Rapid ethnographic assessment of breastfeeding practices in periurban Mexico City

Before carrying out a breastfeeding promotion programme in a periurban area of Mexico City, we conducted a rapid ethnographic study to determine the f actors associated with absence of exclusive breastfeeding. The responses to pilot interviews were used to develop a standardized questionnaire regardi ng reasons for infant feeding choice, sources of advice, and barriers to br eastfeeding. We interviewed a random sample of 150 mothers with a child <5 years of age; 136 (91%) of them had initialed breastfeeding; but only 2% ex clusively breastfed up to 4 months. The mothers consistently stated that th e child's nutrition, health, growth, and hygiene were the main reasons for the type of feeding selected; cost, comfort, and the husband's opinion were less important. Physicians were ranked as the most important source of adv ice. Reduction or cessation of breastfeeding occurred on the doctor's advic e (68%); or when the mothers encountered local folk illnesses such as "cora je" (52%) or "susto"(54%), which are associated with anger or fright; or ha d "not enough milk" (62%) or "bad milk" (56%); or because of illness of the mother (56%) or child (43%). During childhood illnesses and conditions, br eastfeeding was reduced and the use of supplementary foods was increased. T his study emphasizes the importance of cultural values in infant feeding ch oices, defines specific barriers to breastfeeding, and provides a basis for interventions to promote exclusive breastfeeding in the study population.