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.     

Socio-cultural factors influencing nutritional status of infants -- a longitudinal study

During 1985-1986 in India, health workers went to the homes of 200 infants, 1-11 months old at the time they were brought into the study, and followed them until they reached one year. The researchers aimed to evaluate the role of weaning in determining the nutritional status of infants as well as to identify the sociocultural factors affecting weaning practices in the rural area near Aligarh. 99% of the infants received a prelacteal feed, especially ghutti (94%), within 6 hours of delivery. 99% were breast fed. Breast feeding began between 6 and 72 hours of birth. Almost all mothers believed ghutti cleanses the intestines and that colostrum is harmful. They discarded the colostrum. 73.5% of infants received top diluted milk. Mothers did not feed undiluted milk to their infants because they believed it causes diarrhea. 50.5% of mothers did not give their infants semi-solid foods until after 9 months. 20.5% did not give any semi-solid or solid food at one year. They all thought that semi-solid food causes diarrhea. 62.5% of infants received family food. 15% received biscuits. 98% had poor knowledge about nutritional requirements of infants, other than that breast milk is the natural food of infants. Most mothers practiced poor hygiene. Infants less than 6 months old were significantly more likely to have normal nutrition for age than those older than 6 months old (65.5% vs. 32.4%). Nutritional status declined with age, reflecting the unhygienic weaning practices in the area. At the end of 12 months, 6.8% suffered from severe grades of malnutrition. Nutritional status was not associated with social class. Educational status of mothers and fathers was significantly associated with nutritional status. These findings show that inadequate knowledge about proper weaning, not lack of food, is the limiting factor in infant nutrition. Education about the importance of proper weaning and weaning foods imparted by grass-root level workers is needed.     

Patterns and Predictors of Breast Milk Feeding from Birth to Age 4 Months among Primiparous African American Mother–Infant Dyads

The health benefits of breast milk feeding have been well-established, yet disparities exist, with African American mothers having the lowest breast milk feeding rates in the United States. This prospective, longitudinal study examined infant feeding (breast milk and/or infant formula) from birth to age 16 weeks, predictors of any breast milk feeding by age 1 week, and predictors of cessation of any breast milk feeding by ages 3, 8, and 16 weeks among primiparous African American mothers. This secondary analysis included 185 mother–infant dyads from the Sleep SAAF (Strong African American Families) study, a randomized clinical trial testing a responsive parenting vs. child safety control intervention. Mothers reported sociodemographic and psychosocial characteristics at age 1 week and infant feeding practices at ages 1, 3, 8, and 16 weeks. Rates of any breast milk feeding decreased from 66.5% at 1 week to 23.3% at 16 weeks. Bivariate logistic regression models showed that prepregnancy BMI (OR = 1.09), working prepregnancy (OR = 2.25), and food insecurity (OR = 2.49) significantly increased the odds of mothers feeding any breast milk by 1 week, whereas Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation (OR = 0.21) significantly decreased the odds. Bivariate logistic regression models showed that Supplemental Nutrition Assistance Program (SNAP) participation (OR = 2.86) and racial discrimination (OR = 2.14) significantly increased the odds of cessation of any breast milk feeding by 3 weeks. SNAP (OR = 2.33) and WIC (OR = 2.38) participation significantly increased the odds of cessation of any breast milk feeding by 8 weeks, whereas higher prepregnancy BMI (OR = 0.95) decreased the odds. Higher mother’s age (OR = 0.92) significantly decreased the odds of cessation of any breast milk feeding by 16 weeks. The findings can be used to inform targeted interventions to promote mothers feeding any breast milk and help reduce breast milk feeding disparities among African American mothers.     

