Breastfeeding Patterns and Determinants in the Near East: An Analysis for Four Countries

Few detailed studies of the determinants of breastfeeding behaviour have been carried out, especially in the Middle East. We provide a comparative investigation of patterns and determinants of breastfeeding in four Middle East countries (Egypt, Jordan, Tunisia and Yemen) based on WFS data. Differences in factors influencing ever-breastfeeding, continuing breastfeeding from very short to moderate durations, and extending breastfeeding into the second year are observed, indicating ‘structural shifts’ in the determinants of breastfeeding. Differences between countries are also found which can only roughly be associated with differences in modernization and urbanization. Lack of consistently negative effects of women's education and work status variables is attributed to the extremely low levels of both in the region. Interesting results are observed regarding effects of pill use and sex of child (boys being breastfed longer), suggesting the need for thorough studies to explain these findings further.     

Intergenerational Profiles of Socioeconomic (Dis)advantage and Obesity During the Transition to Adulthood

Investigations of socioeconomic status (SES) and health during the transition to adulthood in the United States are complicated by the later and more varied transitions in residence, employment, schooling, and social roles compared with previous generations. Parental SES is an important influence during adolescence but cannot sufficiently capture the SES of the independent young adult. Typical, single SES indicators based on income or education likely misclassify the SES of young adults who have not yet completed their education or other training, or who have entered the labor force early with ultimately lower status attainment. We use a latent class analysis (LCA) framework to characterize five intergenerational SES groups, combining multidimensional SES information from two time points—that is, adolescent (parental) and young adult (self) SES data. Associations of these groups with obesity, a high-risk health outcome in young adults, revealed nuanced relationships not seen using traditional intergenerational SES measures. In males, for example, a middle-class upbringing in adolescence and continued material advantage into adulthood was associated with nearly as high obesity as a working poor upbringing and early, detrimental transitions. This intergenerational typology of early SES exposure facilitates understanding of SES and health during young adulthood.     

Influences of household structure and composition on breast-feeding

Researchers applied longitudinal data on 2884 women who were at least 6 months pregnant between May 1983-April 1984 and living in the Cebu metropolitan area, the Philippines to examine assumptions which may explain the association between lower breast feeding levels and dwindling social support for mothers who breast feed in urban areas. Extended family households were much more common in urban areas than rural areas (46.3% vs. 27.5%). This finding did not support the 3rd assumption of falling extended family patterns with urbanization. Further as the levels of complexity and extension of the household rose so did infant care support regardless of location. For example, the number of hours of help with infant care for mothers in nuclear families in urban areas was 1.23 which climbed from 2.53 for horizontal extended families to 2.9 for vertical extended families and to 3.09 for horizontal and vertical extended families. This result supported the 2nd assumption of much more social support in extended families than nuclear families. Yet social support did not translate into promotion of breast feeding--the 1st assumption. Mothers in horizontally extended families had a lower likelihood of breast feeding than those in nuclear families. Further only adult female relatives of the same generation as the mother has a negative influence on breast feeding in urban mothers, but not rural mothers. In fact, female children of at least 7 years old, female servants, and yayas all negatively affect breast feeding in urban mothers, but not rural mothers. In rural households, young female relatives (at least 7 years old) significantly increased the probability of breast feeding whereas young male relatives decreased the probability.     

Longitudinal analysis of the effects of infant-feeding practices on postpartum amenorrhea*

The Cebu Longitudinal Health and Nutrition Survey is used to examine the effect of various components of infant-feeding patterns on return of menses postpartum. The results show that factors such as active suckling, the use of two breasts versus one, breast-feeding on demand versus on a fixed schedule. and the feeding of other milks and of nonnutritive or low-caloric other liquids can be important under selected circumstances. Discrete-time logistic hazards modeling is used to estimate the weekly probability of return to menses.     

Nutrition,lactation, and birth spacing in filipino women

The Cebu Longitudinal Health and Nutrition Survey is used to examine the roles of women’s nutrition and infant feeding in determining time from birth to menses and time from menses to conception. The analysis sample includes 2,648 Filipino women followed for 24 months postpartum. Recently devised statistical estimation techniques to control for unobserved heterogeneity and endogeneity are employed in estimating a two-state hazard model. Low body mass index and lower dietary fat intake are associated with increased duration of postpartum amenorrhea. Contraceptive use, high dietary fat consumption, higher parity, and absence of spouse predict a longer waiting time to conception once menses have returned. Simulation of the hazard model is used to examine the effects of the key nutrition and lactation factors.     

Surveying a Chicago public housing development: methodological challenges and lessons learned

During the winter and spring of 2003, the Survey Research Laboratory conducted a survey of residents of the Ida Wells and Madden Park housing developments on Chicago's near-south side. This article reviews existing research findings on using indigenous interviewers and reports the findings about the benefits and challenges of using residents as interviewers versus drawing from a regular pool of interviewers. Specifically, the authors talk about the challenges faced in using indigenous interviewers and then look at some data quality indicators among these two groups of interviewers, including cooperation rates, item nonresponse, and differences in responses to sensitive questions.     

The duration of breast-feeding: How is it affected by biological,sociodemographic, health sector,and food industry factors?

Breast-feeding duration has important effects on a wide array of demographic and maternal and infant health outcomes. This study uses a discrete-time logit hazards model to explore the relationship of biological, sociodemographic, health sector, and food industry practices on the duration of full and partial breast-feeding in a sample of more than 2,600 infants from the Cebu Longitudinal Health and Nutrition Survey. Food industry and health sector practices (such as distribution of free samples of infant formula), the mother’s perception of being pregnant, infant fatness, and a set of standard sociodemographic factors all affect breast-feeding duration significantly.     

Child Spacing in the Philippines: The Effect of Current Characteristics and Rural Development

In this study the effects of characteristics current at the beginning of the birth interval on the time elapsing before the next birth are examined. The child-spacing process is viewed as affected by time-varying and fixed characteristics of the community, household, and individual. In the model on which the empirical research is based sociological and economic antecedents are used. The study is based on data from two panels of the Bicol Multipurpose Survey collected in 1978 and 1983. These furnish detailed histories of pregnancy and contraception, together with an extensive set of socio-economic data. Detailed information on services and facilities available in each of the 100 sample communities is also available. Because of the large rural development programme introduced in various sub-areas of the Bicol region, substantial changes in the rural infrastructure and in availability of health and family planning facilities and services occurred between 1976 and 1980, the period on which the analysis is focused. Our results clearly show that current characteristics at the individual, household, and community levels have significant and interpretable effects on the lengths of birth intervals.