EARLY CHILD HEALTH IN LAHORE, PAKISTAN .5. FEEDING PATTERNS

The feeding practices of children (n = 1476) from birth to 24 months, as determined in a longitudinal study, in Lahore, Pakistan, are presen ted. Four socioeconomic groups at various levels of urbanization were included; a village, periurban slum, urban slum and an upper middle cl ass. Initiation of breastfeeding was delayed in all the neonates. Sixt y-five percent of the periurban slum mothers and 45% of the village mo thers 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. Exclu sive breastfeeding was rare, with 9% at one month, declining rapidly w ith age and being highly influenced by season. Partial breastfeeding w as the most common mode of feeding. Water in addition to human milk wa s 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 commerci al 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 ani mal milk was mainly used. More than 50% of die mothers in the village and in the periurban slum gave diluted animal milk even beyond the age of 10-15 months. In die upper middle class 50% of the infants were fe d semisolids at the age of four months, while in the village, the peri urban and the urban slum at 6 months of age only 10%, 12% and 47% of t he infants received semisolids. The results of this study indicate tha t breastfeeding was highly prevalent in the three poorest areas. Howev er, in all the areas initiation of breastfeeding was delayed and prela cteal feeding was the norm. Exclusive breastfeeding was rare, feeding bottles were used by 82-100% of the mothers to feed supplements and hu man milk substitutes, in the four areas.