Children's height, health and appetite influence mothers' weaning decisions in rural Senegal.
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).


CONCLUSIONS
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.
Simondon
K B
KB
Institut de Recherche pour le Développement, Nutrition Unit, Montpellier, France. kirsten.simondon@mpl.ird.fr
Costes
R
R
Delaunay
V
V
Diallo
A
A
Simondon
F
F
D000367:Age Factors; D000704:Analysis of Variance; D001066:Appetite; D001827:Body Height; D001835:Body Weight; D001942:Breast Feeding; D016009:Chi-Square Distribution; D002675:Child, Preschool; D003657:Decision Making; D003906:Developing Countries; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D009752:Nutritional Status; D012307:Risk Factors; D012423:Rural Health; D012675:Senegal / Q000453:epidemiology; D018709:Statistics, Nonparametric; D014886:Weaning