Urban Guatemala Research Articles

Stress During Labor and Delivery Is Associated with Delayed Onset ofLactation among Urban Guatemalan Women

A delayed onset of lactation (OL) is likely to have a negative influence on breast-feeding outcomes. Thus, it is important to identify risk factors for delayed OL. We examined prospectively the association between stress during labor and delivery and OL in a cohort of urban Guatemalan women. Healthy women (n = 136) were recruited during the first stage of labor in the labor unit of a social security hospital in Guatemala City. Women provided salivary samples for cortisol determinations 3.2 +/- 3.2 h before birth and 1.7 +/- 1.9 h and 17.1 +/- 4.7 h after delivery. At the same time points women were asked to respond to a 17-item psychosocial stress and anxiety questionnaire. Women were called daily until OL occurred. Primiparous women had higher antepartum and early postpartum cortisol levels that were twice as high as those among multiparous women (P < 0.05). The parity differential in salivary cortisol concentrations vanished with time. General linear model multivariate analysis indicate that multiparous women (n = 77), irrespective of mode of delivery, had an earlier OL (P < 0.05) than primiparae who underwent emergency cesarean section deliveries (n = 11) (adjusted mean +/- SEM, 2.5 +/- 0.1 vs. 3.4 +/- 0.3 d postpartum, respectively). OL took longer to occur among multiparous women with prenatal salivary cortisol levels above (vs. below) the 40th percentile [3 +/- 0.2 (n = 28) vs. 2.4 +/- 0.2 d postpartum (n = 38), respectively; P = 0.02]. Thus, stress during labor and/or delivery is likely to be a significant risk factor for delayed OL in urban Guatemala.

Intra-household food distribution among Guatemalan families in a supplementary feeding program: Behavior patterns

The present study investigated how food is distributed to various family members differing in age, sex, earning status, family role, and status as target child in families enrolled in supplementary feeding programs in urban Guatemala. Two patterns to explain intra-household food distribution patterns were hypothesized: a Contributions Rule, that individuals considered in the culture to have higher economic value would receive a higher percentage of the family's food; and a Needs Rule, in which those considered to have greater need (but not contribution) would receive a higher percentage of the family's food. The results with 45 families (230 individuals) suggested that the Contribution Rule was a better predictor of food distribution patterns in this setting than the Needs Rule. Specifically, male heads of households received a relatively higher proportion of the family's proteins, and the female heads of households received a relatively higher proportion of the family's calories, given their nutritional requirements, than other family members. There was no evidence that mothers were giving the child targeted as undernourished by the health center any more food than any other similar-aged child.

Maternal Work and Child-Care Strategies in Peri-Urban Guatemala: Nutritional Effects

Associations of 293 mothers' work for earnings and child-care arrangements with the anthropometric status of their children were examined in urban Guatemala. It was hypothesized that during the period of life in which growth often falters (8 through 35 months), maternal employment could be beneficial for children. Informal workers tended to be poorer, less educated, and have more undernourished children than formal workers or nonworkers. When poverty and mother's education were controlled for, no effects of maternal employment on children's anthropometric growth patterns were seen. However, the percent of the family income the mother earned was positively associated with all anthropometric indicators, controlling for confounds. Children taken care of by preteen siblings had significantly lower weight for height than those in other situations, even controlling for SES and maternal employment status. These effects were not found in a 36-48-month-old sample.

Maternal work for earnings and childrens nutritional status in urban Guatemala

Abstract The effects of earnings from work by mothers on their children's nutritional status were examined in urban Guatemala. Effects of the type of work, and age of the children, were analyzed for 121 children at age 1 (infants), 165 at age 2, and 133 at age 3. Working mothers were categorized by type of work into the following categories: domestic, formal and informal workers. The results indicated that infants of domestic workers weighted significantly less than those of non‐workers and that 2 year old children of formal and informal workers were significantly heavier in weight, controlling for confounding variables including economic level of the family, education of the mother, marital status, child care strategies, and duration of breastfeeding. Although breastfeeding was of shorter duration among the formal and informal working mothers compared with domestic workers and non‐workers, such short duration was not associated with lower nutritional status.