Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-27T11:04:10.509Z Has data issue: false hasContentIssue false

Specifying the antecedents of breast-feeding duration in Peru through a structural equation model

Published online by Cambridge University Press:  02 January 2007

Rafael Pérez-Escamilla*
Affiliation:
Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269-4017, USA
José A Cobas
Affiliation:
Department of Sociology, Arizona State University, USA
Hector Balcazar
Affiliation:
Department of Family Resources and Human Development, Arizona State University, USA
Mary Holland Benin
Affiliation:
Department of Sociology, Arizona State University, USA
*
*Corresponding author: Email rperez@canr1.cag.uconn.edu
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

To examine the effects of socioeconomic status and biocultural variables (planned pregnancy, prenatal care, timing of initiation of breast-feeding and caesarean section delivery) on breast-feeding duration in Peru using structural equation models.

Design and setting:

Structural equation models were analysed with LISREL using data from the 1991–92 Peruvian Demographic and Health Survey.

Subjects:

Models were tested among 6020 women whose last child was born within 5 years of the survey and among 2711 women whose last child was born 2–5 years preceding the survey.

Results:

Unplanned pregnancy and socioeconomic status had a negative influence on breast-feeding duration. Prenatal care was positively associated with the timing of breast-feeding initiation in both samples and with breast-feeding duration in the whole sample. The timing of breast-feeding initiation was inversely associated with breast-feeding duration only in the sample of older children.

Conclusions:

These results imply that an unplanned pregnancy, a delayed breast-feeding initiation, and higher socioeconomic status are risk factors for an earlier discontinuation of breast-feeding through complex mechanisms involving direct and indirect effects.

