Milk insufficiency in Esmeraldas, Ecuador: A multidisciplinary approach.

摘要

Perceived milk insufficiency, a widespread breastfeeding problem, affects women of many cultures, social strata, ages, and stages of lactation. The literature shows an association between maternal perceptions of insufficient milk supply and low breastfeeding confidence, maternal anxiety, family advice and professional advice. Milk insufficiency can trigger a chain of events that ends in early weaning, early supplementation, and infant obesity.;This study combined biological and cultural anthropology, test-weighing, creamatocrit analysis, anthropometry, and ethnographic observations; these disparate strategies facilitated an investigation of how cultural and biological factors interact with breastfeeding behavior. This longitudinal study was carried out among 72 Esmeraldan mother-infants pairs during 1998-1999, with a second component in 2001.;Beginning in March 1999, Ecuador underwent an economic crisis with massive inflation, political turmoil and most industry brought to a virtual standstill for months. This crisis created severe hardships for the people of Esmeradas city, leading to widespread despair and anxiety among the participating mothers of this research, with negative consequences for breastfeeding. Reports of milk insufficiency increased during the economic crisis. In other words, severe financial stress was associated with greater prevalence of breastfeeding difficulty.;One goal of this research was to learn whether reports of milk insufficiency correlated with measured levels of milk production. Behavioral variables affected milk production. Results also showed that mothers who complained of milk insufficiency produced less milk than mothers who did not complain of this problem. There were no significant relationships between biological variables such as age, parity, body mass index (BMI) and milk production.;With this research, I have developed methods and theory to understand the milk insufficiency question. By integrating biological and ethnographic methods, this study contributes to multidisciplinary approaches to lactation. I hope that the results of this research will be useful to health professionals in Esmeraldas and elsewhere who work with new mothers and their infants.