This thesis describes surveys of infant feeding in Glasgow, Scotland, and Benin City, Nigeria, during 1980-82 in relation to cultural and socio-economic factors. A comparison was also made of the frequency of diarrhoeal disease in wholly breast-fed infants and those receiving breast milk substitutes (sms) and breast milk supplements (SU).
Contrary to expectation, it was found that 981 of infants in Benin City were receiving '8ffi5' as compared with 48% in Glasgow; whereas 'BffiS' was used as an entire replacement for breastfeeding in Glasgow, the pattern was one of supplementation in Benin City.
The cost of purchasing •sms• and other supplements in Benin was about half of the estimated equivalent cost in Glasgow, but was nevertheless much higher in relation to average earnings in Nigeria.
In both cities the use of 'BS• was significantly associated with availability of free or sponsored supplies by health authorities or manufacturers. In Glasgow lower social class, lower educational levels and lack of antenatal instructions were strongly associated with using • emS' - in Benin these variables did not seem to be influential.
In Glasgow, induced labour, supportive efforts by husbands, and previous experience of breastfeeding affected the extent to which breastfeeding was initiated and sustained.
The frequency of diarrhoeal disease was lower in breastfed infants, but it was not easy to separate this finding from the effects of interior housing and social deprivation which were shown to influence hospital admissions of infants with diarrhoea in Glasgow.
There were no deaths from diarrhoeal diseases in Glasgow; and none in Benin among wholly breastfed infants.
The study revealed a need for action by health and educational authorities to ensure that parents - not only mothers - are instructed in the proper use of •ems• as supplements or replacements, when required.
There is a need also to establish special international codes of marketing and use of • sms• far situations where nursing mothers are illiterate, poorly-educated or short of experienced advice in the immediate antenatal or postnatal periods.