Type
Research Article
Copyright
Copyright © CABI Publishing 1999

References

1: Labbok, MH, Laukaran, VH. Breast feeding and family planning. In: Dilts, PV, Sciarra, JJ, eds. Gynecology and Obstetrics, Vol. 6. Philadelphia: Lippincott, 1994: 113.Google Scholar
2: Heinig, MJ, Dewey, KG. Health advantages of breast-feeding for infants: a critical review. Nutr. Res. Rev. 1996; 9: 89110.CrossRefGoogle ScholarPubMed
3: Pérez-Escamilla, R, Segura-Millán, S, Pollitt, E, et al. Determinants of lactation performance across time in an urban population from Mexico. Soc. Sci. Med. 1993; 37: 1069–78.CrossRefGoogle Scholar
4: Popkin, BM, Bilsborrow, RE, Akin, SA, Yamamoto, ME. Breast feeding determinants in low-income countries. Med. Anthropol. 1983; 7: 131.CrossRefGoogle ScholarPubMed
5: Forman, MR. Review of research on the factors associated with choice and duration of infant feeding in less developed countries. Pediatrics 1984; 74: 667–93.CrossRefGoogle ScholarPubMed
6: Mosley, WH, Chen, LC. An analytical framework for the study of child survival in developing countries. Popul. Dev. Rev. 1984; 10(Suppl.): 2545.CrossRefGoogle Scholar
7: Cebu Study Team. Underlying and proximate determinants of child health: the Cebu Longitudinal Health and Nutrition Study. Am. J. Epidemiol. 1991; 133: 185201.CrossRefGoogle Scholar
8: Adelman, PK, Antonucci, TC, Crohan, SE, Coleman, LM. A causal analysis of employment and health in midlife women. Women Health 1990; 16: 520.CrossRefGoogle Scholar
9: Taylor, SA, Cronin, JJ. Modeling patient satisfaction and service quality. J. Health Care Market. 1994; 14: 3444.Google ScholarPubMed
10: Gruber, JW, Wallack, L. Television beer advertising and drinking knowledge, beliefs, and intentions among schoolchildren. Am. J. Public Health 1994; 84: 254–9.Google Scholar
11: Cobas, JA, Balcazar, H, Benin, MB, et al. Acculturation and low-birthweight among Latino women: a reanalysis of HHANES data with structural equation models. Am. J. Public Health 1996; 86: 394–6.Google Scholar
12: Popkin, BM. The nutrition transition in low income countries: an emerging crisis. Nutr. Rev. 1994; 52: 285–98.CrossRefGoogle ScholarPubMed
13: Monteiro, CA, Mondini, L, Meeiros de Souza, AL, Popkin, BM. The nutrition transition in Brazil. Eur. J. Clin. Nutr. 1995; 49: 105–13.Google ScholarPubMed
14: World Health Organization. Investing in Health Research and Development. Geneva, Switzerland: World Health Organization, 1996.Google Scholar
15: Stuart-Macadam, P, Dettwyler, KA. Breast Feeding: Biocultural Perspectives. New York: Aldine de Gruyter, 1995.Google Scholar
16: Instituto Nacional de Estadística e Informática, Asociación Benéfica PRISMA, Demographic and Health Surveys/Macro International Inc. Perú. Encuesta Demográfica y de Salud Familiar 1991/1992. Calverton, MD: Demographic and Health Surveys/Macro International Inc., 1992.Google Scholar
17: Martorell, R, Khan, LK, Hughes, ML, Grummer-Strawn, LM. Obesity in Latin American women and children. J. Nutr. 1998; 128: 1464–73.CrossRefGoogle ScholarPubMed
18: UNICEF. The State of the World's Children. UNICEF, 1999.Google Scholar
19: Elo, IT, Grummer-Strawn, LM. Changes in breast-feeding initiation and duration in Peru, 1977–1986. Soc. Biol. 1993; 40: 224–43.Google ScholarPubMed
20: Labbok, M, Pérez-Escamilla, R, Peterson, AE, Coly, S. Breastfeeding and Child Spacing: Country Profiles. Washington, DC: Institute for Reproductive Health, 1997.Google Scholar
21: SPSS Inc. SPSS LISREL 7 and PRELIS User's Guide and Reference. Chicago: SPSS Inc., 1990.Google Scholar
22: Muthen, BA. General structural equation model with dichotomous, ordered categorical, and continuous latent variable indicators. Psychometrika 1984; 49: 115–32.CrossRefGoogle Scholar
23: Muthen, B. Tobit factor analysis. Br. J. Math. Stat. Psychol. 1989; 42: 241–50.Google Scholar
24: Adair, LS, Popkin, BM, Guilkey, DK. The duration of breast-feeding: how is it affected by biological, sociodemographic, health sector, and food industry factors? Demography 1993; 30: 6380.CrossRefGoogle Scholar
25: Pérez-Escamilla, R, Lutter, CK, Wickham, C, et al. Identification of risk factors for short breast-feeding duration in Mexico City through survival analysis. Ecol. Food Nutr. 1997; 36: 4364.CrossRefGoogle Scholar
26: Mock, NB, Franklin, RR, Bertrand, WE, et al. Exposure of the modern health service as a predictor of the duration of breast-feeding: a cross-cultural study. Med. Anthropol. 1985; Spring: 123–38.CrossRefGoogle ScholarPubMed
27: Dye, TD, Wojtowycz, MA, Aubry, RH, Quade, J, Kilburn, H. Unintended pregnancy and breast-feeding behavior. Am. J. Public Health 1997; 87: 1709–11.CrossRefGoogle ScholarPubMed
28: Pérez-Escamilla, R, Segura-Millán, S, Canahuati, J, et al. Prelacteal feeds are negatively associated with breast-feeding outcomes in Honduras. J. Nutr. 1996; 126: 2765–73.Google Scholar
29: Perez-Escamilla, R, Maulen-Radovan, I, Dewey, KG. The association between Cesarean delivery and breast-feeding outcomes among Mexican women. Am. J. Public Health 1996; 86: 832–6.CrossRefGoogle ScholarPubMed
30: Hight-Laukaran, V, Rutstein, SO, Peterson, AE, et al. The use of breastmilk substitutes in developing countries: the impact of women's employment. Am. J. Public Health 1996; 86: 1235–40.CrossRefGoogle Scholar
31: Micozzi, MS. Breast cancer, reproductive biology, and breast-feeding. In: Stuart-Macadam, P, Dettwyler, KA, eds. Breast-feeding: Biocultural Perspectives. New York: Aldine de Gruyter, 1995: 347–84.Google Scholar
32: Pérez-Escamilla, R. Breast-feeding patterns in Latin America and the Caribbean. Bull. Pan Am. Health Organ. 1993; 27: 3242.Google Scholar
33: Horton, S, Sanghvi, T, Phillips, M, et al. Breastfeeding promotion and priority setting in health. Health Policy Plan. 1996; 11: 156–68.CrossRefGoogle ScholarPubMed