Early life nutrition in the Gelukspan Health Ward

Breast-feeding, supplementary feeding and weaning practices as well as nutrition during the second year of life were studied in 210 black primiparas, who had cared for their own children through the first year, in a poor, one-crop (maize) rural area in Bophuthatswana. The sampling strategy was similar to the one recommended by UNICEF for assessment of vaccination coverage. Only 1 child had never been breast-fed and 60% were still breast-fed at the time of the interview during the second year of life. A number of factors were detected that seem important determinants of breast-feeding behaviour, e.g. marital status and level of formal education. Early supplementary feeding and early weaning were identified as major problems. Children were weaned onto commercial feeds or low-energy-dense staples, and there was also an obvious lack of energy-dense foods (e.g. butter, coconut oil) during the second year of life. Some determinants of these practices were recorded. The data have implications for the health services and should influence social and educational policy for the area. If properly implemented, the recommendations could result in significant financial saving for the study population. The health services should promote appropriate nutritional education, starting with antenatal care, early and frequent attendance at child health services should be encouraged and education concerning nutrition should be strengthened, and health education should encourage prolonged breast-feeding, discourage the use of commercial weaning foods, and encourage the use of natural multimixes (e.g. bananas, beans, cooking oil) for weaning. The importance of energy-dense foods should be emphasised to mothers and to health workers.