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Infant feeding practices reflect antecedent risk of xerophthalmia in Nepali children
J Gittelsohn1, A V Shankar, K P West
1Center for Human Nutrition, School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Insights
Introducing vitamin A-rich foods during weaning, such as meat, fish, eggs, and mangoes, significantly reduces the risk of vitamin A deficiency (VAD)-associated xerophthalmia in early childhood.
Area of Science:
- Nutritional science
- Ophthalmology
- Pediatric health
Background:
- Xerophthalmia, a leading cause of childhood blindness, is often caused by vitamin A deficiency (VAD).
- Infant feeding practices are suspected to influence VAD risk, but specific dietary patterns require further investigation.
Purpose of the Study:
- To investigate the association between infant feeding history and the risk of developing xerophthalmia in early childhood.
- To identify specific infant dietary patterns that may offer protection against VAD-related eye conditions.
Main Methods:
- A case-control study was conducted in rural Nepal involving 156 children aged 1-6 years, with and without a history of xerophthalmia.
- Infant feeding histories were collected from mothers using a diet history method.
- Conditional logistic regression and exploratory factor analysis were employed to analyze feeding patterns and their association with xerophthalmia risk.
Main Results:
- Consumption of meat, fish, eggs, and mangoes during infancy was associated with a reduced risk of xerophthalmia.
- Factor analysis identified an 'animal flesh' feeding pattern in the second year of life as significantly protective.
- Mothers of control children had higher education levels and fewer deceased children compared to cases.
Conclusions:
- Infant dietary practices play a crucial role in determining the risk of vitamin A deficiency (VAD).
- Early introduction of vitamin A-rich foods during the weaning period is vital for preventing VAD-associated xerophthalmia in preschool children.
Objective:
To determine the relationship between infant feeding history and risk of xerophthalmia due to vitamin A deficiency (VAD) in early childhood.
Design:
A case-control study of previously xerophthalmic and non-xerophthalmic children.
Setting:
Rural lowland region of Nepal.
Subjects:
One hundred and fifty-six children (aged 1-6 y old), half of whom previously had xerophthalmia due to vitamin A-deficiency, the other half matched by locale, age and the presence and age of a younger sibling (n = 102).
Methods:
Xerophthalmia was determined by trained ophthalmic assistants on the basic of current Bitot's spots, corneal xerosis or report of night blindness. Infant feeding history was collected through a diet history method obtained from the mother of the focus child. Exploratory factor analysis was conducted to determine the presence of underlying patterns in infant feeding practices. Conditional logistic regression was used to estimate odds ratios.
Results:
Mothers of control children tended to have a higher level of education (P < 0.10) and to have fewer children who had died (P < 0.10) than mothers of case children. Feeding of meat (OR = 0.09, CI = 0.01-0.70) or fish (OR = 0.41, CI = 0.17-0.99) with liver, eggs (OR = 0.11, CI = 0.01-0.88) and mango (OR = 0.28, CI = 0.13-0.60) were protective in association with xerophthalmia in early childhood. Factor analysis uncovered several distinct patterns in infant feeding, which varied by age of the infant. Only the 'animal flesh' feeding pattern (factor), practiced in the second year of life, proved significantly protective from xerophthalmia (OR = 0.43, CI = 0.20-0.94). Feeding patterns of younger children closely paralleled those of their older siblings with and without VAD.
Conclusions:
The study supports the hypothesis that infant dietary practices can influence subsequent risk for VAD. Our findings emphasize the importance of introducing vitamin A-rich foods during weaning to reduce the risk of VAD-associated xerophthalmia in the later preschool years.