In-depth study of breastfeeding structure: New data from Mali

Abstract

A number of variables, including ethnic affiliation, time of day, infant and maternal ages, and infant dietary supplementation, are used to compare their effects on breastfeeding structure of two groups of rural Malian women. The agro‐fishing Bozo and the transhumant pastoralist Fulbe live in the Inner Niger Delta of Mali. On‐demand breastfeeding is practiced by these groups. Lactation continues throughout the infant's second year of life and often into the third. Comparisons are made with data from other traditional societies to highlight differences in breastfeeding structure and its determinants. Ethnic affiliation does not have any significant effect on nursing variables, and the suckling patterns of the Fulbe and Bozo women are comparable in this study. Suckling activity does not vary according to time of day, although individual women exhibit different temporal patterns of nursing behavior. Infant age is significantly and negatively correlated to session duration. As infants get older and their diets are supplemented with food other than breastmilk, their appetites decrease and, consequently, they suckle less. However, there is much individual variation in this relationship, and it is argued that the decrease in suckling due to supplementation may be offset by an increase in suckling due to infants demanding the breast for physical affection. Maternal age, in contrast, is not correlated with any nursing variable in this study. This indicates that there is no decrease in physiological capacity to provide milk and that access to surrogate caretakers is either not correlated with maternal age, or is not a strategy employed by these women. Am. J. Hum. Biol. 10:179–190, 1998. © 1998 Wiley‐Liss, Inc.

Longitudinal study of breastfeeding structure and women's work in the Brazilian Amazon

“…It was expected that the breastfeeding structure (number of sessions, session duration, and inter‐session interval) of the women in this study would change over the course of lactation as the infants aged and began receiving supplementary foods. In addition, it was expected that Ribeirinha women would allocate less time to both breastfeeding and infant care as their infants aged, as this pattern has been observed in other studies (Huffman et al, 1987; Ford and Huffman, 1988; Panter‐Brick, 1991; Gray, 1995; Marriott, 1998; Ghosh et al, 2006).…”

“…In these contexts, work is considered a major factor contributing to early weaning (Lindberg, 1996; Roe et al, 1999; Guendelman et al, 2009). Less attention has been given to the ways rural women in developing nations integrate work and infant feeding (although see Levine, 1988; Gray, 1995, 1996; Panter‐Brick, 1989, 1991; Marriott, 1998). This is despite the increased importance of breastfeeding in such settings where access to safe, nutritionally adequate breast milk substitutes is limited and pathogen exposure is often high.…”

“…The validity of the above assumptions has been challenged as research indicates that a woman's ability to integrate child care, including breastfeeding, into her daily work routine varies based on the ecological and social environment in which the mother/infant dyad resides (Levine, 1988; Panter‐Brick, 1989, 1992; Gray, 1995, 1996; Marriott, 1998). The dialectic between women's work and breastfeeding occurs on a daily basis resulting in variation in what is referred to as breastfeeding structure (Vitzthum, 1994), which includes the number of times a woman breastfeeds a day, the duration of breastfeeding bouts and the intervals between them.…”

“…An understanding of how women in subsistence‐oriented societies negotiate the time and energy costs of breastfeeding requires knowledge of breastfeeding structure, maternal time allocation and cultural norms and ideals regarding infant care, and is important because it influences women's decisions regarding the introduction of supplementary foods and ultimately, weaning. To date, only a handful of studies have provided data on breastfeeding structure (Whitehead et al, 1978; Konner and Worthman, 1980; Van Steenbergen et al, 1981; Huffman et al, 1987; Vitzthum, 1989; Panter‐Brick, 1991; Gray, 1995; Marriott, 1998; Stallings et al, 1998; Valeggia and Ellison, 2004; Ghosh, 2006) and only a few of these studies (Panter‐Brick, 1991; Gray, 1995; Ghosh, 2006) have analyzed these data in relation to maternal work patterns. Thus, despite an enormous interest in breastfeeding, there remain many questions regarding how women in different ecological settings manage their productive and reproductive roles and the impact of their decisions on their own health, the health of their children and their economic activities.…”

“…The second goal is to further our understanding of how women in different subsistence‐oriented societies integrate their reproductive and productive responsibilities and contribute to our understanding of the “ecological context of breastfeeding” (Marriott, 1998). In these Amazonian communities women's contribution to household subsistence is centered on the collection and processing of manioc roots ( Manihot esculenta Cranz) into farinha , the year‐round dietary staple, which contributes over 50% of total dietary energy and at least 65% of total carbohydrate intake (Piperata and Dufour, 2007).…”