9 months. All the mothers used corn, guinea corn, or millet gruel. A decision to wean a child may be made if the child can crawl, walk, or has a good set of erupted milk teeth, even if the child has not reached the traditional weaning age of 20-24 months. The mean age of weaning was 17 months in this study. 51 (78.5%) of the mothers responded to the question about weaning food taboos, prohibitions, and their reasons during the weaning period. Even when protein is available, a child may be denied the protein because of sociocultural factors. The use of carbohydrate gruels among these low socioeconomic families coupled with sociocultural factors compounded the feeding problem, and, consequently, protein energy malnutrition was common during the weaning period.     

西部贫困农村地区健康信息传播对婴幼儿母亲科学喂养认知的促进

目的 明晰西部贫困农村地区健康信息传播模式对婴幼儿母亲母乳喂养认知的影响,为提高该类地区妇女的婴幼儿喂养认知,从而改善婴幼儿的健康状况,提供科学建议。 方法 分别于2014年、2019年在我国西部贫困农村地区,选取24月龄及以下婴幼儿及其母亲为研究对象,通过问卷调查收集其人口学特征、健康信息传播模式、科学喂养认知等资料。运用回归分析健康信息传播模式对婴幼儿母亲的科学喂养认知的影响。 结果 共纳入1 284对（2014年）、1 049对（2019年）母婴。2019年婴幼儿母亲早开奶知晓率（72.64%）、纯母乳喂养知晓率（31.36%）均分别显著高于2014年（65.73%,25.30%）（均 P < 0.05）。在信息传播模式中,70.54%的婴幼儿母亲主要通过基层医务工作者获取喂养信息。回归分析显示,基层医务工作者结合信息传播材料传递母乳喂养信息( OR = 2.23, 95% CI 1.03～4.85)促进了婴幼儿母亲的早开奶认知;基层医务工作者传播母乳喂养信息( OR = 1.57, 95% CI 1.04～2.38)、基层医务工作者与亲友协同传播母乳喂养信息的交互作用( OR = 2.39, 95% CI 1.48～3.87)促进了婴幼儿母亲纯母乳喂养认知。 结论 以基层医务工作者为核心的母乳喂养信息传播模式促进了西部贫困农村地区婴幼儿母亲早开奶、纯母乳喂养的认知。     

Assessment of health and nutritional status of infants in relation to breast feeding practices in Karmouz area, Alexandria

Infants are most precious part of nation's life. Infant health is a reflection of the health of the mother and it gives an indication of the health of the adult population of the future. The present work was designed to study the health and nutritional status of infants in Karmouz area in Alexandria as well as the effect of breast feeding practices on the health status of infants. Accordingly, a house to house survey was conducted through cluster sampling technique. The total sample amounted to 396 mothers and 409 infants. Data were collected about infants health status and their feeding practices. Weight and length were measured for all infants. Stool samples were collected and examined. The results revealed that 55.3% of infants had acute respiratory tract infections (ARI); 16.4% had bronchitis and 4.9% had pneumonia, 44% of the infants suffered from diarrhea, 13.2% were infected with parasites, Gardia lamblia was the most commonly found parasite (9.0%). High proportion of infants was found to be stunted (22.7%), 8.6% were wasted and 7.6% were underweight, 40.3% of mothers were in partial practice level. Infants below six months of age who received solid foods at three months or less had a significantly higher percentage of diarrhea (70.6%) compared to 51.5% among those of late weaning (four months or later). The diarrhea was significantly more common among infants aged 12 - < 18 months with about two times of risk relative to those aged < 6 months. A significantly higher risk of diarrhea was found for infants of bottle--or complementary feeding (OR = 2.05, 2.07 respectively, model X2 = 9.71, P < 0.01), in addition the protective effect of breast feeding persisted after adjustment of confounders by multiple logistic regression. High proportion of mothers (63.8%) continued to breast-feed their babies during diarrheal episodes. On the other hand breast-feeding was not significantly protective against the acute respiratory tract infection. Stunting of the infants increases rapidly with age from 12.6% among infants under six months to 30.4% among those aged from 9 - < 12 months. The percentage of stunted infants varied greatly by education of the mothers, it was doubled from 14.7% among those of mothers of high level of education to 28.9% of non educated mothers with a significant high risk of 2.31 times. The repeated attacks of diarrhea throughout the two years of life was still significantly associated with stunting even after adjustment of confounders by multiple logistic regression;, those with three attacks or more had about three times of risk relative to those without the disease (OR = 2.56, 95% CL = 1.12-5.81, model X2 = 19.03, P < 0.01). Health education program should be emphasized to all mothers to improve their knowledge and practice about breast-feeding and its importance in prevention of diarrhea.     

Dietary risk factors associated with acute and persistent diarrhea in children in Karachi, Pakistan

Feeding practices may have an important impact on diarrheal diseases in developing countries. This study evaluated feeding practices in three groups of male children aged 6-36 mo: 100 with persistent diarrhea (PD), 79 with acute diarrhea (AD), and 86 in a comparison group (CG). The children came from comparably poor socioeconomic settings in Karachi, Pakistan, except that the literacy rates were higher in mothers of the CG (P = 0.0001). Although greater than 95% of all infants were breast-fed, delayed initiation of breast-feeding was more common in the diarrhea groups. Children with diarrhea were also more likely to receive supplemental milk (PD = 92%, AD = 87%) than were children in the CG (69%, P less than 0.05). Feedings were not withheld during diarrhea but changes were made in the nature of foods given. These results indicate that several feeding practices may be important risk factors for diarrhea in Pakistan.     

Infant feeding practices of Anglo American and Asian Indian American mothers.

