The forty-day rest period and infant feeding practices among Negev Bedouin Arab women in Israel

Abstract

Four hundred and twelve Bedouin Arab women were interviewed within 48 hours of delivering a newborn in 1982 and two months later to examine the effect of social support during the forty-day postpartum rest period on the incidence of exclusive breast feeding at two months. Whereas the distribution of infant feeding practices at two months did not differ among women with and without support during the "forty days," the number of days of help during the "forty days" was significantly associated with type of feeding at two months. The longer the duration of help, the greater were the odds of maintaining exclusive breast feeding after adjustment for covariates by multinomial logistic regression analysis. The association between duration of help and infant feeding practices at two months was modified by the interview month and the feeding practices of the respondents' primary social supports. More respondents with infants who reached two months of age in May and June were exclusively breast feeding than respondents with infants who reached two months in the hot, dry months of July and August. Also, respondents with sisters-in-law who breast fed alone or in combination with the bottle were feeding their infants in the same way after adjustment for covariates. Given the beneficial effects of breast feeding on infant health and development, these findings identify potential avenues of intervention for programs promoting breast feeding.

PIP: In March-June 1982, female Arab students at Ben Gurion University in Beer Sheva, Israel, interviewed 412 mothers within 2 days after they delivered healthy newborns either at the Soroka Medical Center or at home to examine the link between family support during the traditional 40-day rest period and the incidence of exclusive breast feeding during the infant's first 2 months of life. Mothers exclusively breast fed only 86% of the newborns. By 2 months, this percentage fell to just 24%. 22% did not receive any help with chores during the 40-day rest period and only 59% of those who did receive such help had this help for 40 days. These effects were probably a result of the transition from the traditional seminomadic to a sedentary life style. Even though the distribution of infant feeding practices between those who received help with chores during the 40-day rest period and those who did not were not greatly different, the duration of help with cooking did differ between the 2 groups (p = .02). 31% of mothers who had someone help with cooking for =or 40 days exclusively breast fed while only 24% of mothers who had someone help with cooking for 40 days did so. Mothers whose infants were 2 months old in the hot and dry months of July or August were 5 times more likely to switch from breast feeding to breast and bottle feeding than were those whose infants were 2 months old in May or June (p = .006). They were also 4 times more likely to switch from breast feeding to feeding their infants cereal, breast milk and liquids from a bottle (p = .005). Mothers tended to follow the same infant feeding practices as their sisters-in-laws (p = .06 and .01 respectively). The reduction of help with chores during the first 40 days postpartum may adversely affect the health and development of Bedouin mothers and their children.