Maternal and non-maternal time-allocation to infant care, and care during infant illness in rural Java, Indonesia

An estimated 60% of women in Central Java are engaged in income-generating work. This study addresses the manner in which mothers allocate time to infant care as well as to household maintenance and employment. The study investigates the time-allocation to infant care by non-maternal carers, both among infants whose mother is involved in income-generating work and among infants whose mother is not employed. The longitudinal study followed 60 households, one infant per household, of the age range 3-25 months (mean infant age over the course of the study was 13.8 months). Each household was visited every 7 to 10 days from February 1991 through June 1991. One observation day and two separate recall-days were recorded per month. Daily time allocation (6 a.m. to 6 p.m.) to infant care by the mother and other individuals, frequency and minutes of breastfeeding, and infants' non-breastmilk kilocalorie intake were recorded. In addition, mothers recorded any infant symptom(s) on a daily calendar provided to them, and this symptom--data and information on any treatments and/or help-seeking for the infant was collected every 7-10 days. One or more non-maternal caretaker participated in infant care on 90% of the total sample days, for a median of 3 hr 15 min (mean 3 hr 50 min per day), and participated in infant feeding on one-third of all sample days. Grandmothers, sisters, and fathers of the infants were the most important in terms of time allocated to infant care. One or more sister cared for the infant on 30% of total sample days (mean 180 min, median 150 min, 5-645 min), the father on 55% of sample days (mean 90 min, median 65 min, 5-600 min), and grandmother(s) on 32% of sample days (mean 160 min, median 130 min, 5-670 min). Non-maternal care was also substantial during days of symptom-reporting; other carers participated in infant-care on 84% of days, and fed the infant on 28% of days. The study findings suggest that health education messages related to infant care and feeding could be usefully targeted to other persons in addition to mothers. Infant care on symptom-free days were compared to symptom-days using Wilcoxon matched-pair test within each data-collection month (round). While no significant differences were found for the time-allocation to infant care by the mother or others on symptom-days compared to symptom-free days, there was a mean 25% lower non-breastmilk kilocalorie intake on symptom-days (P = 0.00) in four of five data-collection rounds. Mothers reported that lack of appetite accompanied other symptom(s) on 46% of the days of help-seeking in the modern sector. This reflects the mothers' concern for infant appetite in association with illness.