Infant feeding and weaning practices in some semi-arid rural areas of Rajasthan

The paper contains information on infant feeding and weaning practices in the rural communities of a semi-arid district of Rajasthan. The findings have been drawn from a recent survey of 328 rural mothers. The rural women of this area are found to believe in old deep seated beliefs and customs, which in turn deprive their infants from advantages of colostrum (77% discarded colostrum) and nutritionally rich supplements, which otherwise should be supplemented to them at any cost in order to keep them healthy. The practices of prolonged breast feeding and delayed supplementation to infants are rampant in this area. Mean age at weaning (27.1 months) again not only affects the health status of mothers and their children but also leads to the undernutrition among both. The findings of the study necessitate to evolve an exhaustive educative programme dealing with various aspects of infant feeding and weaning practices, keeping in view their traditions, so that the useful practices can be encouraged and harmful ones be prohibited.     

Infant feeding practices among nursing personnel in Malaysia

Concerned by the alarming decline in breast feeding in the urban and rural areas of Malaysia, we conducted a critical review of infant feeding practices among nursing personnel from representative centres using questionnaires. It was found that although 75% of mothers breast-fed their babies at birth only 19% did so at 2 months and 5% at 6 months respectively. Chinese mothers initiated breast feeding less frequently compared with Indian or Malay mothers. The prevalence of breast feeding was higher among lower category nurses, lower income groups and those from health centres. Decision for breast feeding was based in most instances on conviction derived from reading, lectures or advice from relatives. The vast majority of mothers listed "work' as the main reason for termination of breast feeding followed by "insufficient breast milk' and satisfactory past experience with bottle feeding. The ramifications of these findings and measures to improve the prevalence and duration of breast feeding are discussed.     

Infant feeding practices in St. Vincent and factors which affect them

A survey was conducted in the summer of 1975 in 2 towns in St. Vincent--Layou and Georgetown--in the effort to obtain information regarding infant feeding practices and some of the factors which may influence them. Mothers of children from 1-2 years of age were interviewed in their homes. Complete data sets were obtained on 192 of the 216 eligible children in the 2 towns. For most children the period of exclusive breastfeeding (no other milk product given) was very short. About 1/2 of the children had received milk by 2 weeks of age, and 75% by 1 month. This was followed by a much longer period of "mixed" feeding--both breast and bottle--until breastfeeding was stopped at a median age of 6.8 months. Many types of milk were used for infant feeding. For 73% of the infants, infant formula was the 1st type of milk given. This was commonly replaced by a "heavier" full cream powdered milk at a few months of age. Prelacteal feeds were very common, predominantly glucose water. "Tonics," often consisting of vitamin preparations, were another common supplement during the early months of life. Among solid foods, arrowroot, "custard," and commercial infant cereals were the first to be introduced. Relatively inexpensive locally bagged staple foods and milk powders were available in both towns, but most mothers relied heavily on packaged brand name products for infant feeding even though the cost was 2-10 times higher. It was not possible to pinpoint the exact causes for the high levels of bottle feeding, nor for the possible recent decline in breastfeeding, but several important factors were identified. Part of the problem appeared to be due to poor health and nutritional status of the mothers. In addition, in several cases the mothers reported that they had wanted to continue breastfeeding but had received no support from health professionals, and in a few instances had been ordered to stop for seemingly trivial medical reasons.     

Fathers and breast feeding: a pilot observational study

A small pilot survey (n = 113) by questionnaire of the fathers of a sample of children under one year of age was undertaken in order to investigate the involvement of fathers with infant feeding and their attitudes to the method of feeding adopted. The response rate was 72% overall and 79% when the partners of 'single parent' mothers were excluded. Nearly 30% of respondents had not discussed the method of feeding with anyone, but over 60% had discussed it with their partner. 64% of fathers sometimes helped with feeding their child and 17% said that they always helped. The majority of fathers did not mind their partner breast feeding in front of friends or relatives but 42% did not like them feeding in front of strangers and over half did not like them breast feeding in a public place. From this study, based on relatively small numbers, we conclude that fathers may feel left out of infant feeding. They should be given more opportunity to become involved from an early stage and take part in the decision about the method of infant feeding to be adopted.     

