Breast-feeding and the working mother in Nairobi Alice Lakati 1 , Colin Binns 2, * and Mark Stevenson 2 1 Kenya Medical Training College, Nairobi, Kenya: 2 School of Public Health, Curtin University, GPO Box U 1987, Perth, Western Australia 6845, Australia Submitted 17 October 2001: Accepted 28 March 2002 Abstract Objective: In the fast growing city of Nairobi, women often combine the roles of mother and worker in trying to achieve better standards of living. The objective of this study was to document the effect of returning to work on breast-feeding by mothers in Kenya. Design: A cross-sectional survey. Setting: Outpatient clinics of two major hospitals in Nairobi, one government hospital in an economically deprived area and one high-fee private hospital. Subjects: Four hundred and forty-four working mothers from low and higher socio- economic areas in Nairobi. All working mothers with infants aged 4 to 12 months attending during the survey period were invited to participate. Results: The prevalence of breast-feeding at the time of interview was found to be 94.1%. The lower socio-economic group exhibited a higher prevalence of breast- feeding (99%), 10% greater than the higher socio-economic group. The mean number of hours the mothers were away from home due to work was 46.2 hours each week. The majority (54.4%) of the mothers employed a ‘house-girl’ to care for their infant while they were at work, while 28.4% were able to take their infants to work. Most of the breast-feeding mothers (95%) breast-fed their infants at least three times a day and only 23 mothers reported not being able to breast-feed their infants during the day. The lower socio-economic group had a mean of 5.09 breast-feeding times per day while the higher socio-economic group had a mean of 3 times a day. In a logistic regression analysis the mode of work (fixed working hours vs. shift working hours) was associated with exclusive breast-feeding at one month (odds ratio (OR) ¼ 0.45) and two months (OR ¼ 0.39). Conclusion: In Western countries ‘return to work’ is often cited as the reason that breast-feeding is discontinued prematurely. In this study we have shown how mothers in Kenya are able to successfully continue breast-feeding after they have returned to work, often for very long hours. Keywords Nairobi Kenya Breast-feeding Working mothers The promotion of breast-feeding is a global priority, because of its many benefits to infant and mother 1,2 . However, it is often difficult for mothers working outside the home to continue to breast-feed, and return to work is cited as a major reason for the decision to cease breast- feeding 3 . In many developing countries, labour force participation by women of childbearing years has increased rapidly, posing new challenges for women attempting to combine their roles as workers and mothers. In the rapidly modernising city of Nairobi, economic pressures are such that more women have taken up either paid employment or are self-employed. The World Health Organization 4,5 maintains that: ‘the successful integration of women’s productive and reproductive roles is the basis for child survival and economic development’. Employed women are important role models for women in their communities, in their breast-feeding and general health behaviour. They constitute a major reservoir of knowledge and skills and their participation in national development is very important 6 . They are perceived as better-educated and as full participants of the ‘modern’ sector of the society, and their behaviour greatly influences their rural counterparts. For these reasons it was important to study how mothers in Nairobi combine work and breast-feeding. Method A study was undertaken of working mothers from high and low socio-economic areas in Nairobi, Kenya, who had infants aged between 4 months and 12 months. Mothers attending the private hospital, where substantial fees are paid, were classified as the higher socio-economic group, while mothers attending the government hospital were classified as the lower socio-economic group. All mothers attending the maternal and child health clinics during a q The Authors 2002 *Corresponding author: Email c.binns@curtin.edu.au Public Health Nutrition: 5(6), 715–718 DOI: 10.1079/PHN2002349