Changes in nutritional status and morbidity over time among pre-school children from slums in Pune, India.

ABSTRACT

OBJECTIVE:To investigate changes in nutritional status and morbidity over time among pre-school slum children. DESIGN: Longitudinal. METHODS: Children in the age group of 0-5 years from three slums in Pune (n = 845) were studied for a period of two years. Measurement of weight (up to 20 g) and height (up to 0.1 cm), morbidity (in last 7 days) and clinical assessment was undertaken once every four months. RESULTS: Peak prevalence of malnutrition was observed around 18 months and shorter period (3.5 months) of exclusive breastfeeding was probably responsible. Morbidity was generally higher in rainy season and was associated with wasting but not stunting. Gastrointestinal illness and fever contributed 50% of total morbidity days. Higher morbidity affected significantly growth velocities in weight throughout pre-school age. Height velocities were significantly low upto three years of age but there appeared no scope for catch-up growth as velocities remained similar thereafter. Higher morbidity in younger children (less than 2 years) led to deterioration of nutritional status over time in 30% to 50% children. CONCLUSION: Shorter period of exclusive breastfeeding results in undernutrition at an early age among slum children. Morbidity further deteriorates the nutritional status