The reliability of monopolar and bipolar fine-wire electromyographic measurement of muscle fatigue

This longitudinal study was designed to examine reciprocal relationships between feeding practices and infant growth over the first 6 mo of life. The following three hypotheses were tested: 1) early feeding practices predict later infant growth; 2) early infant growth predicts later feeding practices; and 3) these relationships occur after controlling for related background variables. The sample included 226 healthy, well-nourished infants born at the Queen Elizabeth Hospital, Bridgetown, Barbados. Assessments were made at birth, 7 wk, and 3 and 6 mo of age. Factor analysis of a feeding practices questionnaire for those mothers who attended all three postnatal visits yielded five uncorrelated factors. Three of these factors, preference for breast-feeding, feeding intensity and feeding difficulty, declined with infant age. Two of these factors, father helps and relatives help, increased with infant age. Several background variables, including maternal age, anthropometry and reproductive history, and reliance on outside sources of information were correlated with infant growth. Multivariate analyses confirmed all three hypotheses. The group of feeding practices (particularly the preference for breast-feeding) at 7 wk predicted increases in infant lengths at subsequent ages. Conversely, infant weights at 3 and 6 mo predicted subsequent feeding practices, especially feeding intensity. These reciprocal relationships remained even after statistically controlling for the influence of the background variables. Implications for public policy include the need for comprehensive programs advocating breast-feeding and supporting the general health of mothers and infants.     

Infant feeding practices reflect antecedent risk of xerophthalmia in Nepali children

OBJECTIVE: To determine the relationship between infant feeding history and risk of xerophthalmia due to vitamin A deficiency (VAD) in early childhood. DESIGN: A case-control study of previously xerophthalmic and non-xerophthalmic children. SETTING: Rural lowland region of Nepal. SUBJECTS: One hundred and fifty-six children (aged 1-6 y old), half of whom previously had xerophthalmia due to vitamin A-deficiency, the other half matched by locale, age and the presence and age of a younger sibling (n = 102). METHODS: Xerophthalmia was determined by trained ophthalmic assistants on the basic of current Bitot's spots, corneal xerosis or report of night blindness. Infant feeding history was collected through a diet history method obtained from the mother of the focus child. Exploratory factor analysis was conducted to determine the presence of underlying patterns in infant feeding practices. Conditional logistic regression was used to estimate odds ratios. RESULTS: Mothers of control children tended to have a higher level of education (P < 0.10) and to have fewer children who had died (P < 0.10) than mothers of case children. Feeding of meat (OR = 0.09, CI = 0.01-0.70) or fish (OR = 0.41, CI = 0.17-0.99) with liver, eggs (OR = 0.11, CI = 0.01-0.88) and mango (OR = 0.28, CI = 0.13-0.60) were protective in association with xerophthalmia in early childhood. Factor analysis uncovered several distinct patterns in infant feeding, which varied by age of the infant. Only the 'animal flesh' feeding pattern (factor), practiced in the second year of life, proved significantly protective from xerophthalmia (OR = 0.43, CI = 0.20-0.94). Feeding patterns of younger children closely paralleled those of their older siblings with and without VAD. CONCLUSIONS: The study supports the hypothesis that infant dietary practices can influence subsequent risk for VAD. Our findings emphasize the importance of introducing vitamin A-rich foods during weaning to reduce the risk of VAD-associated xerophthalmia in the later preschool years.     

Young child feeding in a rural area in the Red River delta, Vietnam

Infant and young child feeding practices were investigated in a sample survey (1132 mothers) in a rural area in northern Vietnam. Pre-lacteal feeding was almost universal. Mean duration of breast feeding was 17 months, but foods other than breast milk were introduced early. Only 50% of infants between 3 and 5 months of age were predominantly breast fed. The educational level of the mother was strongly associated with breast feeding duration, with illiterate mothers breast feeding the longest. Christian mothers breast fed for longer than non-Christians. Very few were using feeding bottles at the time of the study, although formulas and bottles have recently been appearing on the local market. The breast feeding pattern described together with the rapidly changing social and economic situation in Vietnam could mean a risk of rapid decline in breast feeding.     

