1School of Medicine & Dentistry, University of Rochester, 2Department of Emergency Medicine, University of Rochester, 3Department of Anthropology, University of Georgia
April 14, 2018 , Zilker 1/2/3
Exclusive breastfeeding is well documented to reduce morbidity and mortality for children under the age of six months, yet rates continue to be low in both the developed and developing world. In Malawi, only 4-7% of infants under six months are exclusively breast fed. We collect and interpret ethnographic data about mothers’ decisions to supplement infant diets prior to age six months. We conducted a quantitative and qualitative study of breastfeeding practices in the Ntcheu District of Malawi between October 2016 and June 2017. Mothers with four and five month old babies were recruited at Under 5 Clinics administered by the Gowa Health Center. Surveys at mothers’ homes included demographic information, birthing history, and a 24-hour dietary recall. Qualitative data collection focused on the decision-making process regarding commencing supplemental feeding. 84.4% of 178 mothers interviewed were familiar with the benefits of exclusively breastfeeding their child until the age of six months, but only 16 mothers (8.9%) exclusively breastfed their children in this age group. 62% of 175 mothers stated they introduced supplemental foods because their child was “crying”, “causing trouble”, or had “stomach aches”. Eighty-two mothers (63.4%) counted their child’s age in a way that overinflated the child’s actual age. In addition to presenting the normative weaning trajectories, we show evidence that lack of knowledge is not responsible for low rates of exclusive breastfeeding in rural Malawi. Rather, mothers believe their children are older than they are, subsequently resulting in introductions of supplemental foods prior to six months.
This research was funded by the University of Rochester School of Medicine & Dentistry Office for Medical Education.