Birth spacing in Pakistan

Life table analysis was applied to data from the 1975 Pakistan Fertility Survey to identify child spacing differentials between population subgroups. Women in urban areas had shorter birth intervals than their rural counterparts from parities 1-6; only after parity 7 was this differential reversed. Similarly, women with some education had shorter birth intervals at the earlier parities than uneducated women. While overall family size is relatively homogeneous in Pakistan, women of more modern backgrounds seem to space their children more closely than traditional women. Age at marriage appears to play an important role not only in determining the length of the 1st interval, but also that of subsequent intervals. An unexpected finding was that ever users of contraception had distinctly more rapid spacing of their births than never users. The median interval to 1st birth was shortest in North West Frontier Province, but similar in Punjab and Sind. Multiple classification analysis revealed that some differentials in child spacing by education, residence, and province persisted even after other variables were controlled. Cohort of mother had an independent effect, with younger cohorts having shorter birth intervals. However, the variable that had the strongest effect on length of interval (aside from the 1st interval) was breastfeeding duration. It is likely that increasing urbanization and improved levels of education among women will lead to high levels of marital fertility associated with shorter birth intervals. Even though these trends tend to increase the age at marriage, they are associated with shorter durations of breastfeeding. In the longer term, greater use of contraception among women in the modern sector may partially counteract the fertility increasing effect of reduced birth intervals.     

Regression analysis of "current status" life tables on duration of breastfeeding in Sri Lanka

Provided that women report the dates of their children's births with reasonable accuracy, it is possible to derive good estimates of the duration of breastfeeding from women's breastfeeding status at the time of the interview. This paper illustrates the application of conventional regression techniques to the analysis of breastfeeding rates derived in this manner. Construction of current status rates is explained and a comparison between open interval, closed interval, and current status breastfeeding life tables is presented, indicating the extent of bias to which tables of the former types are open. Birth-weighted rates are used for WFS data from Sri Lanka; the variables entered into the regression equation include parity, educational level, residence, work experience since marriage and use of contraception since the birth. Contraception is not found to influence net breastfeeding rates in the 1st interval (1-16 months), although it is about as prevalent as in later intervals. The positive coefficients at intervals beyond the 1st also imply that contraceptive use is not a substitute for lactation in Sri Lanka or not a predominant one. Lifetime urban residence is associated with short durations of breastfeeding, and being an urban migrant is associated with intermediate durations relative to those of rural women. The effects of residence on breastfeeding are especially pronounced in the 1st interval. By parity as by contraception, differences in breastfeeding rates are not significant at short durations but become so with time as lower parity women reach pregnancy. Patterns by age are similar, but less sharp. Middle school attendance and work at home are both strongly associated with with lactation behavior, the former negatively and the latter to about an equal degree positively. Working outside the home seems not to influence breastfeeding to any great extent. In the multiple attribute regressions, middle schooling depresses breastfeeding durations about as strongly as lifetime urban residence relative to women who are rural and uneducated. Being at parity 5 or above or working at home almost as sharply increases durations. The use of contraception has slightly smaller positive effects. The patterns suggest that as Sri Lankan women become increasingly well educated and urban, and as family sizes decline, durations of breastfeeding will decline. Equally important however, even among better educated urban wives, breastfeeding continues longer than is typical of western countries.     

Breast-feeding in Bangladesh

In this paper the duration of breastfeeding is examined in relation to demographic and socioeconomic characteristics of women and households. 98% of Bangladesh mothers breastfeed their children from birth. In data from the Bangladesh Fertility Survey conducted in 1975-1976 on 4998 live births, the mean duration of breastfeeding was 27.3 months. Duration of breastfeeding was positively related with the age of women. Female children were breastfed for periods about 5 months shorter than male children. Children born to urban mothers were breastfed for shorter durations than children born to rural mothers of all age groups. The duration of breastfeeding decreased with the increase of education of the mother. Promotion of breastfeeding should be a primary responsibility of family planning clinics. Further decline in the duration of breastfeeding would increase levels of fertility and infant and child mortality.     

