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  • Title: The reasons for early weaning among mothers in Teheran.
    Author: Marandi A, Afzali HM, Hossaini AF.
    Journal: Bull World Health Organ; 1993; 71(5):561-9. PubMed ID: 8261559.
    Abstract:
    In order to identify the reasons for early weaning in Teheran, we interviewed 900 mothers using a systematic randomized sampling method. A total of 15% of the mothers were illiterate, 93% were housewives, and 97% had given birth in hospitals. Only 3% of the newborns benefited from rooming-in facilities in hospital, and 68% were bottle-fed while still in hospital. In 3.1% of cases the mother had not breast-fed her newborn at all. Of those who had breast-fed their infant, 38% used only their own milk, whereas 62% used a combination of breast milk and infant formula. The median duration of breast-feeding was 16 months (mean, 14 months). A total of 74% of mothers who used supplementary formula and 39% of those who had completely stopped breast-feeding blamed milk insufficiency, although 67% of these mothers had reached this conclusion only because their infants cried or were irritable. The following factors had a negative influence on the duration of breast-feeding: use of supplementary formula and of estrogen-containing oral contraceptives; fathers with high incomes; and mothers with a high educational level. In contrast, the mother's religious motive to breast-feed and her insistence on breast-feeding had a positive impact. Unfortunately, 21% of the mothers started using supplementary formula during the first month postpartum, and two-thirds before the end of the fourth month. Every month that bottle-feeding was started prematurely shortened the duration of breast-feeding by 20 days.(ABSTRACT TRUNCATED AT 250 WORDS) In January-February 1990, in Iran, family health workers interviewed 900 mothers with a 24-30 month old child who lived in Teheran to determine reasons for early weaning. 68% of the children had been bottle fed in the hospital. Just 6% were breast fed within 5 hours after delivery. Average period between delivery and initiation of breast feeding was 42.5 hours. Median duration of breast feeding was 16 months. Of the mothers who breast fed, only 38% exclusively breast fed while the remaining 62% supplemented their breast milk with formula. 21% of mothers who used formula first supplemented their breast milk during the first month postpartum. 74% of mothers using supplementary formula reported milk insufficiency as the reason for bottle feeding. This was also the leading reason for discontinuation of breast feeding of children less than 24 months (39%). 67% of their mothers claimed to know that their milk was insufficient because the children cried and were irritable. 43% of mothers reporting milk insufficiency did not know what caused milk insufficiency, 52% did nothing to increase their milk supply. 96% of all mothers said that breast milk was better for their child's growth than formula. Sources of knowledge about breast feeding were relatives and friends (45%), radio and television (27%), printed media (12%), and physicians and health workers (4%). The greater the infant's age when mothers started formula, the longer mother continued to breast feed. In addition to supplementary formula, other factors having a negative effect on duration of breast feeding were estrogen-containing oral contraceptives which tend to reduce the quantity and quality of breast milk, fathers with high incomes, and high maternal educational status. Mothers' determination to breast feed and religious motivation had a positive effect on duration of breast feeding.
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