Professorial Paediatric Unit, Lady Ridgeway Hospital for Children, Colombo, Sri Lanka.
Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
BMC Pediatr. 2022 Apr 11;22(1):190. doi: 10.1186/s12887-022-03265-7.
Growth faltering is commonly encountered in breastfed infants during 4-6 months of age in low socioeconomic communities. The objective of this study was to describe the changes of growth indices with age, timing of growth faltering and its association with the feeding practices in children up-to 18 months of age.
A cross sectional descriptive study was conducted in 254 children aged 12 and 18 months attending an immunization clinic. Data on growth were extracted from the Child Health Development Record. Weight and length were measured using standard methods. Feeding practices were assessed using interviewer-administered questionnaire. A drop of > 0.25 in weight-for-age Standard Deviation Score (SDS) from birth SDS was defined as weight faltering.
Weight faltering occurred at some point in 64.2% (n = 163) during first 18 months of life, and 78.5% of whom, had the onset ≤ 4 months of age. Majority (76.6%, n = 98) with weight for age faltering by 4 months remained so at 12 months (p = 0.497), while 29.7% (n = 38) had a weight-for-length below-2SD (p < 0.001). Prevalence of weight faltering was 50.4%, 46.1%, 48.4% and 48% at 4, 6, 9 and 12 months respectively. Exclusive breastfeeding was given at least until 4 months in 88% (n = 223) and up to 6 months in 60% (n = 153) while 92.9% (n = 236) were breastfed at 12 months, with 38.2% (n = 97) were breastfed on demand after six months. Complementary feeding (CF) was started before 6 months in 40.6% (n = 52) with early weight faltering, but only 20.3% received it with proper consistency. Breastfeeding throughout the night was significantly associated with current weight-for-length being < -1SD (OR = 1.89, CI, 1.04-3.45; p = 0.037).
Early growth faltering was found in this population with high exclusive breastfeeding rates and persisting growth faltering was associated with poor feeding practices. Therefore, timely individualized interventions need to be taken to improve long term growth.
在社会经济水平较低的社区，4-6 个月大的母乳喂养婴儿中常出现生长迟缓。本研究的目的是描述生长指数随年龄的变化、生长迟缓的时间及其与 18 个月龄儿童喂养方式的关系。
对 254 名 12 个月和 18 个月龄在免疫诊所就诊的儿童进行横断面描述性研究。从儿童健康发展记录中提取生长数据。采用标准方法测量体重和身长。使用访谈者管理的问卷评估喂养方式。体重与出生时体重年龄标准差评分（SDS）的差距 > 0.25 定义为体重迟缓。
在生命的头 18 个月中，64.2%（n = 163）的儿童出现体重迟缓，其中 78.5%的儿童体重迟缓出现在 4 个月龄之前。大多数（76.6%，n = 98）在 4 个月龄时出现体重迟缓，12 个月龄时仍如此（p = 0.497），而 29.7%（n = 38）的儿童体重与身长的比值低于-2SD（p < 0.001）。4、6、9 和 12 个月时体重迟缓的发生率分别为 50.4%、46.1%、48.4%和 48%。88%（n = 223）的儿童至少在 4 个月龄时进行纯母乳喂养，60%（n = 153）的儿童持续母乳喂养至 6 个月龄，92.9%（n = 236）的儿童在 12 个月龄时仍进行母乳喂养，其中 38.2%（n = 97）在 6 个月龄后按需进行母乳喂养。40.6%（n = 52）的儿童在 6 个月龄前开始添加补充食物，且出现早期体重迟缓，但只有 20.3%的儿童添加了适当稠度的补充食物。夜间持续母乳喂养与当前体重与身长比值低于-1SD 显著相关（OR = 1.89，CI，1.04-3.45；p = 0.037）。
本研究人群中发现了早期生长迟缓，且持续的生长迟缓与不良喂养方式有关。因此，需要及时采取个体化干预措施来改善长期生长情况。
