Impact of promoting healthy infant feeding practices on energy intake and anthropometric measures of children up to 6 years of age: A randomised controlled trial

Abstract

Background The first 2 years of life are the window of opportunity to promote healthy feeding practices. Thus, the present study aimed to assess the impact of a health workers training in infant dietary guidelines on energy intake and anthropometric measurement into childhood. Methods Cluster randomised field trial (NCT00635453) was conducted in Porto Alegre, Brazil. Healthcare centres were randomised into intervention (n = 9) and control (n = 11) groups. In intervention sites, health workers were trained to promote healthy feeding practices based on the Brazilian guideline for children's nutrition. Pregnant women who were in the last trimester of pregnancy were registered as potential mothers who would receive dietary counselling from the health workers. Energy and macronutrient intake and anthropometric measurements were obtained from children at ages 6 months, 12 months, 3 years and 6 years from low‐income families. Results At age 3 years, intervention group had lower consumption of energy [−92.5 kcal; 95% confidence interval (CI) = −153.5 to −31.5], carbohydrates (−11.9 g; 95% CI = −19.9 to −2.3), and total fat (−3.9 g; 95% CI = −6.2 to −1.2), compared to the control group. At 6 years of age, children in the intervention group had lower waist circumference (−1.3 cm; 95% CI = −2.7 to −0.0), triceps (−1.3 mm; 95% CI = −2.5 to −0.0) and subscapular skinfolds (−1.3 mm; 16 95% CI = −2.6 to −0.0) thickness measurements compared to those in the control group. Conclusions The health workers training to promote infant healthy feeding practices resulted in lower energy, carbohydrates and fat intake at 3 years and lower waist circumference, triceps and subscapular skinfolds measurements at 6 years.

Complementary feeding: Should baby be leading the way?

“…At 3 years of age, children in the intervention arm had lower energy, carbohydrate and fat intakes than those in the control arm. At 6 years of age, the children in the intervention arm had smaller waist circumferences and skinfold measurements 16 . This paper shows that that appropriate exposure to professional counselling can have a beneficial impact on the nutrition and growth of young children.…”

“…At 6 years of age, the children in the intervention arm had smaller waist circumferences and skinfold measurements. 16 This paper shows that that appropriate exposure to professional counselling can have a beneficial impact on the nutrition and growth of young children.…”

“…Sangalli et al 16 have demonstrated how a primary care intervention that included training for mothers on the timing of complementary feeding and the types of food that should be used could be rolled out on a large scale in Brazil. Health centres in the intervention arm of the study gave women access to counselling on how to feed babies and children within Brazilian guidelines.…”

Underweight in the First 2 Years of Life and Growth in Later Childhood

“…The first 2 years of life are important for establishing health over the life course. 1,2 Growth is highest in the first 2 years compared with any other life stage. 3,4 Underweight in children has been defined as body mass index (calculated as weight in kilograms divided by height in meters squared) z score (zBMI) less than −2 by the World Health Organization (WHO), [5][6][7] and it may occur when energy expenditure is greater than intake.…”

“…The first 2 years of life are important for establishing health over the life course . Growth is highest in the first 2 years compared with any other life stage .…”