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Factors affecting early weaning of a child in Pakistan

By: Sonia Hassan Ali

Health defined by WHO (1948) as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. To attain the highest level of health is a fundamental human right regardless of age, color, religion and socio-economic status. Ranking 135th on the United Nation’s Human Development Index, Pakistan has a population of approximately 148 million, of whom half are children (Department of Community Health Sciences, AKU, 2001). Children are the future of our country but due to many reasons this assets are leaving from our hand. The Infant Mortality Rate (IMR) at Pakistan is in range of 84-95 per 1000 live births and ranks at 157th in the world (Department of Community Health Sciences, AKU, 2001). This statistics shows that infant mortality rate is increasing day by day due to many reasons in Pakistan. Out of which diarrhea, acute respiratory infections and malnutrition are very common. By looking this dreadful statistics it is important to identify the conditions responsible for these diseases in order to reduce the child mortality rate, which is one of the millennium developmental goals. Early weaning is one of the most important conditions responsible for the above mentioned diseases, which eventually leads to high infant mortality rate. In Pakistan, only 16% of mothers exclusively breast-feed for a period of three months (Bellamy as cited in Bukhari et al., 2003). Breast feeding is the natural source, which has many advantages on both mother and child. Breast milk is an important contributor to overall infant health, because human breast milk represents the most complete form of nutrition for infants. The American Academy of Pediatrics recommends that infant should be exclusively breast-fed for approximately the first six months of life. Despite of these given guidelines many women start weaning early due to several contributing factors. The purpose of this paper is to highlight some of the factors affecting early weaning of child. Along with this, I want to emphasize the role of health care professionals in dealing those factors.

There are several factors affecting early weaning of a child. In many of the studies it was found that percentage of mothers who breast-fed was higher among older, child-bearing, non-working, low family income and less educated than their contrast. It means that early weaning is common among mothers who are younger, primiparous, educated, employed and have high socio-economic conditions. Moreover, higher birth weight, maternal smoking, maternal perception and belief about the initiation of early weaning are also responsible for early initiation of solid food. In further piece of this paper, I will mention the details about some of these factors.

Maternal age is directly associated with the early weaning practices. In many of the studies, it has been found that younger women were significantly less likely to breast- fed than older women. The reason for this discrepancy is that older women are usually more experienced and comfortable in breast feeding their child as compared to younger women. Apart from this, socio-economic status is the controversial factor in initiating early weaning. Researches have shown that higher income women in developing countries may perceive breast feeding as outdated and a sign of lesser social status. It indicates that the women of developing world are more interested in adopting the western culture rather than health of a child. Moreover, parity is also co-related with the early weaning of a child. Primiparous women are less experienced and highly insecure than multiparous women. Similarly, early weaning is also linked with the level of education. In many researches it has been found that when the women have a higher level of education, it is more likely that the women will not practice exclusive breast feeding. Apart from this, employment and breast feeding is an another challenging issue. In studies it has been found that the earlier a women returns to work, the sooner she stops breast feeding. Furthermore, if the lactating mother works more than twenty hours per week, it might end up in early cessation of breast feeding. By considering this, many women in Pakistan are also working day and night in order to increase the economic condition. In this way, employment is stimulating early weaning practices in Pakistan. Apart from the employment, maternal smoking and tobacco use are another major factors contributing to early weaning diet in children. In Pakistan, tobacco use among women is 12.5% (Department of Community Health Sciences, AKU, 2001). Moreover, studies support that mothers who smoke are less likely to initiate breast feeding. The reason is that low fat concentrations in milk from smoking mothers aggravate the energy insufficiency, leading to low milk volume and eventually increasing early weaning. Besides maternal smoking, maternal beliefs are also contributing factor in initiation of early weaning. One of the beliefs is that bottle-fed babies sleep through night at an earlier age than breast-fed babies. While the other perception is that the introduction of solid foods may be seen as a milestone in infant’s development and women may welcome this sign of maturity (Drewett et al. as cited in Anderson, A.S., 2001).

To conclude, weaning too early is associated with an increased rate of morbidity and mortality in children. Researches have already proved that infants introduced to solid food before four months had increased body fat, body mass index and cardiovascular diseases. In addition, early weaning is also associated with more wheezy and respiratory illness in childhood. Apart from this, allergic reactions and diarrhea is also common among those infants, thus increasing the infant mortality rate.

In order to accomplish the millennium developmental goal, it is important to overcome the factors which are responsible for early weaning in a child like maternal age, parity, socio-economic status, education, employment, maternal smoking and beliefs about early weaning. Moreover, further studies to investigate the factors affecting early weaning of a child are also recommended. Along with this, policies and educational efforts to promote exclusive breast feeding are also needed. In this area health care professionals can play a key role but sometimes that themselves lack knowledge in this subject. For this purpose, health care professionals and women should be educate about pedagogy to increase compliance. In the nut shell it can be summarized that being a health care professional, it is our foremost responsibility to look over the factors affecting early weaning of a child in Pakistan and report it through proper channel.