Aspects of the growth and health of the suckling and weanling infant in Ethiopia
This thesis examines inter-relationships between the feeding, health, and growth of infants (aged 0-24 months) in low-income households in Addis Ababa, Ethiopia. Mixed-longitudinal data were collected from a sample of 113 infants and their mothers in Kebele 11, Keftegna 24 from November 1987 to April 1988. Breastfeeding is the culturally esteemed mode of infant feeding. The culture-specific concept of weaning places the emphasis on the termination of breastfeeding, with little consideration of the quality and quantity of weaning foods. As a result, weaning foods are basic and monotonous. Survival data analysis shows that weaning is commenced at the mean age of 9.2 months, and completed at the median age of 20 months. A probabilistic model is proposed that includes a set of inter-related 'infant-centred', 'mother-centred', and other factors such as the seasonal availability of weaning foods influencing the process of weaning. Culturally-prescribed norms appear to play little or no part in the timing of weaning, in particular, the infant's age is of secondary importance. Direct observations of suckling behaviour and infant care reveal that 'on demand' breastfeeding was practised, and the mean duration of suckling sessions was 10.96 minutes. The duration of breastfeeding was influenced significantly by maternal body-mass index. Seasonal patterns were detected in the prevalence of fever, coughing, and vomiting in the infants. Associations between morbidity and other data using log-linear models suggest that infant's diarrhoea is closely linked to the level of household hygiene, maternal education, and mother's morale. Infant's ilnesses caused appreciable deficits in weight, but not in stature. Processes of 'catch-up' and 'catch-down' growth are demonstrated by the seasonal effect of diarrhoeal illness on weight. Avenues for further research and policy reform suggested by the findings of this study are discussed.