Infant feeding practices among clinical nursing staff in urban Papua New Guinea.

Abstract

To determine the personal attitudes of urban public nursing staff toward infant feeding practices, 97 nurses and aides who were mothers and also full-time staff at public health care facilities in Port Moresby were interviewed in 1981. In 1977, Papua New Guinea passed legislation making infant feeding bottles and teats available only through prescription by an authorized health professional. This legislation was supplemented by an educational campaign advocating breastfeeding. The nursing staff is important to this campaign, since those charged with administrative duties can prescribe bottles; moreover, as a result of their close contact with patients, nursing staff influence mothers' attitudes toward infant feeding. The nurses and aides interviewed ranged in age from 21-50 years; 75 had at least 1 child under age 5. Each child was classified as breastfed, mixed-fed (use of supplementary bottle 1 or more times a week), or bottlefed. 185 (71%) of the 260 babies included in the study were exclusively breastfed, while 72 (28%) received milk from both breast and bottle. No significant difference in feeding practices occurred after the 1977 legislation. Attitudes were strongly in favor of breastfeeding, with bottle feeding considered appropriate only under highly specific conditions. There was a significant difference (p0.001) between children of mothers who returned to work within the 1st 6 months postpartum and those of mothers who returned later in the proportion that were bottlefed at least occasionally. More detailed information was elicited on the mothers' youngest child. The mean age of weaning from the breast among the 44 youngest children who were under age 5 1/2 at the time of the interview was 21 months. The mean age for bottle introduction and bottle termination was 2 months and 12 months, respectively. 67 (80%) of mothers in this group returned to work within the 1st 3 months postpartum; however, 41 continued to exclusively breastfeed. This was possible because a creche was provided at the job, or the place of work was close enough for the childminder to bring the infant to the mother for feeding at the 2 1/2 hour breaks provided to all wage-employed mothers. This survey suggests that promotion of breastfeeding must be complemented by the provision of adequate opportunities in the work place for infant feeding.