Feeding practices and growth patterns of moderately low birthweight infants in resource-limited settings: results from a multisite, longitudinal observational study.
| Autor: | Vesel L; Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA lvesel@ariadnelabs.org., Bellad RM; Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India., Manji K; Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Saidi F; University of North Carolina Project Malawi, Lilongwe, Malawi., Velasquez E; Department of Epidemiology and Population Health, Stanford University, Palo Alto, California, USA., Sudfeld CR; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA., Miller K; Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA., Bakari M; Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Lugangira K; Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Kisenge R; Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Salim N; Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Somji S; Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Hoffman I; Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA., Msimuko K; University of North Carolina Project Malawi, Lilongwe, Malawi., Mvalo T; University of North Carolina Project Malawi, Lilongwe, Malawi.; Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA., Nyirenda F; University of North Carolina Project Malawi, Lilongwe, Malawi., Phiri M; University of North Carolina Project Malawi, Lilongwe, Malawi., Das L; Department of Paediatrics, SCB Medical College & Hospital, Cuttack, Orissa, India., Dhaded S; Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India., Goudar SS; Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India., Herekar V; Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India., Kumar Y; Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India., Koujalagi MB; Department of Paediatrics, JJM Medical College, Davangere, Karnataka, India., Guruprasad G; Department of Paediatrics, JJM Medical College, Davangere, Karnataka, India., Panda S; Department of Paediatrics, City Hospital, Cuttack, Orissa, India., Shamanur LG; Department of Paediatrics, SS Institute of Medical Sciences and Research Center, Davangere, Karnataka, India., Somannavar M; Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India., Vernekar SS; Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India., Misra S; Department of Paediatrics, SCB Medical College & Hospital, Cuttack, Orissa, India., Adair L; Department of Nutrition, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA., Bell G; Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA., Caruso BA; Hubert Department of Global Health, Emory University School of Public Health, Atlanta, Georgia, USA., Duggan C; Center for Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA., Fleming K; Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA., Israel-Ballard K; Maternal, Newborn, Child Health and Nutrition Program, PATH, Seattle, Washington, USA., Fishman E; Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA., Lee ACC; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA., Lipsitz S; Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA., Mansen KL; Maternal, Newborn, Child Health and Nutrition Program, PATH, Seattle, Washington, USA., Martin SL; Department of Nutrition, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA., Mokhtar RR; Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA., North K; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Boston, Massachusetts, USA., Pote A; Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA., Spigel L; Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA., Tuller DE; Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA., Young M; Hubert Department of Global Health, Emory University School of Public Health, Atlanta, Georgia, USA., Semrau KEA; Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | BMJ open [BMJ Open] 2023 Feb 15; Vol. 13 (2), pp. e067316. Date of Electronic Publication: 2023 Feb 15. |
| DOI: | 10.1136/bmjopen-2022-067316 |
| Abstrakt: | Objectives: To describe the feeding profile of low birthweight (LBW) infants in the first half of infancy; and to examine growth patterns and early risk factors of poor 6-month growth outcomes. Design: Prospective observational cohort study. Setting and Participants: Stable, moderately LBW (1.50 to <2.50 kg) infants were enrolled at birth from 12 secondary/tertiary facilities in India, Malawi and Tanzania and visited nine times over 6 months. Variables of Interest: Key variables of interest included birth weight, LBW type (combination of preterm/term status and size-for-gestational age at birth), lactation practices and support, feeding profile, birthweight regain by 2 weeks of age and poor 6-month growth outcomes. Results: Between 13 September 2019 and 27 January 2021, 1114 infants were enrolled, comprising 4 LBW types. 363 (37.3%) infants initiated early breast feeding and 425 (43.8%) were exclusively breastfed to 6 months. 231 (22.3%) did not regain birthweight by 2 weeks; at 6 months, 280 (32.6%) were stunted, 222 (25.8%) underweight and 88 (10.2%) wasted. Preterm-small-for-gestational age (SGA) infants had 1.89 (95% CI 1.37 to 2.62) and 2.32 (95% CI 1.48 to 3.62) times greater risks of being stunted and underweight at 6 months compared with preterm-appropriate-for-gestational age (AGA) infants. Term-SGA infants had 2.33 (95% CI 1.77 to 3.08), 2.89 (95% CI 1.97 to 4.24) and 1.99 (95% CI 1.13 to 3.51) times higher risks of being stunted, underweight and wasted compared with preterm-AGA infants. Those not regaining their birthweight by 2 weeks had 1.51 (95% CI 1.23 to 1.85) and 1.55 (95% CI 1.21 to 1.99) times greater risks of being stunted and underweight compared with infants regaining. Conclusion: LBW type, particularly SGA regardless of preterm or term status, and lack of birthweight regain by 2 weeks are important risk identification parameters. Early interventions are needed that include optimal feeding support, action-oriented growth monitoring and understanding of the needs and growth patterns of SGA infants to enable appropriate weight gain and proactive management of vulnerable infants. Trial Registration Number: NCT04002908. Competing Interests: Competing interests: All authors completed the ICMJE conflict of interest form and were funded by the Bill & Melinda Gates Foundation for this work as part of the LIFE study. ACCL, BAC, CD, CRS, DET, KEAS, K-IB, KLM, KM, MY have received funding from the Bill & Melinda Gates Foundation for maternal and newborn health and nutrition work at large. CD reports other funding from American Society for Nutrition, UpToDate and People’s Medical Publishing House. ACCL reports grants from the WHO and National Institute of Health/ NICHD. BAC reports funding from UNICEF and the US National Health Institutes of Health. MY reports grants from NIH, Emory University, and the Centers for Disease Control. K-IB and KM report grants from the Philips Foundation, the WHO and USAID. SLM has received funding from the International Society for Research on Human Milk and Lactation. All other authors have declared no conflicts of interest. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|