Maternal feeding practices and childhood obesity: a focus group study of low-income mothers

OBJECTIVE: To identify maternal beliefs and practices about child feeding that are associated with the development of childhood obesity. DESIGN: Four focus groups. One group of dietitians from the Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the Northern Kentucky Health District and 3 groups of mothers with children enrolled in WIC. SETTING: The WIC program in the Northern Kentucky Health District. PARTICIPANTS: Fifteen WIC dietitians and 14 mothers (14 to 34 years of age) with young children (12 to 36 months of age) enrolled in WIC. RESULTS: The mothers in this study (1) believed that it was better to have a heavy infant because infant weight was the best marker of child health and successful parenting, (2) feared that their infants were not getting enough to eat, which led them to introduce rice cereal and other solid food to the diets before the recommended ages, and (3) used food to shape their children's behaviors (eg, to reward good behavior or to calm fussiness). The mothers acknowledged that some of their child-feeding practices went against the advice of their WIC nutritionists and physicians. Instead, the participants relied on their mothers as their main source of information about child feeding. CONCLUSIONS: Physicians and allied health professionals discussing childhood growth with mothers should avoid implying that infant weight is necessarily a measure of child health or parental competence. Parents who use food to satisfy their children's emotional needs or to promote good behavior in their children may promote obesity by interfering with their children's ability to regulate their own food intake. Interventions to alter child-feeding practices should include education of grandmothers.     

The impact of breast feeding patterns on the biometric analysis of infant mortality

A major assumption of the biometric analysis of infant mortality as developed by Bourgeois-Pichat is that the age structure of infant deaths after the first month of life is virtually constant across time and cultures. Reanalysis of results from studies which compare the mortality of infants according to the type of feeding indicated that the relationship between mortality and age within the first year of life followed different patterns for breast fed and artificially fed infants. Historical data for populations with different breast feeding customs reveal similar differences in the age pattern of infant mortality. In populations where breast feeding was uncommon or of very short duration, infant mortality rises particularly steeply during the early months of the first year of life. The age structure of infant mortality in less developed countries where breast feeding is decreasing rapidly may bsimilarly affected. When substantial deviations from the linear relationship are evident, particular caution is required in applying the biometric technique, since in such situations the estimated endogenous mortality is very much affected by the particular set of data points within the first year of life which are chosen for the basis of the estimates.     

Feeding practices and growth among low-income Peruvian infants: a comparison of internationally-recommended definitions

BACKGROUND: Data from a longitudinal study of 153 low-income Peruvian infants were used to assess the relationship between internationally-recommended definitions of feeding practices and infants' monthly weight gain and weight status at 12 months. METHODS: Infants were classified into feeding categories using monthly reported data. Analysis of variance was used to assess the relationship between reported usual feeding practices and growth. Reported breastfeeding practices were compared to observed breastfeeding practices and to weighted breast milk intakes to determine the validity of recommended breastfeeding definitions. RESULTS: Breastfed infants who consumed non-human milks during the first month of life gained less weight during that month (P < 0.002) than exclusively and predominantly breastfed infants. Reported daily nursing frequency was associated with observed nursing frequency and breast milk energy intake (P < 0.05) for infants < 9 months old. Patterns of growth varied according to early diets. Infants who consumed breast milk and non-human milks and those who were fully weaned by 4 months were more likely to be underweight at 12 months than other infants. Infants classified as token breastfeeders ( < or = 3 times/24 hours) from 0 to 120 days had monthly gains that were similar to those of fully weaned infants. CONCLUSIONS: Infants feeding definitions should 1) continue to differentiate exclusively breastfed infants from other infants who are almost exclusively or predominantly breastfed; 2) distinguish partially breastfed infants who consume only non-breastfeeding frequency or the % of their total daily energy that comes from breast milk.     

Stenosis complications in digestive surgery: a histomorphological contribution. Comparison of mechanical and manual sutures]

Breast feeding a new baby is a special challenge for college students and university employees. Although success is usually associated with availability of support from the community, little is known about the social context for breast feeding on campus. Personal breast feeding experiences, beliefs about outcomes of breast-feeding and bottle feeding, attitudes toward breast feeding and bottle feeding, and regard for appropriateness of various settings for breast feeding in the campus community were investigated. One hundred seven students, faculty, staff, and administrators at a North Central state university participated in the study. Almost all reported at least one personal breast-feeding experience. Benefits of breast feeding over bottle feeding were acknowledged; however, the university community regarded both feeding methods favorably and saw practical advantages to bottle feeding. Personal spaces, such as infant home or family car, were regarded as more appropriate for breast feeding than public settings. Implications for promotion, support, and protection of breast feeding on campus are discussed.     