Maternal employment and breast-feeding initiation: findings from the Millennium Cohort Study

Maternal employment rates have increased rapidly in recent years and little is known about how this influences whether women start breast feeding. We examined data from the Millennium Cohort Study to determine whether a mother's employment status (full-time, part-time, self-employed, on leave, not employed/student) and employment characteristics are related to breast-feeding initiation. This analysis comprised 14 830 white mothers from Britain and Ireland (6917 employed) with singleton babies, born from 2000 to 2002. Information was obtained on infant feeding history and mother's employment when the cohort child was 9 months old. We found that women employed full-time were less likely to initiate breast feeding than mothers who were not employed/students, after adjustment for confounding factors [adjusted rate ratio (aRR) = 0.92; 95% confidence interval (CI) 0.89, 0.96]; however, there were no differences in breast-feeding initiation between mothers employed part-time, self-employed, or on leave and mothers who were not employed/students. Among employed mothers, those who returned to work within 4 months postpartum were less likely to start breast feeding than women who returned at 5 or 6 months [aRR = 0.95; 95% CI 0.92, 0.99], and women who returned within the first 6 weeks were much less likely to start breast feeding [aRR = 0.85; 95% CI 0.77, 0.94]. Mothers returning for financial reasons were also less likely to initiate breast feeding [aRR = 0.96; 95% CI 0.93, 0.99] than those who returned for other reasons. Policies to increase breast feeding should address how both the time and circumstances of a mother's return to employment postpartum influence whether she decides to start breast feeding.     

Infant feeding among women attending an immunisation clinic at a tertiary health institution in Ibadan,Nigeria

Maternal characteristics can affect a mother’s decision to breastfeed. This study used a cross‐sectional design to assess maternal variables and infant feeding patterns among nursing mothers attending an immunisation clinic in Ibadan, Nigeria. A total of 264 mothers who consecutively attended the immunisation clinic and met certain inclusion criteria were interviewed. A majority of mothers (204, 77.2%) were in the middle of the reproductive age span (24–35 years); 180 (68.2%) had attended tertiary educational institutions. Almost all the mothers (257, 97.3%) had good knowledge about exclusive breast‐feeding. Exclusive breast‐feeding decreased with the age of the infant; by six months of age, only 40% of infants were exclusively breastfed. Of the mothers who practiced exclusive breast‐feeding, 30 (18.5%) initiated breast‐feeding within 30 minutes after birth. There may be a need to increase the emphasis placed on the time that complementary feeding should be introduced.     

The epidemiology of breastfeeding cessation in sub-urban Lagos, Nigeria

Two hundred and forty mothers in a sub-urban community in Lagos were studied. Respondents were women who had children 0 -- 24 months of age. They were largely married women of low educational and socioeconomic background. Breastfeeding is commonly practised in this community. Nearly all the mothers (92.4%) breastfed for longer than six months and a large proportion (71.5%) breastfed up to 12 months. The proportion of male infants who were breastfed for longer than 12 months was higher than that of the female infants (75% vs. 67%) although the difference was not statistically significant (X² = 1.77, p=0.279). Older mothers (#lt35 years) tended to breastfeed for slightly longer period than their younger counterparts. There was a significant inverse association between mothers' level of education and the duration of breastfeeding (p = .035). The major reason for stopping breastfeeding as given by 62 percent (149 mothers) was that the child was old enough. The next important reason for stopping breast feeding was that the mother had to resume work. The “insufficient milk syndrome” as reported from many cultures of developed and developing countries of the world has not yet affected the Nigerian suburban women and was not an important reason for stopping breastfeeding.     

Breast‐feeding patterns in Saudi Arabia

A survey was conducted on 1019 mothers in 79 primary health care centers in Saudi Arabia to determine the patterns of breast‐feeding. A large percentage of the mothers (98%) had breast‐fed their infants at birth. This rate dropped to 96.5% during the first week of life. There were 635 (64.1%) mothers who started to breast‐feed their babies within six hours of delivery. Over two thirds (68.9%) of mothers gave supplemental liquids to infants during the first 3 days of their life. More than half fed their infants on demand rather than on schedule. A high proportion (94.4%) breast‐fed at night, with 88.1% feeding their infants more than once. There was no significant relationship between the duration of suckling and the mother's age or work status (p > 0.05). However, a significant relationship (p < 0.001) was found between the duration of suckling and the mother's literacy. More than three quarters of mothers slept in the same bed with their infants or in the same room. A large percentage of women initiated breast‐feeding; however, many introduced a supplement too early, a practice that should be discouraged.     

