Predictors of growth from 1 to 18 months among breast-fed Ghanaian infants

Abstract

Objective: To examine factors associated with the physical growth of breast-fed Ghanaian infants during the ®rst 18 months of life. Design: A community-based longitudinal study. Setting: The study was carried out in Techiman, a district capital and major food trading center in the Brong Ahafo region of Ghana. Subjects: One-month old infants n 216 with birth weight ! 2X5 kg were recruited from Maternal and Child Health Centers. Method: From 6 to 12 months, infants were provided with one of four types of nutritionally enhanced complementary foods. Anthropometric assessments were completed monthly from 1 to 12 months and every other month from 12 to 18 months. Information was collected on household characteristics, morbidity from common infections and dietary intakes. Blood samples were collected at 6 and 12 months to assess iron, zinc, ribo¯avin and vitamin A status. Multiple regression analysis was used to examine factors associated with growth during the age intervals of 1 ± 6, 4 ± 6, 6 ± 12 and 12 ± 18 months as well as size attained at 12 and 18 months. Results: Prevalence of diarrhea and fever were negatively associated with growth during the ®rst year of life. No signi®cant relationship was found between respiratory illness (de®ned as cough or purulent nasal discharge) and growth. With the exception of dietary zinc intake, dietary variables were generally not signi®cantly associated with growth. Maternal education was positively associated with growth during most of the age intervals. Conclusion: These ®ndings suggest that interventions to reduce morbidity and improve the education of girls may bene®t children's growth in this population.

Weaning practices of the Makushi of Guyana and their relationship to infant and child mortality: A preliminary assessment of international recommendations

“…Frongillo and Habicht (1997) suggested that this study understated the potential for exclusive breastfeeding to reduce diarrheal disease, as the complementary foods supplied were hygienic, unlike complementary foods given during uncontrolled, unsanitary weaning conditions. A longitudinal study in Ghana documented that infants who had a term of EBF for less than 6 months had no growth advantage relative to those infants EBF for at least 6 months (Lartey et al, 2000). Correspondingly, the introduction of complementary foods between 4-6 months to infants had no significant effect on growth in research by others (Kusin et al, 1991;Martines et al, 1994;Simondon et al, 1996;Zumrawi et al, 1987).…”

“…If these children are already malnourished as a result of a longer duration of EBF, the potentiating effects of the cycle of infection and malnutrition could take hold, possibly explaining why these children do not have a lower infant and child mortality rate relative to those who are EBF for less than 6 months. Following Cohen et al (1994, Dewey et al (1999), Lartey et al (2000), Moffat (2001), and others, we attempted to evaluate the relationship between term of EBF on infant and child welfare. In particular, we considered the impact of term of EBF on infant and child mortality.…”

Growth chart curves do not describe individual growth biology

“…The specific characteristics of the population frame of reference are an important metric. For example, significant effects on infant size for age are due to factors ranging from genetic predisposition to biological age (gestational age in young infants) (Casey et al, 1991), feeding style (Dewey, 1998), illness (Waterlow, 1994), and altitude (Haas et al, 1982), in addition to broader lifestyle variables such as socioeconomic level (Victora et al, 1987) and maternal education (Lartey et al, 2000), as these mediate availability to the infant of resources ranging from nutrition to health care. Thus a conclusion of ''small for age,'' ''large for age,'' or ''appropriate for age'' for any single individual is entirely contingent on the nature of the comparative framework.…”

Índices antropométricos e retinolemia em crianças menores de cinco anos do e Estado da Paraíba

“…, Hautvast et al 23 e Lartey et al 24 . Entretanto, o efeito da suplementação com vitamina A, anteriormente relatado, é questionável devido aos resultados de experimentos mais recentes que desvendam impacto positivo [25][26][27] .…”

“…Trabalho de cunho prospectivo randomizado com criancas brasileiras 30 revelou que, apesar do tratamento com vitamina A mostrar-se eficaz no parasitismo, esse efeito nao atingiu o peso nem a altura. Em Gana 24 , a associação entre as concentrações de retinol e o crescimento em crianças de 1 a 18 meses amamentadas não foi encontrada. Na Colômbia 20 , o deficit ponderal mostrou-se associado à deficiencia de vitamina A, contrariamente ao resultado mostrado para o deficit de altura.…”