A note on the determinants of breastfeeding durations in an African country

This paper utilizes data from the 1977-78 Kenya Fertility Survey, 1 component of the World Fertility Survey, to analyze the determinants of breastfeeding durations for women 15 to 50 years old who had their last-but-1 live birth between 3 and 15 years prior to the interview. Comparisons are made with the findings fro m the World Fertility Surveys in 8 other developing countries in Asia and Latin America. Findings indicate that literacy, urban residence, secondary school education, and modern employment reduce the duration of breastfeeding in Kenya. In addition, the subgroups of women who appear to be curtailing breastfeeding are growing in proportional size or are composed of women may be innovators or leaders. A continuation of this pattern into the future may increase levels of infant morbidity and mortality and, in the absence of increased modern contraceptive practice, may increase the societal level of fertility. The death of the infant curtails the period of breastfeeding. Although there is a pronounced preference for male children in Kenya, this preference does not lead to differential durations of breastfeeding by sex of child. About 10% of Kenyan women used contraception in the last closed interval. Parity and age explain less than 1% of the variation in duration of breastfeeding in Kenya. Kenyan women are among the least likely to have attended secondary school, to have worked since marriage, and to have used modern contraception. The most traditional groups of Kenyan women, those who are Muslim or who are in polygamous unions, breastfeed for the longest durations. The Kenya Fertility Survey suggests that the subgroup of women with some secondary school education is growing considerably. Kikuyu women may be regarded as innovators in many respects. In addition to having shorter breastfeeding durations, they are the least likely to be in polygamous unions or to want more children, and they are the most likely to be using contraception.     

Breast-feeding, social variables, and infant mortality: a hazards model analysis of the case of Malaysia

A hazards model was used to estimate the relative risks of infant mortality at various points during the 1st year of life among Malaysian infants who were breastfed for various durations. Data on infant mortality, breastfeeding, and social variables were derived from the retrospective Malaysian Family Life Survey. To provide adequate samples in subperiods of the 1st year of life, analysis intervals were constructed starting at ages 0, 2, 4, and 7 months, and including up to 13 months of exposure. The preferred models for the 1st 3 analysis intervals included breastfeeding as a predictor of infant mortality. It is a particularly significant determinant in the 1st and 3rd intervals. The relative risk of death among those who received food other than human milk was 6.26 compared to those who did not, and the infant who was never breastfed was 12 times more likely to die than the infant who was breastfed at some time. Infants breastfed for intermediate durations had intermediate effects estimates. In each analysis interval, the regression coefficient for unsupplemented breastfeeding was of larger magnitude than that for supplemented breastfeeding. Overall, this study shows that breastfeeding is an important determinant of infant mortality in Malaysia. Studies with larger samples are urged to confirm the preliminary finding of a monotonic relationship between breastfeeding duration and lower infant of mortality risks. However, this analysis demonstrates the utility of hazard model methodology as a powerful tool for calculating relative risk estimates when the sample size is relatively small and there are numerous covariates.     

Nutrition, infant feeding and post-partum amenorrhoea in rural Bangladesh

The extent to which differences in the duration of postpartum amenorrhea among chronically malnourished women in rural Bangladesh are related to seasonal patterns of food supply, maternal nutrition, education, and patterns of infant feeding was investigated by application of multivariate hazards models with time-varying covariates. The data were derived from the Birth Interval Dynamics study in Matlab and covered close to 1800 births. Parity, education, season of birth, maternal weight, and infant supplementation all were found to affect the duration of postpartum amenorrhea among these women. Education of 5 or more years had a positive effect on the resumption of menses. Higher parity women, who were older, had longer periods of amenorrhea, as did women who gave birth in October-December. As a measure of nutritional status, the woman's weight at pregnancy termination showed a highly significant positive coefficient, indicating that improved maternal nutrition increased the likelihood of resuming menstruation. Food supplementation, which tends to decrease breastfeeding, also significantly increased the risk of resuming menstruation and had an effect independent of the other variables. When the data were analyzed by season, the most striking finding was the strong influence of education on children born during October-December (who are too young to be directly affected by the larger food supply at birth during the harvest season). The other seasons showed weaker effects of education and a stronger effect of supplementation, perhaps because these infants are older during the harvest season and thus can benefit from supplements.     