The perils of permanent punctal plugs

Satisfactory pain relief with postoperative extradural bupivacaine increases the amount of breast feeding after Caesarean section. To investigate the effect of extradural buprenorphine, we have evaluated the amount of breast feeding and the gain in infant weight for 11 days after Caesarean section in patients who received continuous extradural bupivacaine with or without buprenorphine. Extradural buprenorphine significantly decreased both measures although there was no significant difference in pain intensity. We suggest that extradural buprenorphine suppressed breast feeding after Caesarean section.     

Breast feeding--a year's experience of one group practice

Dissatisfaction at the lack of support and encouragement in the immediate post-partum period of mothers in hospital wishing to breast feed is expressed in their own words. Analysis indicates that mothers in the upper social classes are more likely to breast feed and that those who manage to sustain breast feeding for one week are likely to continue this method of feeding for at least six weeks and possibly for much longer. There is also evidence indicating that women who are encouraged during pregnancy to breast feed have a high success rate. Those responsible for supervising infant feeding need to be better educated in all its aspects.     

Breast-feeding in Egypt

Planning, implementation and evaluation of programmes to promote appropriate infant feeding practices require detailed, current information about these practices in the target populations. To estimate the prevalences and identify the correlates of overall breast-feeding and of exclusive breast-feeding in different age periods during infancy, a cohort of 152 apparently healthy neonates and their mothers were followed during October 1987 through April 1989 in rural Bilbeis, Sharqiya Governorate, Egypt. Feeding data were collected through twice weekly home visits thus reducing the potential for bias in our findings due to respondent recall errors. The prevalence of overall breastfeeding in the infants declined from 100% in age period 0-11 weeks to 89% in age period 36-47 weeks. Mothers with previous living children were associated with significantly higher (odds ratio [OR]: 6.53, 95% confidence interval [CI]: 1.33-32.09) and ownership of refrigerators was associated with significantly lower (OR: 0.18, 95% CI: 0.05-0.67) overall breast-feeding prevalences in age periods 24-35 and 36-47 weeks, respectively. The prevalence of exclusive breast-feeding in breast-fed infants dropped from 20% in age period 0-11 weeks to 0% in age period 36-47 weeks. After multivariate adjustment, prelacteal feeding was significantly negatively (OR: 0.12, 95% CI: 0.04-0.37) associated with exclusive breast-feeding in age period 0-11 weeks. Nearly 90% of Bilbeis infants were breast-fed at age 47 weeks, but the initiation of supplementation at 0-11 weeks in 80% of breast-fed infants is contrary to current recommendations.(ABSTRACT TRUNCATED AT 250 WORDS)     

The use of microbiology in the study of hygiene behaviour

Faecal indicator bacteria have been used to measure levels of hygiene in a variety of settings. This paper describes a study in northern Botswana which used the isolation of faecal indicator bacteria in combination with other quantitative and qualitative techniques to gain information regarding hygiene behaviour. The microbiological samples included, samples from stored drinking water and water sources; eating plates; infant feeding bottles; dishcloths and the fingertips of carers and children. Water was usually clean at source but contaminated after storage. Presumptive faecal coliforms contaminated 31% of the eating plates, 29% of the dishcloths and 40% of the infant feeding bottles. Many of the presumptive faecal coliform isolates were not identified as Escherichia coli, indicating the need for further research into methodologies appropriate for isolating E. coli in tropical climates.     

Effect of cAMP-induced transcription on the repair of the phosphoenolpyruvate carboxykinase gene by hepatocytes isolated from young and old rats

Animal experiments suggest that the fetal brain is sensitive to nicotine. Although much attention has been given to the relation between cigarette smoking during pregnancy and neurodevelopment in children, this remains controversial. Our study describes the relationship between maternal cigarette smoking during pregnancy and babbling abilities of the 8-month-old infant. In a longitudinal cohort, information was collected at the 16th week of gestation, at delivery and when the infant was about 8 months old. At this age babbling abilities of the infant were evaluated by a health visitor during a home visit. Singleton infants without any disability born at Aarhus University Hospital, Denmark, 1991-92 and still living in the Community of Aarhus at the age of 8 months were eligible (n = 2302). Complete follow-up was obtained for 1871 children (81.3%). A dose-response-like relationship between number of cigarettes smoked per day during pregnancy and babbling abilities was found after controlling for potential confounders. Smoking 10 or more cigarettes per day during pregnancy almost doubled the risk (odds ratio [OR] = 2.0, 95% confidence interval [CI] 1.1-3.6) of the infant being a non-babbler at the examination at 8 months. Among children who were breast fed for less than 4 months this risk was even higher (OR = 2.7, CI 1.3-5.8).     

