Following the World Health Organization's Recommendation of Exclusive Breastfeeding to 6 Months of Age Does Not Impact the Growth of Rural Gambian Infants

Eriksen, Kamilla Gehrt; Johnson, William; Sonko, Bakary; Prentice, Andrew M.; Darboe, Momodou K.; Moore, Sophie E.

doi:10.3945/jn.116.241737

Cited by 51 publications

(76 citation statements)

References 30 publications

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“…Previous evidence for associations with other measures of breastfeeding practices is mixed. Some studies and reviews show lack of apparent association between breastfeeding practices (i.e., any breastfeeding, early initiation, exclusive, and continued breastfeeding) and growth among infants and younger children (Bhutta et al, ; Bork, Cames, Barigou, Cournil, & Diallo, ; Eriksen et al, ; Jones et al, ) and older children (Kramer et al, ; Kwok, Schooling, Lam, & Leung, ). In a recent systematic review and meta‐analysis of breastfeeding promotion studies, Giugliani, Horta, Loret de Mola, Lisboa, and Victora () also demonstrate a lack of association between promotion of optimal breastfeeding practices and growth among children.…”

Section: Discussionmentioning

confidence: 99%

Association between breast milk intake at 9–10 months of age and growth and development among Malawian young children

Kumwenda

Hemsworth

Phuka

et al. 2018

Maternal & Child Nutrition

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World Health Organization recommends exclusive breastfeeding for infants for the first 6 months of life, followed by introduction of nutritious complementary foods alongside breastfeeding. Breast milk remains a significant source of nourishment in the second half of infancy and beyond; however, it is not clear whether more breast milk is always better. The present study was designed to determine the association between amount of breast milk intake at 9-10 months of age and infant growth and development by 12-18 months of age. The study was nested in a randomized controlled trial conducted in Malawi. Regression analysis was used to determine associations between breast milk intake and growth and development. Mean (SD) breast milk intake at 9-10 months of age was 752 (244) g/day. Mean (SD) length-for-age z-score at 12 months and change in length-for-age z-score between 12 and 18 months were -1.69 (1.0) and -0.17 (0.6), respectively. At 18 months, mean (SD) expressive vocabulary score was 32 (24) words and median (interquartile range) skills successfully performed for fine, gross, and overall motor skills were 21 (19-22), 18 (16-19), and 38 (26-40), respectively. Breast milk intake (g/day) was not associated with either growth or development. Proportion of total energy intake from breast milk was negatively associated with fine motor (β = -0.18, p = .015) but not other developmental scores in models adjusted for potential confounders. Among Malawian infants, neither breast milk intake nor percent of total energy intake from breast milk at 9-10 months was positively associated with subsequent growth between 12 and 18 months, or development at 18 months.

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Section: Discussionmentioning

confidence: 99%

Association between breast milk intake at 9–10 months of age and growth and development among Malawian young children

Kumwenda

Hemsworth

Phuka

et al. 2018

Maternal & Child Nutrition

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“…Many late‐adolescent girls (20%) had had at least one child, and a majority of adult women (63%) had had at least three children. For 52% of adult women, the most recent child had been born within the last 2 years, suggesting that they might have been lactating at the time of the visit …”

Section: Resultsmentioning

confidence: 99%

“…If both of these conditions were true, due to the very high rates of breastfeeding in this population, the mother may have been lactating. Pregnancy in the last 2 years is therefore reported in Table as a marker of high rates of pregnancy and breastfeeding in this population …”

Section: Methodsmentioning

confidence: 99%

“…Age‐specific cutoffs were used to define mild anemia, as recommended by Ref. : 11.5 g/dL until age 12 years, 12.0 g/dL until age 15 years; 12.0 g/dL after age 15 years (female), and 13.0 g/dL after age 15 years (male). Moderate and severe anemia were defined using thresholds of 11 and 8 g/dL, respectively (in males and females of all ages); hypertension was defined as systolic BP > 140 or diastolic BP > 90 for participants aged 18 or over, or according to U.S. guidelines for adolescents …”