OBJECTIVE: To compare infant feeding practices of Anglo-American (AA) (n = 25) and Asian-Indian American (AIA) mothers (n = 25) residing in the southeastern United States. METHODS: Feeding practices (breast-feeding, formula-feeding, introduction of solid foods) were assessed at infant ages one, three, six, nine and twelve months for a total of 250 interviews conducted in the home. Mothers' sources of information about infant feeding practices and dietary intakes of their infants were collected (24-hour recalls). RESULTS: Compared to their AIA counterparts, AA mothers breast-fed for significantly longer durations and introduced formula and solid foods into the infants' diet at a later age (p<0.05). Throughout the first year, AA mothers relied primarily upon health professionals for infant feeding information compared to AIA mothers, who sought information primarily from the family network during the first six months and relied more on health professionals during the second six months of the infant's life. Throughout the first twelve months, infants of both groups exceeded 100% of the RDA for energy, protein, calcium, iron, vitamin A, and vitamin C. CONCLUSION: Health professionals, including nutrition educators, should educate AIA mothers about and encourage AA mothers to follow current feeding recommendations and guidelines about breast-feeding, formula-feeding and introducing solid foods.     

Nutrition du nourrisson et diversification alimentaire

After an overview of infant nutritional requirements, this paper deals with the various feeding alternatives offered to the newborn, putting forward the definite health benefits of breast-feeding for the first months of life. The diverse types of infant formulas are then described, classical ones as well as those designed for the alleviation of peculiar alimentary disorders (gastro-esophageal reflux, lactose maldigestion, diarrhea, food allergies…). A special attention is paid to the specific nutritional needs of premature babies and infant formulas designed to meet these requirements. To conclude, the introduction of weaning (solid) foods throughout the first two years of life is described.     

An enquiry into the attitudes of Muslim Asian mothers regarding infant feeding practices and dental health

Recent studies have highlighted some unfavourable dietary practices among Asian infants in the UK. A number of reasons for such nutritional patterns have been suggested. In the present study, attitudes, beliefs and expectations of 100 first-generation Muslim Asian mothers regarding infant feeding practices were explored through group discussions in their mother tongue.
It was found that mothers generally favoured breast-feeding but lacked knowledge of weaning practices. There was great emphasis on the consumption of milk. The advice from health professionals to discontinue using a feeding bottle by 12 months of age was not considered acceptable. Some mothers thought the change might cause infants to stop drinking milk and that there was little alternative suitable nourishing food available for that age group. The main requirement for infant foods was that they must be halal. Sugar was used either because it ensured that more milk would be consumed, or because it was considered to be intrinsically beneficial. Some mothers fed children on demand, some stated that children chose what they wanted to eat, and that mothers lacked firm control of dietary intake.
Against a background of conflicting advice from health professionals, pressure from in-laws, and the powerful influence of advertising, there is considerable scope for the training of health professionals and for continuing education for families and communities.     

中国农村地区婴幼儿辅食添加状况

对较贫困农村地区 146 49名 4～ 2 4月龄婴幼儿的辅食添加情况进行分析 ,结果显示婴幼儿平均从出生后 6个月开始添加食物 ,约 1 3的婴幼儿在 4～ 6个月开始添加 ,有 16 4%的婴幼儿在 4个月以前就添加了谷类食物 ;大多数婴幼儿 (74 4% )从 7个月开始每天进食谷类食物 ,蔬菜水果类食物的摄入频率随着年龄的增加有所增加 ,但 1岁以后也只有 5 0 %的的婴幼儿能够每天食用蔬菜水果。蛋白质类食物的摄入频率较低 ,1岁以上婴幼儿能够每天食用的占 38% ,有 15 8%的婴幼儿从未添加过肉蛋类及豆制品类食物。农村地区的大多数婴幼儿是以母乳喂养的 ,但断奶以后只有 2 0 %的婴幼儿能够每天饮奶 ;婴幼儿的食物摄入情况受家庭食物状况的影响 ,随着年龄的增加 ,影响程度增加 ;婴幼儿辅食添加的状况直接影响婴幼儿的生长发育 ,长期不合理的喂养模式 ,就会造成营养不良。应通过营养教育 ,提高婴幼儿看护人的营养知识 ,及时合理地添加辅食对婴幼儿的生长发育非常重要。     

Breast-feeding through the first year predicts maternal control in feeding and subsequent toddler energy intakes

OBJECTIVE: Current recommendations for infant feeding encourage breast-feeding through the first year. This research was conducted to evaluate associations among breast-feeding, maternal control of child feeding, and the dietary intake of toddlers during the second year of life. In particular, we sought to determine whether breast-feeding through the first year and subsequent toddler intake was mediated via maternal control of child feeding. DESIGN/SUBJECTS: Fifty-five white infants and their mothers were monitored longitudinally from age 12 or 13 months to age 18 months. MAIN OUTCOME MEASURES: Breast-feeding through the first year and maternal control in infant feeding were evaluated as predictors of energy intake at age 18 months. STATISTICAL ANALYSES PERFORMED: Regression analysis was used to evaluate predictors of toddler energy intake at age 18 months. A mediation model tested if the relationship between breast-feeding and infant intake was mediated by maternal control in feeding. RESULTS: Breast-feeding through the first year was associated with higher toddler energy intakes at age 18 months through its influence on maternal control in feeding. Mothers who breast-fed their infants for at least 12 months used lower levels of control in feeding. Lower levels of maternal control in feeding were associated with higher toddler energy intakes. The highest energy intakes among children aged 18 months were observed among taller and leaner toddlers. APPLICATIONS/CONCLUSIONS: Our findings suggest that breast-feeding through the first year may have an effect on children's energy intake by shaping mothers' child-feeding practices. These findings may be used by clinicians to assist parents in making informed decisions about choice of infant-feeding method and to provide anticipatory guidance regarding infant-feeding style when initiating dietary diversity.