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 O h 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, breastfeeding 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 breastfeeding. However, mothers who gave infant formula as the first supplementary food stopped breastfeeding slightly earlier, as did younger mothers living in households with more children. Breast-feeding : Supplementary feeding : Weaning

The bacterial contamination of infant weaning foods was examined in the context of a longitudinal study of lactation and infant growth, the Chiang Mai Lactation Study. Sixty-two mother-infant pairs were selected by random sampling from a rural area outside the city of Chiang Mai and studied for 48 hours in their homes on six occasions over the first year of life. Data on food hygiene practices and maternal factors were related to the total bacterial count per gram and coliform content of weaning foods. Bottle feeding, premastication, and mashing were significantly related to an increased bacterial content of weaning foods, while boiling foods to make soups, preparing in and feeding from a banana leaf, and using boiled water to prepare foods all reduced their bacterial content. Storage also increased the bacterial contamination in foods and foods were more highly contaminated in the rainy season. Maternal age and education were also related to some feeding practices. By promoting the feeding of traditional, but less contaminated weaning foods, an intervention is put forward which would aim to reduce weaning food contamination and thereby reduce incidence of diarrhoea in this area of Northern Thailand.

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Samples of weaning food and supplementary water were collected for analysis of bacterial content from among a random sample of 65 infants under the age of 1 year living in a rural area of northern Thailand. Using geometric means, mean total bacterial count of infant's drinking water was 351 organisms/ml (95 per cent CIs 170-770), and the most probable number (MPN) of faecal coliforms/ml was 47 (95 per cent CIs 19-78). Mean total bacterial count of weaning foods was 38,000 (95 per cent CIs 25,000-59,000) organisms/g with 10 per cent recording counts greater than 1,000,000 organisms/g. Bacterial counts were similar to those reported in weaning food and water in other developing countries, and were above internationally recommended 'safe' levels. The bacterial count of water was not affected by boiling, due to poor cleaning and frequent re-use of utensils. Weaning foods were contaminated during preparation, in part through premastication and also via mode of cleaning of utensils.

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