Subjective assessment of lactational performance in Gambian mothers.

Abstract

This study examines the ability of a group of breastfeeding Gambian mothers to assess their own lactational performance. 113 mothers at different stages of lactation entered the study. They were all already participating in a longer ongoing study of lactation with regular monthly estimations of their breast milk outputs by test weighing. Mothers attending the clinic at 6 13 26 39 52 65 and 78 weeks post partum were questioned about their breast milk output. Mothers were asked to estimate their output in absolute terms and then in terms relative to the output of women feeding babies of similar age. They were also asked to assess the growth of their own child when he was entirely breastfed. Finally they were asked whether they had discussed results of their test weighing with field staff and those who did were excluded from the study. The results suggest that mothers can sense how much milk they are producing. In the 1st few months of lactation the infant is growing rapidly and the mothers respond by increasing their breast milk output up to 3-5 months post partum; subjective assessment may therefore be difficult. Towards the end of lactation the breast milk may supply 1/3 or less of the childs nutritional needs. At some stage in lactation 16 mothers reported that they knowingly had their child fed by another woman. Despite language and conceptual difficulties the study did reveal a correlation between lactational performance and maternal estimation of that performance. The valuable questions to ask concerning the absolute output the output relative to that of other mothers at the same stage post partum and the growth of the infant when exclusively breast fed. Planning the health and nutritional care of at-risk children will be possible by using simple comprehensible language in the questionnaires.