Zinc deficiency has been associated with growth deficits, reduced dietary intake and appetite, and has been hypothesized to result in reduced activity. This randomized, double-blind, placebo-controlled study examined whether 10 mg of oral zinc as zinc sulfate, given daily for up to 7 mo, affected activity patterns of 85 Guatemalan infants recruited at 6-9 mo of age. Infant activity was assessed by time sampling-observation method at 10-min intervals during a 12-h data collection period, at base line, 3 and 7 mo follow-up. Motor development and the percentage of time infants were observed in various positions (being carried, lying down, sitting, crawling, standing or walking) and engaged in various activities (eating, sleeping, resting, crying/whining or playing) were compared by treatment group. No differences in motor development were observed by treatment group. However, at follow-up 2 (after 7 mo of supplementation), zinc-supplemented infants were significantly more frequently observed sitting up compared with lying down, and were playing during 4.18 +/- 1.95% (P < 0.05) more observations than unsupplemented infants. They were also somewhat less likely to be observed crying or whining (P < 0.10) compared with those receiving the placebo. These effects are independent of other factors including infant age, motor development, sex, maternal education, family socioeconomic status and nutritional status at base line. Further research must be conducted to determine the long-term developmental importance of these differences in activity patterns associated with zinc supplementation in this setting.
Beliefs about child illness were investigated using semi-structured interviews with mothers and providers in four rural Guatemalan communities. The two most common forms of child illness in Guatemala -diarrhoea and respiratory disease -were focused upon. These illnesses are particularly difficult to prevent and treat, especially with the rudimentary health services available in rural areas of developing countries. Comparisons with other ethnographic studies in Guatemala suggest that some traditional models of illness causation identified in these earlier investigations are relatively unimportant in the communities studied here. This finding, in conjunction with frequent responses related to hygiene and water, suggests that traditional explanations may be co-existing with biomedical views of illness causation to a greater degree today than in the past.
Feeding is an ideal context in which to examine the interaction between biological development and cultural variability in international efforts to promote children's survival and health. The transition from liquid to semisolid and solid feeding is a major developmental milestone that occurs in the first year of life. Appetite is a central component in the decision making process used by caregivers to determine when and how much to feed their infants. Anecdotal, qualitative, and dietary consumption data provide evidence that both illness-related and chronic anorexia is an important problem among infants and young children in developing countries. For example, nutrition programme personnel have noted that children simply do not appear to be hungry or to eat all that is offered to them, even if they are clearly undernourished. Following the UNICEF triple-A framework, this paper describes programme strategies to improve child-feeding and appetite.
In order to measure accurately indigenous Guatemalan women and young children's exposure to smoke from cooking fires, three techniques were compared: 1) observation; 2) recall 24 hours later based on duration of activities; and 3) recall 24 hours later based on the time each activity started and stopped (elapsed time). To measure recall accuracy, 43 women and their children under two years were observed during meal preparation and consumption, and the next day were asked to recall these activities. Women were reasonably accurate when recalling durations, but recall was significantly less accurate using elapsed times. Recall accuracy increased when two days' measurements were averaged. Women spent more time in the kitchen if they had a husband, and spoke only the indigenous language. For children, mothers' patterns and child's age were associated with time in the kitchen. Children who could walk spent significantly less time in the kitchen than non-walkers. Implications for action to prevent indoor air pollution for women and children are discussed.
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