Rivera J, Ruel M T
National Institute of Public Health, Cuernavaca, Morelos, Mexico.
Eur J Clin Nutr. 1997 Feb;51(2):92-6. doi: 10.1038/sj.ejcn.1600371.
We tested the hypothesis that growth faltering in rural Guatemala starts earlier than between 3-6 months of life, as generally assumed.
The sample included children from the INCAP longitudinal trial (1969-1977), who had adequate birth weight (> -1 s.d.) (n = 79). Two groups were formed according to weight-for-age (WAZ) at 3 y: Group A: WAZ < -2 s.d. (growth-retarded), and Group B: WAZ > or = -2 s.d. Weight increments were computed and sex- and gender-specific deficits in weight increments from 0-36 months were calculated by comparing values of the WHO/CDC reference data. For the period between 0-12 months, weight increments were also compared to velocity standards: (1) the Fels data and (2) the WHO growth curves for breast fed infants.
At 3 y of age, growth-retarded children were 3.6 kg smaller than the WHO/CDC median. Depending on the reference data used, between 19 and 34% of the deficit at 3 y of age was due to failure to thrive during the first 3 months of life, an additional 12-19% occurred between 3 and 6 months and 12-25% between 6 and 9 months. By 12 months of age, infants had accumulated 45-80% of their total deficit in weight at 3 y of age. Compared to group B, children from group A had greater morbidity during their first 9 months of life, and their mothers had poorer nutritional status at 3 months postpartum. There were indications that children from group A came from more deprived families.
Growth faltering starts soon after birth in rural Guatemala and thus, effective interventions should be targeted to mothers and their infant as early as possible during the first year.
