RECOGNIZING THE REVERSIBLE NATURE OF CHILD-FEEDING DECISIONS - BREAST-FEEDING, WEANING, AND RELACTATION PATTERNS IN A SHANTY-TOWN COMMUNITYOF LIMA, PERU

Researchers have normally considered weaning to be a non-reversible ev ent. To determine the validity of this assumption, we interviewed 36 m others of toddlers who were living in a poor shanty town of Lima, Peru . Data from 32 women were complete and used in this analysis. Mothers described their beliefs, practices, and decisions about breastfeeding, weaning, and relactation (the reintroduction of breastfeeding after w eaning). We recorded attempted weaning events if the mother reported ( 1) purposefully not breastfeeding with the intention to wean, or (2) c arrying out an action that was believed to cause the child to stop bre astfeeding. Using a constant comparative approach, references to child -feeding decisions were coded, categorized, and analyzed. All mothers breastfed for at least 12 months; the median duration of breastfeeding was 25 months. There were several different patterns of child-feeding . Thirteen women never attempted to wean their children or had weaned on the first attempt. The majority (n = 19) of women, however, attempt ed to wean their children - some as early as 3 months of age - but rel actated between less than 1 day and 3 months later. Factors that influ enced feeding decisions were primarily related to maternal and child h ealth, and maternal time commitments. Children were weaned when there was a perceived problem of maternal health or time commitments and chi ld health was not at risk of deterioration. Mothers postponed weaning because of poor child health. The primary reason for relactation was a child's negative reaction to weaning (e.g., incessant crying or refus al to eat). Personalities of the mother and child were important deter minants of feeding decisions. These results demonstrate that maternal and child factors jointly influence child-feeding decisions and that t hese decisions are easily reversed. As relactation is.culturally accep table, health practitioners should consider recommending relactation w hen children have been prematurely weaned and human milk would improve their nutritional and health status. (C) 1998 Elsevier Science Ltd. A ll rights reserved.