Section: Methodsmentioning

confidence: 99%

“…Hemoglobin concentration was measured from fasting venous blood samples as part of a full blood count using a Boule Medical Medonic M‐series 3‐part Haematology Analyser (Boule Diagnostics AB, Sweden). Age‐specific cutoffs were used to define mild anemia, as recommended: 11.5 g/dL up to 11.99 years, 12.0 g/dL up to 14.99 years, 12.0 g/dL after age 15 years (female), and 13.0 g/dL after age 15 years (male). Moderate and severe anemia were defined using thresholds of 11 and 8 g/dL, respectively (in males and females of all ages).…”

Section: Methodsmentioning

confidence: 99%

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In rural Gambia, do adolescents have increased nutritional vulnerability compared with adults?

Schoenbuchner

Moore

Johnson

et al. 2018

Annals of the New York Academy of Sciences

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Adolescents may be particularly susceptible to malnutrition owing to the energy and nutrient costs of the pubertal growth spurt. Here, our aim is to compare differences in selected markers of nutritional status between adolescents and adults in rural Gambia. The Keneba Biobank collects cross‐sectional data and samples for all consenting individuals resident in the West Kiang region of the Gambia. For this study, participants between the ages of 10 and 40 years were selected (n = 4201, females 2447). Height, body mass index, body composition, hemoglobin concentration, fasting glucose concentration, and blood pressure were compared using linear regression models adjusting for age, parity, season of measurement, and residence, across three age groups: early adolescent (10–14.9 years), late adolescent (15–19.9 years), and adult (20–39.9 years). Adolescents, particularly early‐adolescent girls and boys, were shorter, lighter, and leaner than adults. By late adolescence, differences were smaller, particularly in girls where, notably, the prevalence of overweight, hypertension, and impaired fasting glucose was low. Given the importance of maternal health for reproductive outcomes and intergenerational health, the results of the study, albeit with limited biomarkers available, indicate that adolescent girls are no more compromised than adult women or males from the same population.

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Maternal acceptability of iron supplementation in young breastfed rural Gambian infants

Stelle

Bah

Saidykhan

et al. 2023

Repro Female Child Health

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Introduction A recent analysis of Gambian infants showed that plasma iron concentrations decline rapidly from birth to levels below the 95% reference range within 5 months of age. To address this issue, a clinical trial was initiated to assess the efficacy of early iron supplementation in breastfed infants under 6 months of age (‘Iron Babies’; NCT04751994). To understand if such an intervention is feasible for scaleup, the acceptability, through the lens of local stakeholders and mothers (as the primary caregiver), must be considered. Methods An embedded qualitative study, therefore, explored acceptability through focus group discussions with local stakeholders and interviews with mothers. Four focus group discussions with local stakeholders (n = 19) and individual interviews (n = 14) with mothers whose infants were enrolled in the clinical trial were conducted. Qualitative data were analysed with respect to an implementation acceptability framework using Template Analysis. Results From the focus group discussions, there was a general sense of enthusiasm for the intervention, but also a concern due to confusion around nutritional messaging. The intervention was acceptable to mothers with limited mention of side effects and enthusiasm for participating in clinical trials on iron supplementation. However, when looking at scaleup, there were mixed opinions on the practicality of daily supplementation, as well as concerns around costs. In addition, it was suggested that proper dissemination of information and inclusion of all family members in decision‐making, especially fathers, is key to acceptability. Conclusion There was no indication that stakeholders or mothers were resistant to iron supplementation of breastfed infants.

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Following the World Health Organization's Recommendation of Exclusive Breastfeeding to 6 Months of Age Does Not Impact the Growth of Rural Gambian Infants

Cited by 51 publications

References 30 publications

Association between breast milk intake at 9–10 months of age and growth and development among Malawian young children

Association between breast milk intake at 9–10 months of age and growth and development among Malawian young children

In rural Gambia, do adolescents have increased nutritional vulnerability compared with adults?

Maternal acceptability of iron supplementation in young breastfed rural Gambian infants

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