DETERMINANTS OF INFANT FEEDING PATTERNS

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This project will investigate the socioeconomic, demographic, and community, influences on infant feeding patterns and trends in Indonesia. Virtually all Indonesian infants are breastfed, and they are among the latest in the world to be weaned. Over the last three decades, the trend in Indonesia has been toward even longer durations of breastfeeding. However, Indonesian mothers tend to include other liquids or food in the infant's diet relatively early in the child's life, foregoing the potentially life-saving benefits of unsupplemented breastfeeding (which isolates infants from the bacterial pathogens that cause diseases of the digestive tract). The conceptual model guiding the research views infant feeding patterns as the result of decisions parents make based on their perceptions of the costs and benefits of unsupplemented and supplemented breastfeeding vis-a- vis other modes of feeding. These decisions are constrained by resources, institutions, cultural norms, and underlying physiological mechanisms. This framework yields as a number of hypotheses about influences on the incidence and duration of unsupplemented and supplemented breastfeeding, which will be tested using new retrospective data, from the Indonesian Family Life Survey (IFLS), on a large number of mothers and on each of their children. Systems of duration and limited-dependent-variable models will be used to investigate determinants of the decision to initiate breastfeeding, the duration of total breastfeeding, and the timing of supplementation. The analyses will allow the influences on infant feeding decisions to vary over the course of infancy and will recognize the sequential and correlated nature of decisions for different children in the same family. Explanatory variables include prices of water and sanitation, medical are, infant foods, and contraceptives; women's value of time; household resources; and the information available about the health and contraceptive effects of breastfeeding. Influences on the initiation and duration of breastfeeding in Indonesia will be compared with those in Malaysia, which has one of the shortest durations of breastfeeding among developing countries. The Malaysian analysis will use data from the First and Second Malaysian Family Life Surveys (MFLS-1 and MFLS-2). The MFLS data will also be used to evaluate the quality of long-term recall about infant feeding, by comparing MFLS-2 reports (in 1988) about births in 1976 and earlier to MFLS-1 reports (in 1976) about those same births.