Breast-feeding patterns in Saudi Arabia

A survey was conducted on 1019 mothers in 79 primary health care centers in Saudi Arabia to determine the patterns of breast feeding. A large percentage of mothers (98%) had breastfed their infants at birth. This rate dropped to 96.5% during the first week of life. There were 635 (64.1%) mothers who started to breastfeed their babies within 6 hours of delivery. Over two-thirds (68.9%) of mothers gave supplemental liquids to infants during the first 3 days of their life. More than half fed their infants on demand rather than on schedule. A high proportion (94.4%) breastfed at night, with 88.1% feeding their infants more than once. There was no significant relationship between the duration of suckling and the mother's age or work status (p 0.05). However, a significant relationship (p 0.001) was found between the duration of suckling and the mother's literacy. More than three-quarters of mothers slept in the same bed with their infants or in the same room. A large percentage of women initiated breast feeding; however, many introduced a supplement too early, a practice that should be discouraged.     

Breastfeeding and weaning practices in Bahrain: the role of mothers' education

This rapid assessment survey was undertaken to find out the current practices of infant feeding in Bahrain and the impact of educational level of the mothers on these practices. A total sample of 200 Bahraini mothers of children less than 2 years were interviewed in the health centers. The age of mothers ranged from 18 to 47 years. About one third of mothers (39.8%) initiated breastfeeding at the first hour of delivery, and there was no significant association between education of mothers and initiating of breastfeeding. Most infants were placed in the same bed as their mothers (71%), however the proportion was lower among infants with high education (61.8%) compared to low (73.7%) and middle (72.5%) education mothers. The introduction of foods during the first 3 days of the infant's life as well as the practising of breastfeeding on schedule increased with the increased of educational level of mothers. Highly educated mothers tended to introduce rice, wheat, infant formula and fruit at an earlier age of the infant's life than other education groups. The study demonstrates an improvement in infant feeding practices during the last decade. However, the practice of sound infant feeding was less among highly educated mothers when compared to low and middle education mothers. This is mainly due to socio-economic factors rather than lack of awareness.     

A study on the impact of maternal knowledge and practice on the nutritional status of infants

In India, health workers interviewed 123 mothers of infants attending the child health clinic of the S.K. Institute of Medical Sciences in Srinagar to determine whether maternal knowledge and practice were associated with the nutritional status of the infants. 28 children were considered to be well nourished, while the remaining 95 children were determined to be in various degrees of malnutrition. Mothers whose infants were well nourished had a higher level of breast feeding knowledge than did those whose infants were moderate to severely malnourished (score, 27.13 vs. 16.01-18.75; p .0001). None of the mothers of malnourished infants had an excellent score on breast feeding practices. Differences in the mean score values for breast feeding practices between all consecutive grades of nutrition were significant (20.22 for excellent score, 16.85, 15.53, and 14.18 for grades I, II, and III, respectively; p .001). The only mothers who had an excellent score for infant weaning awareness were 3 mothers whose infants had an excellent nutritional status. A significant difference in mean score values for knowledge of infant weaning between mothers of well nourished infants and grade I malnourished infants (26 vs. 17.19; p .001) as well as between those of grade II malnourished infants and grade III malnourished infants (17.06 vs. 13.64; p .01) were significant. Little difference in infant nutritional status existed between mothers who scored fair and those who scored poor, but, among mothers of well nourished infants, those who scored well were more likely to be have infants of good nutritional status than those who did not score well (47.05% v. 19.56% and 18.33%; p .001). These findings show a decreasing trend between awareness and practice of breast feeding/infant weaning, suggesting that further improvement of health education is needed to reduce the lag between breast feeding awareness and practice.     

