International Journal of Epidemiology 2001;30:476-481
© International Epidemiological Association 2001
Child Health in Africa |
Children's height, health and appetite influence mothers' weaning decisions in rural Senegal
Institut de Recherche pour le Développement (IRD, formerly named ORSTOM),
a Nutrition Unit, Montpellier, France;
b Infectious Disease Research Unit, Montpellier, France, and
c Niakhar Population and Health Project, Dakar, Senegal.
Reprint requests to: Kirsten Simondon, IRD, BP 5045, 34032 Montpellier Cedex, France. E-mail: kirsten.simondon{at}mpl.ird.fr
Abstract
Background In many developing countries, breastfed children have a lower nutritional status than those weaned from 12 months of age. Reverse causality, that is, earlier weaning of healthy and well-nourished children, is a possible explanation.
Methods Maternal reasons for early and late weaning were investigated in a cohort of 485 rural Senegalese children using structured interviews during two rounds at the ages of 18–28 and 23–33 months, respectively. Length, weight and height were assessed, and dates of weaning were monitored.
Results The mean duration of breastfeeding was 24.1 months (quartiles 21.9 and 26.3). Two-thirds of mothers of breastfed children under 2 stated that they would wean at the age of 2, while for breastfed children aged 2 years, a ‘tall and strong’ child was the most prevalent criterion. The main reasons for weaning prior to 2 years (N = 244) were that the child ate well from the family plate (60%), that the child was ‘tall and strong’ (46%) and maternal pregnancy (35%). The main reasons for weaning later than the age of 2 were: a ‘little, weak’ child (33%), food shortage (25%), illness of the child (24%) and refusal of family food (14%, N = 120). Children breastfed above the age of 2 because they were ‘small and weak’ had lower mean height-for-age and a greater prevalence of stunting than children breastfed late for other reasons (P < 0.0001).
Conclusion The habit of postponing weaning of stunted children very likely explains why breastfed children have lower height-for-age than weaned children in this setting.
Keywords Breastfeeding, weaning, reverse causality, toddlers, stunting, Africa
Accepted 30 March 2000
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