Pattern and characteristics of growth faltering in early infancy in an urban sub-Saharan African setting

To determine the pattern of and factors associated with changes in nutritional status in early infancy in a resource-poor setting.

A cohort study in Lagos, Nigeria, in which the nutritional status at birth was compared with status at the first postnatal check-up routinely scheduled for 6-8 weeks based on the World Health Organization's multicenter growth reference and the Centers for Disease Control and Prevention 2000 growth charts. Factors associated with improved, worsened or steady nutritional status at follow-up based on z-scores for weight-for-age, length-for-age and weight-for-length were determined with multinomial regression analysis.

The mean length-for-age and weight-for-length based on the Centers for Disease Control and Prevention for the 445 full-term singletons studied were higher than the corresponding World Health Organization's multicenter growth reference values at birth and at follow-up, while mean weight-for-age was lower at birth but higher subsequently. Some 20.7% of infants were undernourished by at least one nutritional measure initially, which declined to 16.4% at follow-up. Also 8.1% of the infants remained undernourished, 8.3% became undernourished, and 5.6% became well-nourished at follow-up. Low birthweight full-term infants were significantly likely to remain undernourished (p < 0.001) or become well-nourished (p < 0.001) at follow-up while the offspring of elderly mothers (p = 0.024) or first-time mothers (p = 0.036) had an elevated risk of remaining undernourished by at least one measure at follow-up.

Many infants are likely to exhibit individual nutritional changes at variance with the overall/summary trend. Those whose nutritional status is likely to deteriorate or remain poor require timely intervention to minimize the risk of subsequent developmental delays/deficits from early infancy.