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Undernutrition among Bedouin Arab infants: the Bedouin Infant Feeding Study
M R Forman1, K S Guptill, D N Chang
1Prevention Research Program, National Institute of Child Health and Human Development, Rockville, MD.
Insights
Early breastfeeding may reduce stunting risk in Bedouin Arab infants. However, stunting prevalence increased significantly over 18 months, with early stunting strongly predicting later growth faltering.
Area of Science:
- Pediatrics
- Human Growth and Development
- Nutritional Epidemiology
Background:
- Infant feeding practices are crucial for child growth and development.
- Understanding growth patterns during social change is vital for public health.
- Stunting (impaired growth) is a significant global child health concern.
Purpose of the Study:
- To investigate the association between infant feeding practices and growth in Bedouin Arab newborns.
- To examine growth trajectories during a period of planned social change.
- To identify factors influencing stunting and linear growth in early childhood.
Main Methods:
- Longitudinal study of 274 healthy Bedouin Arab newborns from 1981 to 18 months of age.
- Assessed infant feeding practices (breastfeeding, supplementation, weaning).
- Utilized multiple logistic and linear regression analyses to identify predictors of stunting and growth.
Main Results:
- Stunting prevalence increased from 12% at 6 months to 32% by 18 months.
- Early breastfeeding (exclusive or supplemented) was associated with reduced odds of stunting at 6 months.
- Stunting at 6 months significantly predicted stunting at 12 and 18 months (ORs 13 and 14, respectively).
- Seasonality, breastfeeding duration, morbidity, and early growth explained only 12% of growth variation.
Conclusions:
- Breastfeeding may offer protection against early childhood stunting.
- Persistence of stunting is a major concern, highlighting the importance of early intervention.
- Infant feeding practices alone did not fully explain long-term growth faltering, suggesting multifactorial influences.
Abstract:
Two hundred seventy-four healthy Bedouin Arab newborns in 1981 were followed for 18 mo to examine the relationship between infant-feeding practices and growth during planned social change. Although wasting was not prevalent, the prevalence rate of stunting (less than or equal to -2 SDs) increased from 12% to 19% to 32% at 6, 12, and 18 mo, respectively. After multiple-logistic-regression adjustment for covariates, the odds ratio (OR) of stunting at 6 mo was reduced among infants breast-fed only or fed with supplement compared with weaned infants. Infant-feeding practices were not associated with stunting in later infancy; however, those stunted at 6 mo had an OR of 13 of stunting at 12 mo and those stunted at 12 mo had an OR of 14 of stunting at 18 mo. In a multiple-linear-regression analysis, seasonality, duration of breast-feeding, hospitalized morbidity, and residual of height at 6 mo were negatively associated with daily average linear growth from 6 to 12 mo; these factors only explained 12% of the variation in daily linear growth.