Breastfeeding and weaning in a poor urban neighborhood in Cairo, Egypt: Maternal beliefs and perceptions

Maternal beliefs and perceptions about breastfeeding and weaning were investigated in a series of in-depth, open-ended interviews with 20 mothers of infants aged 2-12 months in a poor neighborhood of metropolitan Cairo during July-September 1990. The traditional pattern of breastfeeding well into or through the second year of life is changing rapidly, although essentially all mothers still wish to breastfeed and do so at least initially. Beliefs and behaviors reported varied somewhat by rural/urban origins of the mother herself, but exhibited consensus on many issues. The ability to breastfeed successfully is perceived to be a blessing, and to require maturity, patience and a sense of responsibility. The quantity and quality of breast milk are believed to be influenced by a wide variety of factors including the childs age and individual characteristics, the psychological and physical state of the mother, and her diet. Mothers reported a number of behaviors that are perceived to influence the quality of breast milk including changes in their diet when the infant was ill and behaviors designed to optimize the humoral qualities (hot/cold, light/heavy) of the milk. Supplementation with sugar water begins very early, and gradual introduction of other foods generally is begun soon after 40 days of age. Mixed formula and breastfeeding is commonly perceived to increase the nutritional quality of the childs diet. Weaning is ideally related to developmental milestones (walking, complete dentition) but often occurs early due to a variety of factors including maternal illness, desire for another pregnancy, and perceptions that breast milk may be inadequate. Weaning is perceived to be a difficult and dangerous transition. The timing of weaning may be influenced by perceptions of summertime as a time of heightened risk of diarrheal illness, by the mothers decision regarding fasting during Ramadan, and by a desire to minimize the period of vulnerability to illness between the time of weaning and the beginning of the following month in the Islamic calendar.