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Weaning in southern Brazil: is there a "weanling's dilemma"?

J C Martines1, J P Habicht, A Ashworth

  • 1Diarrhoeal Disease Control Programme, World Health Organization, Geneva, Switzerland.

Insights

Access to clean water significantly impacts infant growth, especially for non-breastfed babies in low-income settings. Breastfeeding offers protection against diarrhea and supports better weight gain, mitigating risks associated with poor water access.

Area of Science:

  • Pediatrics
  • Public Health
  • Nutrition

Background:

  • Infant feeding practices and growth are influenced by socioeconomic factors and environmental conditions.
  • Access to safe water is a critical determinant of child health, particularly in developing regions.
  • Diarrhea poses a significant threat to infant growth and survival.

Purpose of the Study:

  • To investigate the interplay between infant feeding patterns, growth, access to water, and diarrhea incidence.
  • To determine the specific effects of water access on the growth of breastfed and non-breastfed infants.
  • To examine the concept of a "weanling's dilemma" in the study population.

Main Methods:

  • Longitudinal study following 400 newborns from low-income families in Pelotas, Brazil, up to 26 weeks of life.
  • Data collection on feeding patterns, infant weight gain, access to indoor water taps, and incidence of diarrhea.
  • Statistical analysis to assess the relationships between feeding, water access, diarrhea, and infant growth.

Main Results:

  • Non-breastfed infants in homes without indoor water taps showed approximately half the weight gain in the first 3 months compared to breastfed infants.
  • In homes with indoor water taps, non-breastfed infants' growth was comparable to or better than predominantly breastfed infants after 2 months.
  • Breastfed infants experienced less weight loss during diarrhea and reduced diarrhea incidence, especially in homes lacking water taps.

Conclusions:

  • Access to safe water is crucial for non-breastfed infant growth, particularly in environments with limited resources.
  • Breastfeeding provides significant protection against diarrhea and supports better growth, irrespective of water access.
  • The study found no evidence of a "weanling's dilemma" in this population, as the critical period for breastfeeding benefits did not align with the age when breast milk alone becomes suboptimal.

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