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Growth patterns of breastfed infants in seven countries
Insights
International research on infant growth reveals breastfed babies from diverse backgrounds exhibit similar growth patterns. However, specific populations, like Chinese and Indian infants, show slight variations, highlighting the need for inclusive growth references.
Area of Science:
- Pediatrics
- Human Growth and Development
- Nutritional Science
Background:
- Current international growth references may not accurately reflect breastfed infants' growth patterns.
- Limited comprehensive data exists for diverse populations of breastfed infants worldwide.
Purpose of the Study:
- To establish a new international growth reference for young children, particularly breastfed infants.
- To analyze growth patterns across multiple international sites using data from the WHO Multinational Study of Breastfeeding and Lactational Amenorrhea.
Main Methods:
- Collected bi-weekly weight and length measurements from approximately 120 breastfed infants per site across Australia, Chile, China, Guatemala, India, Nigeria, and Sweden.
- Employed multi-level modeling to analyze growth differences, adjusting for maternal stature and infant feeding patterns.
- Ensured mothers were literate with above-average educational levels, though not restricted to high socioeconomic status.
Main Results:
- Growth curves for breastfed infants were remarkably similar across most international sites.
- Chinese infants were approximately 3% shorter, and Indian infants up to 15% lighter at 12 months compared to Australian infants.
- Maternal education significantly impacted infant weight only in India.
Conclusions:
- Breastfed infants from socioeconomically stable families demonstrate consistent growth globally.
- Further rigorous assessment of South and East Asian populations is crucial for developing a new international growth reference.
- The study underscores the interplay of environmental and genetic factors in child growth and the complexities of growth data analysis.
Abstract:
An international effort is underway to develop a new international growth reference for assessing the growth of young children, especially breastfed infants who appear to falter relative to the currently recommended National Center for Health Statistics/World Health Organization reference. While limited data from high socioeconomic status children from different parts of the world suggest that their growth patterns are similar, there is no comprehensive study of breastfed infants. The WHO Multinational Study of Breastfeeding and Lactational Amenorrhea provides bi-weekly weights and 2-4 weekly length measurements on breastfed babies from selected sites in Australia, Chile, China, Guatemala, India, Nigeria and Sweden. Multi-level modelling was used to analyse between-site differences in the growth of approximately 120 infants per site, after adjustment for maternal stature and infant feeding pattern. All mothers were literate and mean educational levels were well above national averages, but the study was not restricted to infants of high socioeconomic status. Maternal education was significantly associated with infant weight only in India. The growth curves of infants from most sites were strikingly similar, but relative to the Australians (the reference category), the Chinese babies were about 3% shorter at 12 mo of age and the Indians up to 15% lighter. The present results suggest that breastfed babies from reasonably well-off families in different continents show very similar growth patterns. However, it is important that the growth of children from South and East Asian populations be rigorously assessed in the process of developing the new international growth reference. This paper discusses the relative importance of environmental versus genetic influences in the growth of young children and illustrates the complexities involved in the analysis of growth data.