A Novel method for the identification and quantification of weight faltering

Abstract

Objective We describe a new method for identifying and quantifying the magnitude and rate of short‐term weight faltering episodes, and assess how (a) these episodes relate to broader growth outcomes, and (b) different data collection intervals influence the quantification of weight faltering. Materials and methods We apply this method to longitudinal growth data collected every other day across the first year of life in Gambian infants (n = 124, males = 65, females = 59). Weight faltering episodes are identified from velocity peaks and troughs. Rate of weight loss and regain, maximum weight loss, and duration of each episode were calculated. We systematically reduced our dataset to mimic various potential measurement intervals, to assess how these intervals affect the ability to derive information about short‐term weight faltering episodes. We fit linear models to test whether metrics associated with growth faltering were associated with growth outcomes at 1 year, and generalized additive mixed models to determine whether different collection intervals influence episode identification and metrics. Results Three hundred weight faltering episodes from 119 individuals were identified. The number and magnitude of episodes negatively impacted growth outcomes at 1 year. As data collection interval increases, weight faltering episodes are missed and the duration of episodes is overestimated, resulting in the rate of weight loss and regain being underestimated. Conclusions This method identifies and quantifies short‐term weight faltering episodes, that are in turn negatively associated with growth outcomes. This approach offers a tool for investigators interested in understanding how short‐term weight faltering relates to longer‐term outcomes.

Infant Weight Faltering and Feeding Patterns at 6 Weeks Post-Delivery in a Rural East African Community:Comparing Incremental Versus Static Weight Assessments

“…Rwanda is a low-income, agricultural and landlocked country with approximately 11 million people living in five provinces, covering an area of 26,338 km 2 . It is called the home of a ‘1000 hills’ 9 .…”

“…1 This definition was based on static (one-time) growth assessment, which suggests attained growth and does not include or it minimizes changes in growth trajectories over time. 2 Because infant growth is dynamic and their growth pattern is exponiential rather than linear, especially in the first 6 months of life, incremental (interval) growth assessment is more appropriate rather than static assessment in this early age group. Relying only on static growth assessment (whether one-time or serially), as it is being implemented currently, in many developing countries, could lead to misdiagnosis or late diagnosis of growth faltering in this age group.…”

“…The static assessment might remain the same over a period of time, while the incremental or interval growth assessment may reveal earlier, an accelerated, flat or decelerated growth trend. 2…”

“…1 This definition was based on static (one-time) growth assessment, which suggests attained growth and does not include or it minimizes changes in growth trajectories over time. 2 Because infant growth is dynamic and their growth pattern is exponiential rather than linear, especially in the first 6 months of life, incremental (interval) growth assessment is more appropriate rather than static assessment in this early age group.…”

“…The static assessment might remain the same over a period of time, while the incremental or interval growth assessment may reveal earlier, an accelerated, flat or decelerated growth trend. 2 According to the principles of human growth, postnatal growth occurs in discontinuous saltatory spurts with a stagnant background in between those spurts. Also growth is highly variable and maximum during early infancy, compared to other phases of postnatal human growth.…”