Cross-cultural dimensions of breastfeeding practices and abstinence: Evidence from Uttar Pradesh and Tamilnadu, India

Summary and Conclusion The analysis contained in this paper brings out very clearly that the practice of breastfeeding and abstinence in the two major states of India: Uttar Pradesh and Tamilnadu are highly related to socio-cultural factors and changes in generational gaps. The findings reveal that literate, non-Hindu, and rich (high SLI) women have shorter breastfeeding durations than illiterates, Hindus, and poor (low SLI) women of Uttar Pradesh and Tamilnadu. In addition, the breastfeeding practice in Uttar Pradesh is influenced by residence background and generational age-gaps. The role of socio-cultural factors in influencing post-partum sexual abstinence period has been found to be significantly important through the variables; residence background, generational age-gaps, religion and working status of women. The results reveal that urban women, of younger cohorts (below 30 years), non-Hindu, and non-working women have shorter abstinence periods compared to rural women, of older cohorts (above 30 years), Hindus, and working women in both the states. The findings from this analysis suggest that apart from modernization process, defined in terms of higher literacy levels, higher developmental and urbanization levels, the changing perceptions and attitude towards lactational practices over the generation has significant dent on shortening of breastfeeding durations and abstinence periods. Thus, the study support the hypothesis that the process of modernization defined in terms of improvement in level of education, family income, urbanization tends to shorten the period of breastfeeding and abstinence, and consequently, the post-partum infecundability is reduced. Such reductions in the infertile periods can be expected to contribute to an increase in natural fertility levels of the population and also on the observed fertility levels, if not counter balanced by the fertility reducing effects of contraception.     

Variability of breast sucking, associated milk transfer and the duration of lactational amenorrhoea.

Quantitative relationships between physical parameters of sucking, milk transfer and the duration of amenorrhoea were examined in normal mother-baby pairs under exclusive breastfeeding. Sucking pressures were recorded twice on the second and once on the fifth month after birth, during complete breastfeeding episodes, by means of a catheter attached to the nipple and connected to a pressure transducer, the signals of which were analysed by computer. Babies were weighed before and after each sucking episode to estimate milk transfer. In the first nursing episode after noon, 2-month-old babies sucked from 140 to > 800 times during 4-15 min from the first breast, obtaining from 20 to > 100 g milk. The physical parameters of sucking and milk transfer exhibited high inter-individual but low intra-individual variabilities. There were significant differences in the physical parameters of sucking and milk transfer efficiency between first and second breast and between the second and fifth months after birth. Milk transfer efficiency was inversely correlated with time occupied by non-sucking pauses > or = 1.5 s, and was directly correlated with mean intersuck intervals in the first breast and with duration of the sucking episode, number of sucks, mean pressure and area under the pressure curve in the second breast. There was no correlation between the physical parameters of sucking and duration of lactational amenorrhoea (n = 62). However, significantly more mothers had amenorrhoea lasting > 180 days among those whose babies spent a longer proportion of the nursing episode in non-sucking pauses > or = 1.5 s. This finding indicates that sensory stimulation of the nipple produced during a nursing episode by stimuli other than sucking itself may have an important role in sustaining lactational amenorrhoea. It is concluded that nursing episodes have a complex structure that allows the development of a breastfeeding phenotype in each mother-baby pair, exhibiting important inter-individual variability. The present analysis does not support the contention that this source of variability accounts for the variability in the duration of lactational amenorrhoea.     

