Session/Event: Maternal and Child Health (Oral 15)

(OR15-04-22) Complementary Feeding and Growth Among Low Birthweight Infants in the The Second Half of Infancy: Results From a Multi-Site Observational Cohort

On Demand

Presenting Author(s)

Linda Vesel, PhD MPH

Scientific Lead and Research Scientist
Ariadne Labs, Harvard University School of Public Health
Boston, Massachusetts, United States

Disclosure: Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

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Co-Author(s)

Christopher P. Duggan, MD, PhD

Editor in Chief, American Journal of Clinical Nutrition
Boston Children’s Hospital
Boston, Massachusetts, United States
BK

Bhavna Koppad

Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research
KM

Karim P. Manji, MD, MPH

Muhimbili University of Health and Allied Sciences
KM

Kate Miller

Ariadne Labs, Harvard University
TM

Tisungane Mvalo

University of North Carolina Project Malawi, Department of Pediatrics
MP

Melda Phiri

University of North Carolina Project Malawi, Department of Pediatrics
FS

Friday Saidi

University of North Carolina Project Malawi, Department of Pediatrics
LS

Latha G. Shamanur

SS Institute of Medical Sciences and Research Center, Department of Paediatrics
ES

E S Siddhartha

Women & Children's Hospital
Christopher R. Sudfeld, ScD

Assistant Professor of Global Health and Nutrition
Harvard T.H. Chan School of Public Health
Boston, Massachusetts, United States

Objectives: This study was designed to address the high prevalence of infant undernutrition among low birthweight (LBW, < 2.5kg) infants in the second half of infancy, and the dearth of evidence on the optimal transition and provision of complementary feeding and growth of LBW infants. The objectives were to understand the complementary feeding profile and growth outcomes in the second half of infancy; and to assess the relationship between poor nutritional status at the time of transition to complementary feeding and poor growth outcomes at one year.

Methods: The results presented in this abstract are part of the larger Low Birthweight Infant Feeding Exploration (LIFE) study conducted in India, Malawi and Tanzania. This was a formative, multi-site, observational cohort study that collected data on over 1100 moderately LBW infants throughout infancy. After the six month visit, mother-infant pairs were visited at nine and 12 months.

Results: A total of 1114 infants and their mothers were enrolled in the observational study. More than 95% of infants were fed breast milk at six, nine and 12 months of age. At nine and 12 months respectively, 48% and 31% of infants were not achieving a minimum acceptable diet, highlighting gaps in dietary diversity. A lack of dietary diversity was exacerbated among infants born to younger, less educated and/or multiparous mothers. Proteins were more limited than any other food group; only 66% and 70% of infants were fed animal source foods at nine and 12 months, respectively. Prevalence of stunting ( >30%) increased from six to 12 months while underweight (26%) and wasting (10%) remained consistent; regional differences were observed. Importantly, poor growth outcomes at six months were predictive of those at 12 months even when adjusted for key covariates (stunting RR=2.84, p< 0.001; underweight RR=6.41, p< 0.001; wasting RR=4.89, p< 0.001).

Conclusions: Given the gaps in the optimal quality of complementary feeding and predictive relationship between six and 12 month growth outcomes, efforts should be made to enhance the promotion of feeding counseling before and during the transition to complementary feeding and to address key barriers to the provision of a diverse diet. In addition, growth monitoring and proactive intervention at six months or earlier could serve to prevent poor outcomes at one year of life.

Funding Sources: Bill & Melinda Gates Foundation