ABSTRACT
A cohort of all infants born between January 1, 1969 and February 28, 1977 in four rural villages in Eastern Guatemala which were participating in a longitudinal project of nutrition and mental development was studied. As part of the study, prospective information on anthropometric measurements, morbidity, dietary intake and socioeconomic and cultural characteristics was collected. In addition, two types of food supplements were distributed: calorie and protein-calorie. Attendance at the feeding centers in each village and the amount of supplements consumed by children and pregnant and lactating mothers were recorded daily. We studied the effect of the supplements consumed by the mother during pregnancy and lactation and by the infant on trimestral infant weight and length changes during the first year of life. The data indicate that infant calorie supplementation before three months of age is significantly and negatively associated with infant growth; after three months of age, supplemental calories consumed by the infant are significantly and positively associated with infant weight and length gains. In addition, a small positive association was found between maternal caloric supplementation during lactation and infant growth during the first two trimesters of life, after controlling for potentially confounding factors for which data are available in this study.
PIP: The interrelationships between maternal nutrition, breastfeeding, infant nutrition, and infant growth in the context of a quasi-experimental longitudinal investigation carried out in rural Guatemala was examined. This is the 1st publication from the Guatemalan study to focus on the relationship of maternal and infant nutrition to infant growth during lactation utilizing all data collected between 1969-1977. The subjects were inhabitants of 4 agricultural villages participating in a longitudinal study of the relationship between malnutrition, physical growth, and mental development, which was conducted between 1969 and 1977. The entire population of the 4 communities was 3359 in 1975. The sample for these analyses was all children born between January 1, 1969 and February 28, 1977 (n=1106) and who were followed up to 12 months of age. Data on a variety of anthropometric measurements were taken by trained and standardized anthropometrists at specific ages (15 days, 3, 6, 9, and 12 months for children and quarterly for mothers during pregnancy and lactation). The main independent variable is nutrient intake, which includes supplement consumed at the feeding center and home diet and supplement intake. In general, the results of the longitudinal study attest to an effect of maternal dietary supplementation on infant growth, particularly infant weight gain from birth to 3 months and from 3-6 months of age. The data indicate that infant supplementation prior to 3 months of age is significantly and negatively correlated with infant growth, after controlling for potentially confounding factors for which data are available in this study. After 3 months of age, supplemental calories consumed by the infant are significantly, positively correlated to infant weight and length gains. The small association between maternal food suppplementation and infant growth could be due, in part, to the fact that only a small fraction of the energy consumed by the infant is utilized for growth after the 1st trimester of age and infant adaptation to limited caloric intake could be achieved by a reduction of physical activities. The negative association between infant supplementation and infant growth is probably because mothers whose infants were not growing adequately began to give supplements to the infants earlier than those with more adequate growth. The results also reflect the previously reported relationship between such factors as anthropometric measurement of the parents, obstetrical characteristics, infant morbidity, lactation, and infant growth.
