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  • Title: Infant-feeding practices in urban and rural communities of the Sudan.
    Author: el Bushra HM, Salih MA, Satti SA, Ahmed Mel F, Kamil IA.
    Journal: Trop Geogr Med; 1994; 46(5):309-12. PubMed ID: 7855919.
    Abstract:
    Infant-feeding and weaning practices were investigated in a multistage randomly selected sample of 1,039 Sudanese mothers who represented six of the nine States of the Sudan. The majority (77.9%) believed that breast milk was best for their babies, emphasizing the previously reported high breast-feeding rate in Sudanese mothers. Food supplementation started by 6 months in 82.5% mainly in urban middle and high classes (UMC and UHC) compared to urban poor class (UPC) and the rural group (RG; p < 0.001). A mixture of food items was used for supplementation by 62.1% of the study group, whereas giving one food item was significantly more practised in RG (54.9%) compared to others (p < 0.001). Household food was introduced by 6 months in 35.4%. Weaning started between 6 and 12 months in 27.1% and thereafter in 64.9%. A greater proportion of rural mothers (36.5%) weaned their babies after the age of 18 months (p < 0.001). About half the children (52.8%) were weaned abruptly, mainly among UPC and RG. The first food item of choice for weaning was fresh goat's or cow's milk (77.6%), followed by powdered or formula milk (16.1%). The commonest second preferred food was a starch gruel (39.1%) made either of rice (24.5%) or fermented sorghum. In six of the nine states of the Sudan, a random multistage cluster sampling technique was used to select 1039 mothers in the towns of Shandi, Port Sudan, El Fashir, Kosti, El Hasahisa, Omdurman, the village of Ellirri, and villages near Shandi, Sinkat, and Abu Hamad. Medical students from the selected areas interviewed the mothers. The study aimed to examine infant feeding and weaning practices. 77.4% of the mothers considered breast milk to be best for their baby, reflecting the high breast feeding rate (92% at 6 months) reported previously. The foods identified as second-best were local cereals (e.g., fermented sorghum gruel) (36.9%), fresh goat's or cow's milk (22.5%), bananas and oranges (11.3%), and formula milk (7.7%). Only 1% of newborns received food supplements. 82.5% of mothers supplemented breast milk with other foods by age 6 months. The urban high and middle classes were more likely to practice food supplementation at 6 months than the urban poor and the rural groups (90.3% and 89.7% vs. 79.3% and 74.1%, respectively; p 0.001). 62.1% of all mothers supplemented breast milk with a mixture of foods. Rural mothers were more likely to supplement with only one food item than urban mothers (54.9% vs. 28.3-30.6%; p 0.001). 35.4% and 90.7% of mothers introduced household foods at 6 and 9 months, respectively. 27.1% of mothers began weaning between 6 and 12 months. 64.9% of mothers began weaning after 12 months. A significant percentage of rural mothers (36.5%) began weaning after 18 months (p 0.001). 52.8% of mothers weaned their children abruptly, especially rural women and the urban poor. The most preferred first weaning foods were fresh milk (77.6%) and powdered or formula milk (16.1%). The most preferred second weaning foods were starch gruel made of fermented sorghum or rice (39.1%) and powdered or formula milk (19.1%).
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