Concerned by the alarming decline in breast feeding in the urban and rural areas of Malaysia, we conducted a critical review of infant feeding practices among nursing personnel from representative centres using questionnaires. It was found that although 75% of mothers breast-fed their babies at birth only 19% did so at 2 months and 5% at 6 months respectively. Chinese mothers initiated breast feeding less frequently compared with Indian or Malay mothers. The prevalence of breast feeding was higher among lower category nurses, lower income groups and those from health centres. Decision for breast feeding was based in most instances on conviction derived from reading, lectures or advice from relatives. The vast majority of mothers listed "work' as the main reason for termination of breast feeding followed by "insufficient breast milk' and satisfactory past experience with bottle feeding. The ramifications of these findings and measures to improve the prevalence and duration of breast feeding are discussed.
The birthweights of 13,614 singleton infants comprising 5376 Malays, 5352 Chinese and 2886 Indians born at the Maternity Hospital Kuala Lumpur, during 1973, 1975 and 1977 have been extracted and analysed. Male Chinese infants (3.16 ± 0.37 kg) were significantly heavier than Malay and Indian infants while the male Malay infants (3.12 ± 0.41 kg) were significantly heavier than the Indian (2.97 ± 0.41 kg). Both female Chinese (3.04 ± 0.38 kg) and Malay infants (3.05 ± 0.38 kg) were heavier than the female Indian (2.89 ± 0.39 kg) but there was no difference in birthweight between Chinese and Malay female infants. The mean gestational period and the proportion of full-term births were similar for all 3 races with averages of 39.9 weeks and 77.8 percent respectively. Maternal age at first birth was also closely similar for the three communities with an average of 22.9 years. Significant correlations were found between birthweight and length of neonates, birthweight and gravida, birthweight and maternal age. Indians have a higher incidence of low birthweight or small-for-gestational age infants (14.5 percent) compared to the Chinese (5.6 percent) and the Malays (7.6 percent); the incidence of low birthweights being higher in girls than in boys. Present-day Malay and Indian full-term male and female infants are significantly heavier than their counterparts born at the same Hospital two decades ago, but no difference in birthweight was observed for Chinese infants during this time interval. The gap between the incidence of low birthweight found in Malaysia and those in the developed countries seems to be narrowing and this may be taken to reflect the overall effects of socioeconomic development, including the greater availability of general health and ante-natal care throughout the country since its Independence in 1957.
A random sample of 23 591 single livebirths was drawn from the Singapore Registry for 1967-1974, and information extracted from the birth certificates. The proportion of low birthweight infants (2500 g or less) fell markedly from 9.1% in 1967 to 5.7% in 1974, which has not been the finding in other studies. Variation in the proportions of low birthweight infants by sex, maternal age, parity, and social class, are broadly in agreement with other studies. Indians were found to have significantly smaller babies (mean weight of 3020 g) with a higher proportion of low birthweight ones (11.5%) than the Malays (3080 g and 8.1%) and the Chinese (3130 g and 6.1%). This is despite similar distributions of gestational age, and for term babies the differences in low birthweight proportions are highly significant with Chinese 5.0%, Malays 6.5%, and Indians 9.8%. The reasons for this are discussed with the implication that lower birthweights in Indians are to some extent of ethnic/genetic origin.
This paper presents evidence from the Malaysian Family Life Survey that mothers' reports of their babies' birthweights, including reports of unweighed babies' approximate size at birth, can be used to examine many biological and socioeconomic correlates of birthweight. The study uses a sample of 5583 singleton births that occurred between 1945 and 1976. In these data, the frequency distribution of birthweights and their bivariate and multivariate relationships with the biological correlates of mother's age, baby's sex, first parity and infant mortality are consistent with those found in prospective studies. A new biological correlate, mother's age at menarche, is introduced as a proxy for the mother's nutrition during childhood. Late age at menarche is associated with lower birthweight. Other results show mothers younger than 20 years and older than 35 appear to be at greater risk of bearing small babies, but the former effect is no longer important when parity is controlled. Short interbirth intervals are associated with small babies. We attempt to distinguish whether this is due to prematurity or to maternal nutritional depletion; both effects appear to be operating. Higher income appears to mitigate the pernicious effect of short interbirth intervals. Indian babies weigh significantly less than those of other ethnic groups. Furthermore, birthweights have increased since the 1950s for Malays and Chinese, but not for Indians. The lower birthweights and lack of improvement over time for Indians appear to be due to close birthspacing, lack of access to medical care and falling incomes.
The different methods of prenatal diagnosis are discussed with special reference to ultrasound scan, amniocentesis for cell culture with processing for chromosome study, biochemical analysis and DNA recombination analysis. Chorionic villi aspiration and fetoscopy are new methods which will enhance considerably the methods for prenatal diagnosis. With regard to chromosome study of amniotic cells, experience with 623 cases is reviewed. 2.7% demonstrated chromosome anomalies and of these Downs anomaly was the commonest. A large proportion of cases requesting for amniocentesis are Caucasians who represent only 2% of the population in Singapore, but 25% of the 440 requests were from Caucasions. The various problems associated with the different methods for prenatal deafness are discussed.