VIETNAMESE FAMILIES IN PHILADELPHIA: AN ANALYSIS OF HOUSEHOLD FOOD DECISIONS AND THE NUTRITIONAL STATUS OF VIETNAMESE WOMEN AND CHILDREN LIVING IN PHILADELPHIA: 1980-1984 (GROWTH, INDOCHINESE, REFUGEES, INFANTS, BREASTFEEDING)

This dissertation is an analysis of the household-based food decision and distribution process as it affected the child-feeding practices of Vietnamese living in Philadelphia. It describes the beliefs and attitudes that Vietnamese parents held concerning food and health. Ecological, social and linguistic origins are used to interpret these concepts. A model of intra-household food distribution is constructed; and factors affecting pregnancy, infant and child nutrition are detailed, largely through the words of participants. The growth of children fed according to this system is analyzed and used to demonstrate how parents\u27 assessments of their children\u27s health, and the perceived potential for health within a new environment, led to changes in child feeding practices. In Vietnam, the elderly reinforced child-feeding practices that tradition suggested led to good health and adequate growth, as defined by Vietnamese to suit the Vietnamese environment. Families in Philadelphia confronted new environmental and cultural conditions. A combination of economic and social factors resulted in variations in food selection and consumption by pregnant women and children. The variations were classified by household organization and characteristics of the food decision maker as follows: Type 1. First-time mothers in households without elders selected foods according to a new system of health beliefs acquired from American physicians and nutritionists (working for the WIC Program). Type 2. Experienced mothers in households without elders selected foods according to traditional conceptions of health. They modified child-feeding practices more than those affecting their own diets during pregnancy. Type 3. Elders in extended households continued to exercise child-care responsibilities, maintaining traditional child-feeding practices. It is suggested that Vietnamese dietary traditions in pregnancy and the postpartum supplied women with calories and some other nutrients normally absent from their diets due to traditional food distribution rules. Consumption of these traditional supplements, or, consumption of supplements provided by the WIC program, were associated with heavier infant birth weights in households Type 1 and 2. Children appeared to grow better at six, twelve and eighteen months of age in Type 2 households than in either Type 1 or 3. Changes in parents\u27 attitudes towards appropriate infant size and diet are associated with these trends in growth