我国5城市已婚育龄妇女母乳喂养影响因素分析

目的 :了解城市居民中母乳喂养状况及其影响因素。方法 :以“计划生育问卷调查”的方式 ,对广州等 5城市已婚育龄妇女进行抽样调查 ,以寿命表法等统计方法进行分析。结果 :5城市妇女产后母乳喂养率为 94 .5 7%。平均母乳喂养时间 8.0 1月 ,4个月后继续母乳喂养率为 6 1.0 3%。母亲文化程度高者、初产婴儿产后母乳喂养率高。但继续母乳喂养率 ,受母亲生理及自身文化程度等社会心理特征和家庭多种因素的影响。结论 :母乳喂养受母亲、家庭和社会的多种因素的影响 ,应有针对性地加强产妇出院后继续母乳喂养的宣教工作     

Neonatal feeding practices in Periurban Bolivia

Early initiation of breastfeeding offers numerous benefits, but in many cultures the first suckling is delayed and the infant is instead given various prelacteal foods. Mothers residing in periurban areas of two Bolivian cities were interviewed regarding their neonatal feeding practices. Virtually all infants were breastfed, but the first breastfeed was typically delayed for more than 1–2 hours after birth; about 15% did not suckle for at least 24 hours. When asked whether they gave colostrum, three‐quarters of mothers answered affirmatively, although some who initiated breastfeeding on the first day answered negatively. Of those who did not give colostrum, many said they refrained because of concern that it would harm the infant. Advice from medical professionals was variously cited as the reason for giving or for not giving colostrum. Herbal teas were commonly fed in the first few days. Education programs should encourage mothers to begin breastfeeding immediately after birth and to not feed their newborns any other foods.     

Breast feeding practices in urban and rural health centres: impact of baby friendly hospital initiative in Ile-Ife, Nigeria

The present study was carried out to assess the impact of the Baby Friendly Hospital Initiative (BFHI) on breast feeding practices. The variables used to evaluate the BFHI centre included time of initiation of breastfeeding (BF) after delivery, intended duration of BF, adoption of exclusive breastfeeding (EBF) in relation to educational status, location of health centre, and knowledge and practice of positioning the child at the breast. Observation, questionnaire and interview techniques were employed to collect the data among 217 and 214 nursing mothers (NMs) from Urban and Rural Health Centres. Of the 228 NMs who initiated BF within 30 minutes after delivery, 140 (61%) were from a designated BFHI Centre and 88 (39%) were from an undesignated BFHI rural health centre. There was a significant relationship between the practice of EBF and designation of BFHI centre (P = 0.0001). The higher the level of education of the NMs, the higher the present of NMs subscribing to EBF (P = 0.0001). The present study has also confirmed that EBF which was once considered to be less than 3%, has increased significantly to 61%. The success was not unconnected with the inauguration of BFHI. The BFHI is recording huge success in the urban area but the impact is still to be felt in the rural areas.     

Selection of infant feeding method: a population-based study in a rural area

The selection of infant feeding method was studied in a rural area. At discharge from the hospital, 70 percent of women were breast feeding, with 47 percent still breast feeding at three months. The decision regarding feeding method was made early, with the majority of women deciding before the pregnancy. Multiparous women almost always used the method that was favored by their experience feeding previous children. For primiparous women, the husband and mother were the most important sources of information. Educational efforts designed to increase the use of breast feeding should reach future parents prior to pregnancy, and every effort should be made to ensure that the first experience with breast feeding is successful and rewarding.     