Resumption of menstruation among urban post-partum women in Bangladesh.

To investigate the return of menstruation among postpartum women in Dacca, a random sample of 360 women (1-12 months postpartum) was selected from 4 Dacca hospitals for a cross-sectional study; another random sample of 200 women ( 1 month postpartum at time of interview) was selected from the same hospitals for prospective follow up. Many of the women were from rural areas who left the city after delivering their babies; most were under 25 years old at the time of interview. Results of the cross sectional study showed that 63% started menstruating by the 6th postpartum month; 10% were still amenorrhoeic by the 12th postpartum month; 46% were breastfeeding their infants by the 4th month; 90% resumed sexual relations, and 48% were using contraceptives, by the 6th month. Results of the prospective study showed that slightly more than half of the women started menstruating by the end of the 5th postpartum month; almost half stopped breastfeeding by the 5th month, 88.8% were having sexual relations with their husbands, and about 50.5% were on some form of birth control. The findings suggest a much shorter duration of lactational amenorrhea than has been claimed for a rural area of Bangladesh; they also suggest that urban women start menstruating earlier because of their primary reliance on supplementary feeding. The contraceptive effectiveness, as well as health benefits to infants, of prolonged and intensive lactation should be promoted to urban mothers.     

Son preference and its effects on Korean lactation practices

Using retrospective data from Korea, multivariate log-linear analyses were used to determine if the sex of a child influences the probability of it being breastfed, or if it influences the number of months he/she was breastfed. In Korea the likelihood of a woman not breastfeeding a child is very small. The fact that a woman is without living sons increased the average odds of not breastfeeding by 1.55 times. The absence of living sons has the strongest effect of any of the predictor variables used. The highest predicted conditional odds of not breastfeeding are for women with female infants, who live in rural areas, have less than 3 children of which none are boys, and who do not use oral contraceptives. The lowest predicted conditional odds of a woman not breastfeeding are for a city dweller, with 3 or more children of which at least 1 is a boy, who uses the pill, and whose infant is a boy. Although oral contraceptive use is significant for deciding how long to breastfeed, the direction of its effect is not what was expected had it affected lactation physiologically. Apparently, social factors are operative which make pill users more likely to breast feed than non-users. 1 possible explanation for this is that Korean women are aware of the fertility-suppressing effects of lactation and are using breastfeeding as a deliberate form of birth control. The fact that the effect of pill use becomes progressively stronger the longer that women breastfeed lends further support to this explanation. The effect of sex of child is not significant in determining the duration he/she will be breastfed. This study indicates support for the contention that Korean women are aware of the contraceptive effects of lactation, and that their decisions of breastfeed are affected by their preference for sons.     

Factors associated with exclusive breastfeeding at discharge during the COVID-19 pandemic in 17 WHO European Region countries

Both the consumption of breastmilk in infancy and a person’s season of birth influences his or her health, educational, professional, and behavioral outcomes. Further, season of birth effects differ by sex. However, current research, for the most part, neglects to examine if season of birth and breastfeeding are related. This paper examines the impact of sex-based variations in season of birth on breastfeeding likelihood and duration in the U.S. Using data from children born to female respondents of the National Longitudinal Survey of Youth 1979 (born between 1970 and 2012), this study examines with Probit, Negative Binomial, and Ordinary Least Squares (OLS) regressions if a child’s season of birth and sex are correlated with breastfeeding incidence and duration. The breastfeeding incidence and duration data are self-reported by the mother. Season of birth has a small but statistically significant impact on the incidence and duration of breastfeeding, which varies depending on the sex of the infant. Mothers giving birth to sons in the spring are 13.5% less likely to breastfeed than those giving birth to sons in the winter (with a p - value of 0.0269). Mothers with daughters born in the summer or fall (autumn) breastfeed slightly longer than mothers with daughters born in the spring. On average, mothers of summer-born daughters breastfeed 4.1% longer (with a 95% confidence interval of 0.3 - 7.8) and those with fall-born daughters 3.8% longer (with a 95% confidence interval of 0 - 7.5). Mothers giving birth to daughters in the spring are also significantly less likely to reach the breastfeeding six-week duration target (compared to fall and winter births) and the one-year duration target (compared to fall births). These findings suggest that the costs and benefits of breastfeeding an infant vary with the season of birth and the sex of the child. This finding could explain some of the season of birth effects previously identified in the literature. Further, policymakers seeking to increase breastfeeding rates should consider the reduced breastfeeding rates and durations for children born in the spring.     

