Reasons for weaning and the introduction of bottle-feeding: an alternative approach

Abstract

Reasons, alleged by mothers, for early weaning and for the introduction of breast-milk substitutes were studied, in 1985, in a public maternity hospital of S. Paulo City. These mothers were part of an intervention project to support and promote breast-feeding through public health services. Eight hundred and seventy-five women were followed up from delivery to the 4th month of the baby's life. Reasons for weaning were collected immediately afterwards ("single interview") and were also again asked for when the mother returned to the health unit ("multiple interview"). All the reasons given were collected and classified according to "responsibility": of the mother (her own desire to wean), of her baby (attributed to the baby), of her body (the mother's physical reasons) and of other people (doctor, husband, neighbor, etc.). The most prevalent reasons for the introduction of breast-milk substitutes, according to "multiple interview", were: mother had to work out (20.5%), got agitated (12.5%) and convenience (11.0%). According to "single interview" they were: the baby's crying (23.0%), prior conceptions of infant feeding (12.5%), working out (11.0%). These differences were not so evident among the reasons for complete weaning; however, considering weaning as a long process in which the reasons for the introduction of breast-milk substitutes may be linked to reasons for the "sevrage", the advantages of utilizing all the answers of different contacts with the women ("multiple interview") over against just one answer given on one ocasion as a contribution to the clarification of the weaning process in each cultural site, is indicated. The reasons gathered and classified according to "responsibility" show that "multiple interview" beings to light more answers related to the desire to wean on the part of the mother herself than the baby, or the mother's body. It is argued that the health system has limits to its ability to intervene in the most prevalent reasons for early weaning and the necessity for social policies, such as maternity protection legislation, child nurseries, etc., in support of breast-feeding, is commented on.