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  • Title: Early termination of breastfeeding among Philippine urban poor.
    Author: Guthrie GM, Guthrie HA, Fernandez TL, Estrera N.
    Journal: Ecol Food Nutr; 1983; 12(4):195-202. PubMed ID: 12265406.
    Abstract:
    The research objective was to identify factors that caused mothers to terminate breastfeeding prematurely, i.e., before the infant reached his or her 1st birthday. Nursing for at least 1 year was a minimum goal of health authorities in the area of this research. The study was conducted in 2 urban poor areas and in 2 fringe squatter settlements of Cebu City, a metropolitan area of 500,000 people in the central Philippines. The data were collected by 2 women field workers. The 130 participants, who were within 3 months of delivery, pre- or postpartum were recruited in 1979. They were visited in their homes once a month by the worker who weighed the mother and the baby, inquired about their diets, and recorded breastfeeding experiences and plans. Special attention was given to any problems the mothers were having that might interfere with continued nursing. Other than encouraging mothers to use the local health center, workers did not intervene to support breastfeeding. The mothers were followed for at least the crucial 1st 6 months. Many were followed for a year or more. Of those who agreed to participate prior to delivery, and who composed 1/3 of the total group, some 95% initiated breastfeeding. Of the 3 who did not, 2 tried to nurse but gave up when the newborn showed persistent diarrhea. Between 10-20% of babies were on a mixed diet of breast and bottle feeding, some beginning as early as the 1st month when mothers returned to part-time work. Other mothers, feeling that the babies were not getting enough to eat, added bottles regularly. This pattern did not necessarily lead to the early termination of breastfeeding. With the exception of 2 instances when mothers decided that their babies were big enough to get along without breast milk, the mothers were forced by circumstances as they perceived them to wean the child. Almost all the terminations were abrupt, with the mother continuing to have an adequate supply of milk. The insufficient milk situation reported by 9 mothers is an exception. In most cases, stopping was a crisis, because the mothers felt that to continue would endanger the child while to stop would sacrifice the benefits of breastfeeding. The major reasons for early termination are discussed: diarrhea, insufficient milk, returning to work, mother sick or pregnant, infant refuses the breast or is not growing, and milk is salty or not good.
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