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Feeding practices and growth among low-income Peruvian infants: a comparison of internationally-recommended
E G Piwoz1, H Creed de Kanashiro, G L Lopez de Romaña
1Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205, USA.
Insights
Introducing non-human milk in the first month negatively impacts infant weight gain. Early infant feeding patterns, including early weaning, are linked to being underweight at 12 months.
Area of Science:
- Pediatrics
- Nutrition Science
- Growth Monitoring
Background:
- Longitudinal study of 153 low-income Peruvian infants.
- Focus on internationally-recommended infant feeding practice definitions.
- Assessment of relationship between feeding practices, monthly weight gain, and 12-month weight status.
Purpose of the Study:
- Evaluate the association between infant feeding definitions and growth outcomes.
- Determine the validity of recommended breastfeeding definitions.
- Analyze the impact of early diet on infant weight gain and status.
Main Methods:
- Monthly classification of infants into feeding categories based on reported data.
- Analysis of variance (ANOVA) to correlate feeding practices with growth.
- Comparison of reported vs. observed breastfeeding and breast milk intake.
Main Results:
- Infants receiving non-human milk in the first month showed significantly less weight gain (P < 0.002).
- Reported nursing frequency correlated with observed frequency and breast milk intake in infants under 9 months (P < 0.05).
- Early introduction of non-human milk or early weaning (by 4 months) increased likelihood of being underweight at 12 months.
Conclusions:
- Continue differentiating exclusively breastfed infants from predominantly or almost exclusively breastfed infants.
- Refine definitions for partially breastfed infants based on non-breast milk intake and breast milk energy percentage.
Background:
Data from a longitudinal study of 153 low-income Peruvian infants were used to assess the relationship between internationally-recommended definitions of feeding practices and infants' monthly weight gain and weight status at 12 months.
Methods:
Infants were classified into feeding categories using monthly reported data. Analysis of variance was used to assess the relationship between reported usual feeding practices and growth. Reported breastfeeding practices were compared to observed breastfeeding practices and to weighted breast milk intakes to determine the validity of recommended breastfeeding definitions.
Results:
Breastfed infants who consumed non-human milks during the first month of life gained less weight during that month (P < 0.002) than exclusively and predominantly breastfed infants. Reported daily nursing frequency was associated with observed nursing frequency and breast milk energy intake (P < 0.05) for infants < 9 months old. Patterns of growth varied according to early diets. Infants who consumed breast milk and non-human milks and those who were fully weaned by 4 months were more likely to be underweight at 12 months than other infants. Infants classified as token breastfeeders ( < or = 3 times/24 hours) from 0 to 120 days had monthly gains that were similar to those of fully weaned infants.
Conclusions:
Infants feeding definitions should 1) continue to differentiate exclusively breastfed infants from other infants who are almost exclusively or predominantly breastfed; 2) distinguish partially breastfed infants who consume only non-breastfeeding frequency or the % of their total daily energy that comes from breast milk.