Plasma and erythrocyte alpha-tocopherol and plasma retinol concentrations in term infants fed formula enriched with long-chain polyunsaturated fatty acids

OBJECTIVE: To assess the effect of long-chain polyunsaturated fatty acids (LCPUFA)- and vitamin E-supplemented formula feeding on erythrocyte and plasma alpha-tocopherol (VE), and plasma retinol (VA) concentrations in neonates and to compare these values with those found in infants feeding on infant formula without LCPUFA or breast milk SETTING: University Hospital of Granada, Spain. SUBJECTS: 49 full-term infants. DESIGN AND INTERVENTION: Subjects who chose not to breast feed were fed either (i) unsupplemented infant formula (F) or (ii) infant formula supplemented with LCPUFA and vitamin E (FL). Alpha-tocopherol and retinol were measured at 7 days, 1 month and 3 months. RESULTS: Plasma and erythrocyte VE concentrations and plasma VE/total lipids ratio increased significantly in all groups at 1 month of life (P < 0.05), but did not change significantly between 1 month and 3 months in any group (P > 0.05). Erythrocyte VE and VA retinol concentrations were higher in infants fed an infant formula than in breast milk-fed infants at 1 month of life (P < 0.05). Finally, there were no significant differences in plasma or erythrocyte VE levels, plasma VA or plasma VE/total lipid ratio between any groups at 3 months of life (P > 0.05). CONCLUSION: Infants fed on LCPUFA- and vitamin E-supplemented infant formula for 3 months have similar vitamin E and A status to infants fed on breast milk or infant formula without LCPUFA supplementation.     

Infant weaning practises of some Idoma women in Makurdi, Nigeria

The weaning practices in infants aged 4-9 months of two hundred Idoma women resident in Makurdi were examined. A pre-tested standard questionnaire was used to collect data from mothers who regularly visited the post-natal health clinics in Makurdi. The results showed that better educated mothers breast fed for a shorter time or planned to cease breast feeding after a shorter period than mothers who had little education or no formal training. Most mothers (97%) fed milk formula which they claimed was used to supplement breast milk and was good for their babies. The most influential factors were the hospital and the husband. The majority of the mothers fed pap; 73% using corn in its preparation, with 91% of them storing such paps in flask. More than half of the mothers used a bottle in feeding the paper or gruel to their infants while a similar proportion (65.5%) fed legumes to their infants in addition to fruits. The implications of these practices in comparison with other ethnic groups is discussed.     

Study on feeding of infants

OBJECTIVE: To evaluate feeding behaviour in infants, with regard to the duration of breast-feeding (BF), the beginning of artificial feeding (AF) and the introduction of complementary feeding (CF). DESIGN: Medical audit. Retrospective study. SETTING: Primary Care paediatrics. PARTICIPANTS: The 327 children born in 1994 and monitored by paediatricians from 4 Health Centres in Salamanca. MEASUREMENTS AND MAIN RESULTS: The mean duration of BF for the 327 children was 3.61 months, with 92.3% starting BF and 52.3% still doing it at 3 months. 30% began AF at birth; 33% between birth and 3 months; 29.6% between the third and sixth months; and 7.4% after 6 months. CF was started as follows: only 2.1% before 4 months; 92% had gluten introduced after 8 months, but only 1.2% before 6 months. 96.3% started on cow's milk after one year. CONCLUSIONS: Over 50% of children fed on breast milk for at least 3 months. Only 1.2% had gluten introduced before 6 months. 3.7% started on cow's milk before 12 months. 30% of children began AF at birth.     

Effect of feeding methods in infants on serum lipid profile

Mothers very often do not start to breast feed their children, or stop very quickly and introduce various formulas based either on modified or unmodified cow's milk. These infant formulas differ from human milk in their chemical composition. Breast milk is the most suitable source of all nutrients required for the development of a newborn or infant. The serum levels of total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides and phospholipids were determined. The influence of the type of feeding on the levels of the above-mentioned lipids was analyzed. Higher serum levels of triglycerides in babies fed formulas based on modified cow's milk than in those fed formulas based on unmodified milk were found. Higher serum levels of phospholipids were found in breast-fed babies than in those fed formulas based on unmodified cow's milk.