Review of Research on the Factors Associated with Choice and Duration of Infant Feeding in Less-Developed Countries

Abstract

Research on factors associated with infant-feeding choice and duration has the following objectives: to describe the associated factors; to determine the degree of association; and to determine factors that are amenable to intervention in order to plan and implement infant nutrition programs. Underlying these objectives are a series of questions including: (1) What are the factors associated with the decision to breast-feed and/or bottle-feed at birth? (2) Among less-developed groups, in particular, what are the factors associated with use of prelacteal feeds before or in combination with breast-feeding or feeding by breast and bottle? (3) What are the factors associated with duration of exclusive breast-feeding, time of introduction of liquid breast milk substitutes, time of introduction of solids, and duration of partial breast-feeding? These questions are addressed in this review. This review encompasses research from a variety of disciplines—anthropology, epidemiology, nutrition, economics, and demography, for example. This is because infant feeding can be considered a behavior, a perception, a nutritional pattern, and a risk factor in infant growth and development. When infant feeding is classified as a behavior, the objective is to describe the infant's actions as he/she feeds at the breast or from the container for the breast milk substitute. The focus is on measuring the sucking action; the ability of the infant to latch onto the breast; and the frequency of, interval between, and duration of feeds. To examine a mother's perception of her infant-feeding practice requires answers to the following: Does the mother consider herself an exclusive breast-feeder, a breast-feeder and bottle-feeder, or an exclusive bottle-feeder? Does she feed on demand or on schedule? The focus of this research is on the mother's perception of her infant-feeding status rather than on the actual practice of infant feeding; the correlation between perception and practice may be examined but is commonly assumed.