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Breastfeeding and the use of maternal health services in Sarawak.


 In Malaysia, a demographer analyzed data on 1583 children born to 1047 15-49 year old mothers in the 5 years before the 1989 Population and Family Survey was conducted in all districts of Sarawak, except Belaga. She examined the relationship between use of maternal health services, including contraception, and the breast feeding pattern. Most women used prenatal care and postnatal care services (98.2% and 82.6%, respectively). The mean duration of breast feeding was only 6.13 months while the median duration was even shorter (3 months). Mothers who received prenatal care were more likely to initiate breast feeding than those who received no prenatal care (84.1% vs. 75%), but their duration of breast feeding was much shorter (median, 5 vs. 14.3 months). Women who delivered at a private hospital compared to those who delivered elsewhere were less likely to initiate breast feeding (70.6% vs. 84.6-88.9%) and breast feed for a shorter period of time (median, 2.36 vs. 4.41-13.56 months). Nurses in private hospitals care for newborns in a separate room and give prelacteal feeds, particularly commercial infant formula, which jeopardizes mothers' initiation of breast feeding. Women who were assisted by a physician had the lowest rate of initiation of breast feeding (70.5% vs. 86.2-92.4%) and the shortest duration of breast feeding (2.68 vs. 4.67-14.55 months). Women who had ever used contraception compared to those who had never used contraception were somewhat less likely to initiate breast feeding (83.2% vs. 87.5%) and breast feed for a shorter time (4.29 vs. 12.82 months). These results suggest that the government needs to change its policies on health services to promote breast feeding. It should target health personnel and clients in the private sector and family planning workers.
