WEANING PRACTICES AND THEIR …

1 Biomedica Vol. 23 (Jul. - Dec. 2007) E:/Biomedica Jul. Dec. 2007/Bio-19 (A) WEANING PRACTICES AND THEIR determinants among MOTHERS OF INFANTS RAZIA CHAUDHRY AND NAHEED HUMAYUN Department of Community Medicine, Allama Iqbal Medical College, Lahore This study was designed to assess the WEANING PRACTICES among mothers of infants 6-12 months of age and to compare these PRACTICES among different socio-economic and demographic vari-ables. This is a cross-sectional study conducted in D & E blocks of AIMC residential colony, from May 2006 to September 2006. A total of 50 infants (6-12m of age) were included in the study. THEIR feeding pattern and WEANING PRACTICES were studied using self-administered question-naire. They were grouped in two categories according to THEIR age of commencement of wean-ing.

2 Forty two (84%) infants were receiving WEANING foods in addition to milk. Recom-mended age (6 months) was noticed in 42 cases (84%), while delayed WEANING was seen in 8 (16%). Tim-ely WEANING was noticed in breastfed infants, 34 (70%). Even if WEANING was started at the cor-rect age, several problems were observed. This included infrequent feeding, use of expensive co-mmercial cereals given in diluted form instead of home prepared foods and improper food pre-paration PRACTICES were also observed. The quality, type and choice of food was not ideal for an adequate growth. Recommended WEANING time (4-6 m) and delayed WEANING was analysed in relation to socio-economic and demographic characteristics of the infant s mothers and THEIR families.

3 Delayed commencement of WEANING had a statistical significant relationship with age, education, family income, occupation of father and mother, parity of mother and also large family size (p< ). Bottle-fed babies had significantly delayed WEANING more than 9 mon-ths. Sex of the child was not significantly related to early or delayed WEANING (p> ). Incor-rect WEANING PRACTICES are an issue of public health in developing countries. The identification and analysis of WEANING PRACTICES prevalent in low socioeconomic households can lead to reme-dial strategies for improving the nutritional status of infants and, thereby, help to reduce infant mortality and morbidity rate. Fulfilling the nutritional requirement helps to ach-ieve the basic goal of satisfactory growth and pre-vention of acute and chronic Human milk is the most appropriate of all available milk for the human infants because it is uniquely adapted to its needs.

4 A healthy mother can produce enough (400 -800ml/day) milk to meet the caloric require-ments of child till the age of 6 months. Hence, WHO recommends exclusive breast feeding till this Due to this superiority of breast milk to other kinds of milk, the duration of exclusive bre-ast feeding has been increased up to 6 months3. In Pakistan there is commendable Government. Poli-cy from the Ministry of Health according to WHO guidelines4. The term WEANING has been traditio-nally described as withdrawal from breast feed-ing, when breast feeding is gradually replaced by fresh or modified animal milk, or by semisolid food5. It is transitional to change from liquid to solid diet, the feeding behaviour changes from suc-king to chewing and biting and the obligatory in-troduction with the mother or other caretaker cha-nges to independent feeling6.

5 Malnutrition and mi-cronutrient deficiencies during WEANING period is reported from Pakistan7-8 and many other develop-ing countries9-10. Complementary feeding as desc-ribed by WHO refers to the addition of energy and non-energy containing fluids, non-human milk, and semi-solids or solids to children s diet11. Wea-ning is easier if a child has taken milk from some other source besides mother s breast before that time. So it's a good idea to give an occasional bot-tle of breast milk to the child around 4 to 7 months (or sooner if you decide to wean earlier) - even if one plans to continue breastfeeding, this can facili-tate the WEANING process in the Natural WEANING occurs as the infant begins to accept inc-reasing amounts and types of complementary fee-dings while still breastfeeding on demand.

6 When natural WEANING is practiced, complete WEANING usually takes place between two and four years of age. Planned WEANING occurs when the mother decides to wean without receiving signals from the infant that he is ready to stop breastfeeding. Some reasons commonly given for planned WEANING inc-lude the following: not enough milk or concerns about the baby s growth, painful feedings or mas-titis, returning to work, a new pregnancy etc13. The WEANING PRACTICES AND THEIRE determinants among MOTHERS 121 Biomedica Vol. 23 (Jul. - Dec. 2007) objectives of this study were to estimate the aver-age age of commencement of WEANING , and to det-ermine the feeding pattern of infants, including the types of commonly used foods for WEANING , THEIR frequency and preparation in the studied po-pulation.

7 SUBJECTS AND METHODS A cross-sectional study was conducted among mothers of infants 6-12 months of age, resident of D&E blocks of AIMC, colony Lahore. All the infants of 6-12 months old were included in study. A house to house survey was conducted and the researcher herself filled the closed ended struc-tured questionnaire. The related information rega-rding introduction and administration of WEANING foods to infants was collected. Structured questio-nnaire required 20 min. to half an hour. Data was collected in one week. The data analysis was done using a statistical package, Epi-info ver Chi-square test for com-parison between groups was undertaken. In all statistical analysis only p-value < were consi-dered significant.

8 RESULTS among the 50 infants included, 24 were males and 26 females. The male to female ratio was 1: The mean age was ( + ) months and the median age was 8 months. The age of index child-ren was grouped in 2 categories based on recom-mended feeding PRACTICES for the particular age gr-oup and start of WEANING foods. The mean age of mothers in the study was ( + ) years and median age was 27 years. The youngest mother interviewed was 20 years old and the oldest mother was 40 years of age. Other mate-rnal characteristics included education, occupation Table 1: Age, gender and breast feeding pattern distribution of children. Age in m. Male Female Excl. B. Feeding No Mixed F 6 - 8 m. 19 (79%) 20 (76%) 24 (96%) 10 (100%) 5 (33%) 8 - 12 m.

9 05 (21%) 06 (24%) 01 (4%) 00 (0%) 10 (67%) Total 24 26 25 10 15 n = 50 n= 50 Table 2: Late WEANING by socio-economic and demographic variables (n=50). Late WEANING Socio-economic and demographic variables No. of Subjects No (%) P- value 20-30 45 6 ( ) Mother s age 34-40 05 2 (40) Illiterate 18 5 (28) Education Literate 32 3 ( ) Working 5 2 (40) Occupation of mother Non working 45 6 ( ) <4 30 1 ( ) Parity >4 20 7 (35) <1800 32 5 ( ) Family income/ capita >1800 18 3 ( ) <3 32 2 ( ) Family Members 3&> 18 6 ( ) Male 24 3 (15) Sex of infant Female 26 5 (19) Bottle / mixed 25 14 (6) Top feeding Excl. Brest 25 23 (94) and parity. Assessment of educational status of mo-thers showed that 19 (38%) were illiterate.

10 among literate, 9 (18%) and 22 (44%) were under matric and above matric respectively. Regarding occupation large majority of mothers, 44 (88%) were housewives. Regarding parity 30 had < than 4 alive child-ren, 10 had 4 and 10 had >4 alive children. The av-erage family size was 5. Thirty-two infants lived in a family of < 3, and 18 had > 6 family members. The type of family was nuclear in 35 cases and extended in rest of the cases. The family income was < Rs. 1800 / capita / month in 66% respond-ents while 34% had an income of above capita/month. Thus maj-ority of respondents be-longed to the low-income group. The analysis of feed-ing pattern included the type of milk infants were taking at the time of the study and THEIR WEANING PRACTICES in regard to age122 RAZIA CHAUDHRY AND NAHEED HUMAYUN Biomedica Vol.