Factors influencing duration of breast feeding among low-income women

Forty low-income breast feeding primiparous women were interviewed to determine whether family member and peer attitudes toward breast feeding and available postpartum support were associated with continued or early termination of breast feeding. Mean breast feeding duration equalled 20.5 weeks (range, 1 to 52 weeks). When an outside source of assistance (a doula) was available during the first 2 weeks postpartum, mean duration was 23.4 weeks compared with 12.3 weeks when a doula was unavailable (p less than .05). Breast feeding duration was independent of the doula's attitude regarding breast feeding. Duration of breast feeding was significantly longer for breast feeding women who participated in the USDA Special Supplemental Program for Women, Infants, and Children (WIC) than for those who did not participate. All of the women claimed to like breast feeding; 93% of the husbands or boyfriends, 83% of the women's mothers, and 81% of the women's best friends had positive attitudes toward breast feeding. The more breast feeding friends the woman had, the longer she breast fed (r = .32, p less than .05). Termination of breast feeding was not due to perceived negative attitudes of family members and peers regarding breast feeding.     

Breast-feeding in the modern health sector in Indonesia: the mother's perspective

This paper presents findings of a study of postpartum women in major hospitals throughout Indonesia. The objective was to assess the mothers' practices and attitudes regarding several key aspects of breast-feeding and 'rooming-in'. The study found that most of the women breast-fed their babies, with many believing infants should be breast-fed for 18 months or longer. However, many mothers lacked information about ideal infant feeding patterns and were unaware of how to solve problems that may arise. Only 38% recognized the value of feeding colostrum, and many feared the effect of breast-feeding on breast shape. They often gave supplementary formula. Almost none understood the importance of frequent suckling in promoting milk production. Only 50% of infants were kept in the same hospital room with their mothers for 24 hr a day, or full rooming-in. Women who kept their infants in the nursery (39%) were generally younger, better educated, primiparous, or had non-normal deliveries. They knew little about rooming-in, and if given more information to allay their doubts, they might consider rooming-in as a viable and safe arrangement. The results of this study reinforce the importance of identifying the perceptions and the knowledge of women concerning breast-feeding and rooming-in, so that hospital administrator, and health professionals can design programs and provide environments that encourage women to breast-feed their infants in optimal ways.     

Beliefs and practices in infant feeding among the Wagogo of Chigongwe (Dodoma rural district), Tanzania. I. Breastfeeding

Fieldwork conducted in 1989-91 among the Wagogo, a semipastoral people in central Tanzania, documented the cultural and social contexts of infant nutrition. 120 breast-feeding mothers were observed extensively and 291 mothers of 322 children attending a health center were interviewed. In this setting, repeated pregnancy and lactation are natural conditions for all adult women. Breast milk is perceived as an essential source of nutrition, energy, vigor, and strength. Lactation failure does not occur in this society. All infants nurse within a few hours of delivery and receive colostrum. The infant remains with the mother night and day, even when she is working in the fields. Breast feeding is on demand, generally in response to crying, and lasts for 2-3 years. Any changes in the quality of breast milk are viewed as associated with maternal disease or witchcraft due to jealousy. "Bad" milk is believed to cause diarrhea and withheld from the infant. In many cases, milk in one breast is perceived as bad and that breast is no longer used for feeding. Sexual intercourse is prohibited during lactation, and women who become pregnant before weaning are shamed. The progressive weakening of the child associated with the cessation of breast feeding at the time of a new pregnancy is viewed as a consequence of the breach of sexual taboos ant not recognized as malnutrition.     

Infant feeding practices of urban low income group in Ibadan

The feeding pattern of 915 children from the low income areas of Ibadan were determined with the aid of a questionnaire administered on their mothers. All the 915 infants were breast-fed for varying periods starting from birth. About 80% of the infants were breast-fed within 48 hours of delivery but most of the mothers in all areas claimed to have discarded the colostrum produced in the first 24 hours postpartum. Infants not breast-fed until a few days postpartum were fed on glucose water or herbal preparations. Culture played no significant role in infant feeding practices.     

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.