Nursing behaviour and its relation to duration of post-partum amenorrhoea in an Andean community

Abstract

Nurloa is a high altitude rural Peruvian community characterized by socioeconomic stratification and differential access to the market economy. Nursing practices and the effects of nursing are also stratified; this translates into a risk of menses at 12 months post-partum nearly seven times greater in wealthier than in poorer women.Most nursing occurs in the morning, among those who practise ondemand breast-feeding. Nursing episodes are clustered into sessions; the amount of breast-feeding is regulated by varying the number of episodes per session rather than by changing the duration of suckling episodes or the frequency of sessions per hour. Thus, resumption of ovulation is not dependent on the variable spacing of nursing episodes or sessions. The components of nursing activity most likely to be responsible for variation in the duration of post-partum amenorrhoea in these nursing women are mean session duration and mean number of episodes per session.The mean duration of morning nursing sessions is negatively associated with infant's age, reflecting the greater reliance of younger children on breastmilk. The mean duration of afternoon nursing sessions is positively associated with mother's age, independent of infant's age, possibly reflecting maternal age-related variation in milk production capabilities. Baby minding by older daughters may also help to explain variation in afternoon nursing.

Correlates of breastfeeding frequency among nomadic pastoralists of Turkana, Kenya: A retrospective study

“…The term bouts, when used in this paper, refers to extended periods of on-demand breastfeeding as reported by mothers during 24 h recall interviews. It is used with the specific purpose of differentiating recalled breastfeeding data from prospective data; since neither the frequency nor duration of suckling episodes during these bouts was known, it was felt that the use of the suckling unit session (as defined by Vitzthum, 1989) to describe such activity was inappropriate.…”

“…Jones (1988, 19901, applying the results of research by McNeilly et al (19881, used multiple hazards analysis to demonstrate the effects of both breastfeeding structure and the duration of lactation on the timing of the return to menses postpartum. Vitzthum (1989) and Wood et al (1985) showed that components of individual breastfeeding bouts (the intervals between bouts and the duration of suckling during bouts) may be determined by quite different sets offactors and must therefore be treated independently in analysis. The work of Panter-Brick (1991) and Vitzthum (1988) successfully integrated cultural variables such as labor demands on mothers and economic change into analysis of factors affecting infant feeding practices.…”

“…Results of the prospective component were presented in detail in Gray (1994a), in which comparison of breastfeeding structure among Gainj of New Guinea (Wood et al, 19851, Quechua of Peru (Vitzthum, 1989), and Turkana was undertaken. To facilitate comparison with those studies, temporal patterns of suckling activity were defined as in Vitzthum (1989) and Wood et al (1985). A nursing event was recorded any time the child took the nipple into its mouth.…”

Relationship between subsistence and age at weaning in “preindustrial” societies

“…Although it is not the only factor influencing fertihty, extended breastfeeding tends to increase birth intervals and decrease fertility through lactational amenorrhea (Dewey et al 1997;Rosetta 1989;Short et al 1991;Taylor et al 1999;Tracer 1996;Vitzthum 1989). However, the common assumption that in preindustrial populations any shift towards agriculture was accompanied by an increased availability of starchy weaning foods and led to the erosion of exclusive, predominant, and prolonged breastfeeding and shortened birth intervals must be questioned in light of these results.…”

Effect of coca‐leaf chewing on salivary progesterone assays

“…Poor nutrition, inadequate health care, later age at first marriage, and infant feeding practices are all implicated (cf. De Jong, 1970;Weitz et al, 1978;Dutt, 1980;Goldstein et al, 1983Goldstein et al, , 1984aAbelson, 1984;Hoff, 1984;Kashiwazaki et al, 1988;Vitzthum, 1988Vitzthum, , 1989. Because it is likely that several interacting determinants contribute to lowered fertility in high altitude populations, the controversy regarding cause and mechanism continues.…”