Waist-to-hip ratio and woman's education level as predictors of breastfeeding duration

The possible existence of a relationship between breastfeeding duration, educational status and waist-hip ratio (WHR) as a measure of fertility and biological fitness in a sample of the Polish population is examined in this article. Data on age, height, weight, waist and hip circumferences, educational level (as a proxy for socio-economic status), and duration of breast feeding were collected for women using questionnaires in 11 outpatients' surgeries for healthy children, and in 5 general practices in three districts of Wroclaw, Poland. An ordinal multinominal linear model with logit link was used to determine the extent to which duration of lactation was influenced by maternal WHR and level of education. The best single predictor for the duration of lactation was WHR. While WHR decreases according to increasing duration of lactation for mothers with university or high school education, no such differences were observed among women at the lowest level of education. This study confirms the greater biological fitness of women with low WHR in the Polish population, and shows that this is mediated by level of educational attainment of the women.     

Breastfeeding in the United States

The breastfeeding of US infants born in 1974-76 is analyzed using data form the 1976 National Survey of Family Growth. Life table estimates of the proportion of children breastfed by duration since birth and mean breastfeeding durations are presented. The life tables reported are constructed by standard cohort table methods. To compare life tables for children of mothers in various attribute categories, generalised Wilcoxon tests are used, together with multiple classification analysis for continuation at select durations. Variables considered include mother's age at the birth, ethnicity, educational level, education by ethnicity, region of residence and the child's birth order. Findings are restricted to infants remaining with their mothers for at least 2 months following delivery and surviving as of the survey date in January-September 1976. It is found that the proportion of infants breastfed was increasing rapidly, with the highest rates found among white (39%), college-educated (56%), western (56%) mothers and lowest rates among black mothers (17%) mothers with less than a high school education (19%) and mothers living in the south (24%). By age, the highest proportions are mothers at ages 25-29 (44%), followed closely by the mothers under 25 (29%). The proportions breastfeeding were also found to be higher in urban than in rural areas (38% vs. 28%) and higher at parities 1-2 (29%). A multiple classification analysis of the factors most strongly influencing breastfeeding in 1975 shows educational level to be the strongest single predictor of breastfeeding, followed by western residence and white ethnicity. Age effects were found to correlate strongly with education. Reviewing 1971-1981 changes, the proportion of mothers with less than a college education who breastfed their children increased from 19% to 51% over the decade, while the proportion among college-educated mothers rose from 42% to 74%. For children who were breastfed, the median duration was about 4.5 months. The mean was 5.5 months, with a range from about 3.0 months among black mothers with less than a high school education, to 6.0 months among college-educated white women. The nationwide changes in breastfeeding patterns and duration may confer modest health benefits on current generations of youngsters, although not benefits that are easily measured, since human milk substitutes are routinely subjected to rigourous testing for nutritional adequacy.     

High initiation and long duration of breastfeeding despite absence of early skin-to-skin contact in Karen refugees on the Thai-Myanmar border: a mixed methods study

Background

Early skin-to-skin contact (SSC) after birth is recommended as part of the United Nations Children’s Fund (UNICEF) baby friendly health initiative to promote optimum breastfeeding. This paper reports rates of breastfeeding initiation and duration in a low resource environment, where early SSC is not practised, and explores views of pregnant women and midwives surrounding breastfeeding and swaddling.

