Early child health in Lahore, Pakistan: V. Feeding patterns

Abstract

The feeding practices of children (n = 1476) from birth to 24 months, as determined in a longitudinal study, in Lahore, Pakistan, are presented. Four socioeconomic groups at various levels of urbanization were included; a village, periurban slum, urban slum and an upper middle class. Initiation of breastfeeding was delayed in all the neonates. Sixty-five percent of the periurban slum mothers and 45% of the village mothers had not started breastfeeding at 48 hours after the birth of the infant. Prelacteal feedings, especially of herb water and honey, were the norm. Breastfeeding was highly prevalent. Eighty-seven to 98% of the infants in all the areas were breastfed at one month of age. Exclusive breastfeeding was rare, with 9% at one month, declining rapidly with age and being highly influenced by season. Partial breastfeeding was the most common mode of feeding. Water in addition to human milk was given by 45-73% of the mothers living in the urban slum, village and periurban slum at one month of age. Fresh animal milk and/or commercial formula was already being given at 1 month by 22-64% of the mothers in all areas. Commercial formula was the preferred food in the upper middle class, while in the other three areas it was rare and fresh animal milk was mainly used. More than 50% of the mothers in the village and in the periurban slum gave diluted animal milk even beyond the age of 10-15 months. In the upper middle class 50% of the infants were fed semisolids at the age of four months, while in the village, the periurban and the urban slum at 6 months of age only 10%, 12% and 47% of the infants received semisolids. The results of this study indicate that breastfeeding was highly prevalent in the three poorest areas. However, in all the areas initiation of breastfeeding was delayed and prelacteal feeding was the norm. Exclusive breastfeeding was rare, feeding bottles were used by 82-100% of the mothers to feed supplements and human milk substitutes, in the four areas.

Exploring and optimising maternal and infant nutrition in North West Pakistan

“…Commercial Ghutti is now available on the market. The traditional and/or ceremonial foods that may be given, in place of colostrum, for example honey, rosewater, or cardamom water have a high potential for contamination (Ashraf et al, 1993) and may be described as 'risky feeding practices' (Fikree et al, 2005, p. 911). From the focus group data following the health promotion programme it appears that, based on the perceptions of the LHWs, women's understanding did change to their recognition that exclusive breast feeding for 6 months was the optimum.…”

Exclusive breast-feeding is rarely practised in rural and urban Morogoro, Tanzania

“…Otherwise delay in initiation and discarding of colostrum was observed more in rural than in urban areas 23,24,27,30,31 . Other studies have suggested that prelacteal feeds are given to infants in both rural and urban areas 7,20,27,32 except in Sudan, where breast milk was given as the first feed to a higher proportion of infants in the urban areas than in the rural ones 8 . The proportion of infants less than 4 months of age who were fully breastfed in 17 studied countries in sub-Saharan Africa was higher in the rural areas than in the urban areas.…”

Maternal and infant health problems after normal childbirth: a randomised controlled study in Zambia

“…Similar findings from other studies have been reported to be associated with increased incidence of hypothermia, diarrhoea, and acute respiratory tract infections in infants who are not exclusively breast fed. [25][26][27] It is known that Zambian mothers in general breast feed for long periods, but little is known about the details of the breast feeding behaviour, or the type and use of supplementary and weaning foods in urban mothers. 28 A major problem among the newborns during the first weeks of life was eye infection and this was identified both by the mother and the midwife.…”