Longitudinal study of breastfeeding structure and women's work in the Brazilian Amazon

It is well established that breast milk is the ideal food for infants and that breastfeeding has short- and long-term health benefits for the mother and child. However, there is variation in breastfeeding patterns between populations. Women's work is thought to influence breastfeeding patterns and timing of supplementation and it is often assumed that women in subsistence-oriented societies can more easily integrate their productive and reproductive activities. This article reports longitudinal data, collected in three rounds (resguardo [<40 days], peak [2-4 months], and late [14-16 months] lactation), on breastfeeding structure, infant care, and work patterns of 17 rural Amazonian women in an effort to understand how breastfeeding structure and maternal time allocation changed over time, as well as the strategies women used to integrate their productive and reproductive roles. Women breastfed 10.6 ± 3.1, 9.4 ± 3.4, and 9.6 ± 5.5 times per 9-h period in the three rounds, respectively. Breastfeeding structure, specifically session duration, changed over time (P < 0.05). As lactation progressed, women spent less time breastfeeding and in infant care and more time in subsistence work. In peak lactation, subsistence work was negatively correlated with infant care (r = -0.4, P = 0.01), breastfeeding (r = -0.29, P = 0.05) and session duration (r = -0.39, P < 0.01) and in late lactation was negatively correlated with time spent breastfeeding (r = -0.39, P < 0.01) and in infant care (r = -0.50, P < 0.01) and positively correlated with inter-session interval (r = 0.40, P < 0.01). Generally, women reduced time in subsistence work when breastfeeding was more intense and returned to normal activity patterns once infants were being supplemented. The costs and benefits associated with women's strategies are discussed.