Methods

Data from records from a single hospital on the Thai-Myanmar border where refugee women gave birth during a one-year period (2010) were used to determine breastfeeding initiation rates and the time of the first breastfeed, and duration of breastfeeding of the previous alive child in multigravidae. Focus group discussions (FGD) were conducted to obtain information from pregnant women attending antenatal care about their intended or previous duration of breastfeeding and views on breastfeeding. Interviews with local midwives explored reasons for high rates of breastfeeding in this setting and the practice of newborn swaddling.

Results

Of 1404 live births in 2010 in Maela refugee camp there were 982 evaluable mother-newborn pairs, including 80 infants born before 37 weeks gestation. Initiation of breastfeeding within the first hour after birth and exclusive breastfeeding at discharge in term mother-newborn pairs was 91.2% (823/902) and 99.3% (896/902); and before 37 weeks gestation, 48.8% (39/80) and 98.8% (79/80). Reported duration of previous breastfeeding was 19 (range 2 to 72) months.During FGD all primigravidae (n?=?17) intended to breastfeed and all multigravidae (n?=?33) had previously breastfed; expected or previous duration of feeding was for more than one year or longer. The major theme identified during FGD was breastfeeding is “good”. Women stated their intention to breastfeed with certainty. This certainty was echoed during the interviews with midwifery staff. SSC requires a delay in early swaddling that in Karen people, with animistic beliefs, could risk loss of the spirit of the newborn or attract malevolent spirits.

Conclusions

In a population with a strong culture of breastfeeding and robust breastfeeding practices, high rates of initiation and duration of breastfeeding were found despite a lack of early skin-to-skin contact. Local preferences, traditions and practices that protect, support and maintain high rates of breastfeeding should be promoted.

     

A note on the determinants of breastfeeding durations in an African country

Abstract

This paper utilizes data from the 1977–78 Kenya Fertility Survey, one component of the World Fertility Survey, to analyze the determinants of breastfeeding durations for women 15 to 50 years old who had their last‐but‐one live birth between 3 and 15 years prior to the interview. Comparisons are made with the findings from the World Fertility Surveys in eight other developing countries in Asia and Latin America. Findings indicate that literacy, urban residence, secondary school education, and modern employment reduce the duration of breastfeeding in Kenya. In addition, the subgroups of women who appear to be curtailing breastfeeding are growing in proportional size or are composed of women who may be innovators or leaders. A continuation of this pattern into the future may increase levels of infant morbidity and mortality and, in the absence of increased modern contraceptive practice, may increase the societal level of fertility.     

Covariates of age at first birth in Guyana: a hazards model analysis

Analysis of data from the Guyana Fertility Survey on the trends and covariates of age at 1st birth among various birth cohorts of women ever in union indicates that an early entry into union is associated with young age at 1st birth and higher number of children born. Multivariate analysis showed that women with higher education, urban residence, and entry into 1st birth compared to others, and that young women are delaying their 1st birth for longer durations than older women. Work status of women before 1st birth and the starting age of union seem to be the 2 major contributory factors for age at 1st birth. Noticeably, the role of education has changed and is now more significant among younger cohorts than among older ones for 1st birth timing.     

Longitudinal study of breastfeeding structure and women's work in the Brazilian Amazon

