Reason for termination of breastfeeding and the length of breastfeeding

Background. In third world countries the length of breastfeeding often has a major influence on child mortality, morbidity and nutritional status. When evaluating the impact of length of breastfeeding the reason why a mother terminates breastfeeding is usually not taken into consideration. Methods. Risk factors for termination of breastfeeding were studied in a prospective community study following 1678 children in Guinea Bissau, West Africa from birth to cessation of breastfeeding, migration or death. Results. The median weaning age was 22.6 months, Illness of the child, new pregnancy of the mother and illness of the mother were associated with a significantly shorter lactation period compared with children weaned because they were 'healthy' or 'old enough'. These explanations had an impact independent of other determinants for weaning, including ethnic group, mother's age, mother's education, birth order and number of dead siblings. Weaning before 12 months of age was only associated with illness of the mother or child and new pregnancy and not with any socioeconomic or cultural factors. Conclusions. Health workers should pay special attention to the encouragement of breastfeeding in connection with illness of the mother or child; these considerations may also be important in the planning of breastfeeding promotion campaigns. Since premature termination of breastfeeding is associated with new pregnancy, family planning should be part of any breastfeeding promotion programme.