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Cross-cultural patterns of growth and nutritional status of breast-fed infants
1Department of Nutrition and Program in International Nutrition, University of California, Davis 95616-8669, USA. kgdewey@ucdavis.edu
Insights
Infant growth faltering during the first year of breastfeeding may be linked to prenatal factors, not solely diet. Ensuring adequate complementary feeding post-six months is crucial for infant development.
Area of Science:
- Pediatrics
- Human Nutrition
- Global Health
Background:
- Breastfeeding is a primary nutrition source for infants globally.
- Growth faltering and iron status are critical indicators of infant health.
- Variations in socioeconomic status and geographic location impact infant development.
Purpose of the Study:
- To examine infant growth patterns and iron status in diverse populations.
- To assess the impact of breastfeeding and complementary feeding on infant development.
- To identify factors contributing to growth faltering in the first year of life.
Main Methods:
- Comparative analysis of growth data (weight-for-age, length-for-age, weight-for-length) across four distinct infant populations.
- Calculation of z scores using National Center for Health Statistics and pooled data.
- Adjustment of z scores for birth weight and maternal height to evaluate growth faltering.
Main Results:
- Normal birth weight infants in Honduras showed robust early growth, comparable to high-income groups.
- Low birth weight infants consistently exhibited lower growth metrics throughout the first year.
- Ghanaian infants experienced weight faltering earlier than length faltering; iron status varied with birth weight and diet.
- Adjusted z scores indicated no significant growth faltering attributable to postnatal feeding practices alone.
Conclusions:
- Growth faltering in exclusively breastfed infants may be primarily influenced by prenatal factors and maternal stature.
- Effective complementary feeding after six months is essential for optimal infant growth.
- Preventing child stunting and malnutrition requires a holistic approach addressing both prenatal and postnatal influences.
Abstract:
Growth patterns and iron status of infants who were breast-fed throughout their first year of life were examined in four populations: 1) a group of high socioeconomic status in California (the DARLING Study), 2) infants of normal birth weight (NBW) but from low-income families in Honduras, 3) low-birth-weight (LBW), full-term infants in Honduras, and 4) infants in Ghana. z Scores were calculated by using both the current National Center for Health Statistics reference data and a pooled data set based on breast-fed infants in six industrialized countries. The NBW infants in Honduras showed rapid growth in the first few months and were similar in weight-for-age to the DARLING infants until approximately 9 mo. By contrast, the LBW infants remained far below the other cohorts throughout the first 12 mo, despite an initial period of catch-up growth. In the Ghanaian infants, weight-for-age faltered beginning at 3-4 mo, but length-for-age did not falter until after 9 mo. Weight-for-length was highest in the NBW Honduran infants and lowest in the Ghanaian infants. When z scores were adjusted for birth weight and maternal height, no significant faltering was evident in either weight or length in any of the cohorts during the first 12 mo. Thus, when breast-feeding is continued during the first year of life and efforts are made to ensure adequate complementary feeding after 6 mo, if growth faltering occurs it is probably attributable to prenatal factors and maternal stature. Population differences in iron status reflected variation in birth weight and in the use of iron-rich foods. Therefore, efforts to prevent child stunting and malnutrition must pay attention to prenatal as well as postnatal factors.