It is well established that breast milk is the ideal food for infants and that breastfeeding has short‐ and long‐term health benefits for the mother and child. However, there is variation in breastfeeding patterns between populations. Women's work is thought to influence breastfeeding patterns and timing of supplementation and it is often assumed that women in subsistence‐oriented societies can more easily integrate their productive and reproductive activities. This article reports longitudinal data, collected in three rounds (resguardo [<40 days], peak [2–4 months], and late [14–16 months] lactation), on breastfeeding structure, infant care, and work patterns of 17 rural Amazonian women in an effort to understand how breastfeeding structure and maternal time allocation changed over time, as well as the strategies women used to integrate their productive and reproductive roles. Women breastfed 10.6 ± 3.1, 9.4 ± 3.4, and 9.6 ± 5.5 times per 9‐h period in the three rounds, respectively. Breastfeeding structure, specifically session duration, changed over time (P < 0.05). As lactation progressed, women spent less time breastfeeding and in infant care and more time in subsistence work. In peak lactation, subsistence work was negatively correlated with infant care (r = ?0.4, P = 0.01), breastfeeding (r = ?0.29, P = 0.05) and session duration (r = ?0.39, P < 0.01) and in late lactation was negatively correlated with time spent breastfeeding (r = ?0.39, P < 0.01) and in infant care (r = ?0.50, P < 0.01) and positively correlated with inter‐session interval (r = 0.40, P < 0.01). Generally, women reduced time in subsistence work when breastfeeding was more intense and returned to normal activity patterns once infants were being supplemented. The costs and benefits associated with women's strategies are discussed. Am J Phys Anthropol, 2011. © 2010 Wiley‐Liss, Inc.     

Birth spacing,breastfeeding, and early child mortality in a traditional Indian society: A hazards model analysis

Abstract

There are few studies of the interrelationships among breastfeeding, child spacing, and child mortality in traditional societies that incorporate extensive controls for social and demographic characteristics of the mother and child. In this paper, we investigate the impact of breastfeeding and the length of the preceding birth interval on early child mortality (defined as a death in the first two years of life) using data from a traditional society of India. Multivariate hazards models are used to analyze the data. Most prior analyses related the impact of breastfeeding duration to the duration of child survivability by taking breastfeeding as a fixed covariate. The present study has a methodological focus in the sense that breastfeeding information from retrospective survey data is treated as a time‐dependent covariate both as a status variate as well as a duration—with empirical findings compared across the two specifications. The effects of postpartum amenorrhoea and various other demographic and socioeconomic characteristics of mother and child are also studied. The results suggest that breastfeeding duration has a strong impact in reducing the relative risk of early child mortality; but it does not explain the effect of the length of the preceding birth interval on early child mortality.     

Breast-feeding pattern in an urban Nigerian community

This paper examines the pattern of breastfeeding among women still in their prime childbearing ages (15-35 years) in Ilorin, the capital city of Kwara state in Nigeria. While breastfeeding is still a common practice among urban women, there is wide variation in the duration of breastfeeding depending on the socioeconomic characteristics of the mothers. Mother's education and father's education have very strong negative associations with duration of breastfeeding. Use of contraception also has a significant independent but negative effect on breastfeeding duration. Christians continue breastfeeding for shorter periods than Muslims. The introduction of supplementary feedings to the infant occurs in this population much earlier than is recommended by various authorities. Decline in breastfeeding practice may have deleterious effects on the health and survival of children in developing countries and may also lead to higher fertility and more rapid population growth. The high morbidity and mortality among artificially fed infants in many developing countries can be attributed to improper preparation as well as contamination of infant formula and other foods.     

The pattern of reproductive life in a Berber population of morocco

Abstract

Reproductive patterns were studied from data collected in 1,450 Berber households in the province of Marrakesh, Morocco in 1984. Women aged 45–49 years had a mean of 8.9 pregnancies to achieve 5.7 living children. Social influences on fertility rates show the importance of tradition, particularly through time‐dependent variables such as age at marriage, waiting time to first birth, interbirth intervals, and duration of breastfeeding. Birth control does not appear to affect the tempo of fertility; rather, its main use is to bring the reproductive period to a close. The comparison of two subsamples of women separated by a 25‐year interval indicates an actual acceleration of the tempo of fertility by the reduction of waiting time to first birth and of interbirth intervals. The supposed ongoing process of demographic transition is not clearly observed in this population.