Patterns of breastfeeding and weaning in Burundi and Zimbabwe.

In this discussion of breast feeding and weaning practices in Zimbabwe and Burundi survey results as well as the identification of the limitation of the data set for child nutrition and food supplementation are reported. The data sets are from the Demographic and Health surveys of Burundi and Zimbabwe. Both countries have in common food crops and the environment but Zimbabwe represents prosperity and Burundi poverty. Women age 15-49 (3970 in Burundi and 4201 in Zimbabwe) are nationally represented in a 2-stage self-weighted sample. Breast feeding food supplementation and health care data were collected for only those with children <5 years (3885 in Burundi and 3476 in Zimbabwe excluding Europeans). Background information is given on breast feeding and nutrition e.g. an inadequate diet during weaning contributed to poorer nutritional status as the operating principle in developing countries. Duration of breast feeding and age at weaning follow typical patterns by economic characteristics and maternal education. Mean age of weaning in Burundi is 21.3 months; in Zimbabwe 16.9. Mean age of weaning by higher education level indicates shorter weaning periods. Interpretations are that mothers are returning to work but the % stating the reason for weaning as "had to work" or "inconvenient" was 3.5% in Zimbabwe and .7% in Burundi and it was insignificant for mothers <25 years (larger sample is needed for more conclusive studies). In both countries shorter duration of breast feeding was associated with closer birth intervals <18 months. One limitation -- heaping -- is evidenced in the Burundi data at 12 and 18 months and in Zimbabwe at 12 and 24 months. Another limitation is that quantity of milk consumed is not measurable. Data quality issues that impact on nutrition are correctable by reordering such that all breast feeding and food intake questions are together defining the time period as e.g. within 24 hours of since noon and clarifying on demand and sleeps at breast. The term mushy food cannot provide any nutritional information has an unknown frame of reference and it needs to be replaced with a specific food(s). Questions on the type and timing of supplementation need to be included as well as rephrasing questions such as: did you eat instead of have you given 1 of the following foods and has the child eaten any of the foods since sunrise...yesterday to eliminate problems of translating "with 24 hours" for Shona language speakers.