Historical review of the changing pattern of infant feeding in developing countries: the case of Malaysia, the Caribbean, Nigeria and Zaire

Prolonged lactation and early supplementation have been traditional practices among low-income mothers in Malaysia, the Caribbean, Nigeria and Zaire. Early supplementation is still the norm but there have been some substantial changes in the types of supplement offered. Thus, except in Zaire, there is now widespread use of processed milks as supplements for very young infants. The use of processed milks began in the 1920s in Malaysia and the Caribbean, but not until the 1960s in Nigeria. Processed milks are, as yet, rarely used in Zaire. The use of processed milks has not, however, led to the abandonment of traditional paps. The latter are still given as supplements to young infants in Nigeria and to older infants in Malaysia and the Caribbean. Breast-feeding duration has declined in Malaysia and the Caribbean although initiation is almost universal. In Nigeria and Zaire most low-income mothers continue to breast-feed for at least 12 months. The changes in the types of supplements used and in breast-feeding duration are analogous to the changes observed in industrialised countries from the mid-19th century, and many of the associated factors are similar: urbanisation; female participation in the labour force; increased availability of processed milks and their promotion both by companies and the health sector; and the regimentation of breast-feeding. This review highlights the negative role played by the health sector in the past, and discusses its future role in promoting and supporting breast-feeding.