Maternal activity budgets: Feasibility of exclusive breastfeeding for six months among urban women in Honduras

Although exclusive breastfeeding for 6 months is likely to be beneficial for infant health, mothers often cite time pressures as a reason to introduce other foods. Using 12-hr in-home observations at 19 and 24 wk postpartum, we compared maternal activity budgets and time spent breastfeeding among low-income, urban mothers not employed outside the home who exclusively breastfed (EBF) or gave other foods in addition to breast milk (BF + SF). Breastfeeding time was similar between groups (averaging approx 75 min 12 hr) except that multiparous EBF mothers at 24 wk spent more time breastfeeding their infants than did BF + SF mothers. However, total time devoted to infant feeding (including preparation and feeding of solids in the BF + SF group) was significantly greater in the BF + SF group than in the EBF group (except among multiparous women at 24 wk). Feeding frequency per 12-hr averaged 6.7-8.9 in the EBF group and 5.4-8.1 BF + 1.8 meals in the BF + SF group. Both EBF and BF + SF mothers had considerable 'free' time; they spent, on average, 2-3 hr during each 12-hr period resting, chatting or watching TV. Primiparous women tended to spend less time at household chores and child care than multiparous women. Of the BF + SF mothers, 60% said that breastfeeding was 'somewhat' or 'very' time-demanding (vs 15% of EBF mothers), 49% said that it interfered with other activities (vs 6% of EBF mothers), and 26% said that they gave other foods to extend the time between breastfeeds. Although many of the BF + SF mothers knew that giving foods may increase infant illness, there were cultural pressures not to exclusively breastfeed. For example, many introduced solids to their infants prior to 6 months because they believed that infants should 'learn' how to eat other foods, to 'acclimate' the stomach and learn to differentiate flavors. We conclude that time constraints are not a barrier to exclusive breastfeeding in this population, although they may be perceived as a barrier.