Infant care in rural Malawi. A prospective study of morbidity and growth in relation to environmental factors.

In connection with the introduction of piped surface water delivered by community taps in a rural area of Malawi, 46 infants were studied prospectively during a 10-month period to monitor infant care and health. Compared with the reference population, newborn infants generally weighed less and were shorter. Breastfeeding was universal and appeared adequate for catch-up in weight during the 1st 3 months. Growth faltering occurred from the age of 3 months when the prevalence of infectious diseases gradually increased and suitable supplementary foods were lacking. Babies were given highly contaminated water from the 1st days of life, but, in spite of this, diarrhoea was infrequent during the 1st 5 months when respiratory tract infections and episodes of fever were the most common symptoms of disease. Diarrhoea became a problem from the age of 5-6 months. No differences in morbidity or growth patterns were observed between infants using piped and traditional water sources. Thus, the quality of drinking water seemed to have no substantial effect on the health of the studied infants during the 1st months of life.