Women's Work

Women's employment outside the home does not appear to be a primary determinant of early discontinuation of breastfeeding, but rather the conditions under which women work may be influential (Laukaran et al., 1981). Important aspects of the potential impact of employment on infant feeding decisions include the following: (1) the duration of formal or informal maternity leave, which affects whether the mother has sufficient time with her Want during the initial postpartum period to successfully establish lactation before enduring prolonged intervals of separation from her infant during the work day, (2) the proximity of the work site, which affects the length of intervals of separation between mother and infant; and (3) the frequency and duration of break times during working hours, which determine the number of occasions during the day that a mother is able to breastfeed her child. While work hi the formal sector has been associated with serious constraints to breastfeeding, the seventy of restrictions in the modern work force can be ameliorated by progressive government and corporate policies and specific pieces of labor legislation (Popkin et al., 1979).

In many communities traditional work patterns also place heavy time and energy demands on women. These demands affect breastfeeding. The degree of flexibility in adjusting to these demands is often less during periods when the demand for example, for agricultural labor, is at its peak, so that the impact of women's work on breastfeeding may vary seasonally. Moreover, changing employment activities of men, including migration out of rural areas, affects infant feeding decisions and produces greater variability within communities, based on the economic adjustments of individual households.

Health Services and Personnel

A number of aspects of modern systems of maternity and newborn care are associated with decreased rates of breastfeeding initiation and poor rates of continuation among those who do initiate it (Winikoff et al., 1986b). The features of modern health care found to be associated with lower rates of breastfeeding include the following: (1) delays or interruptions of nursing; (2) routine use of supplemental formula in the hospital and its distribution to the mother at discharge; (3) fixed feeding schedules; (4) lack of knowledge about breastfeeding technique and management among medical and nursing practitioners or a lack of initiative to modify standing procedures to better assist the new mother (AAP, 1982, Lawrence, 1982).

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