Investigation Of Infants Feeding Practice And Physical Growth During 1-12 Months Of Age

PARTⅠA CROSS-SECTION INVESTIGATION OF INFANT FOLLOWS THE LATEST WHO INFANT FEED RECOMMENDATIONObjective:Adequate nutrition during infancy is fundamental to the development of each child's full human potential. It is well recognized that the period from birth to one year of age is a'critical window'for the promotion of optimal growth, health and behavioral development. Many infant feed recommendation were issued by WHO (World health organization) in the past decade. Little detailed information is available on feeding practices follow the latest infant feed recommendation which was issued by WHO in 2001.Methods:A cross-section investigation was conducted in department of primary child care, Children's hospital of Chongqing medical University, which was located in southwest of China, in June 2008 to May 2009.Total 978 health infants were recruited not by randomized, 529/976(54.20%) boys and 447/976 (45.80%) girls, aged 2months(n=6), 3months(n=47), 4months(n=116), 5months(n=234), 6months(n=284), 7months(n=109), 8months(n=88), 9months(n=45), 10months(n=28), 11months(n=11),12months(n=8), respectively. A qualitative questionnaire was used to collect information of infants'data and feeding practice was assessed by 24-hours recall from mother or grandmother. The anthropometric data of infants include weight and length was measured by qualified nurses use standard instrument which adjustment regularly. Weight-for-age Z-score (WAZ) and length-for-age Z-score (LAZ), weight-for-length Z-score (WLZ),were calculated with Anthro software (version 3, April 2009). Mean of weight, length, WAZ, LAZ, WLZ at different ages were compared with WHO growth standards using student's t test.Results: There was a considerable variety feeding practices when compare with the latest infant feed recommendation issued by WHO. About 89.8% infants were breastfed, of which 41.54% were exclusively breastfed after delivery. Another 10.2% of infants had never been breastfed by any reasons. The proportion of breastfed infants was 25/45(55.5%) at 3 months, 53/124(42.8%) at 4 months, 114/233(48.9%) at 5 months and 100/283(35.3%)at 6 months, respectively. The proportion of exclusively breastfed infants was 15/45(33.3%) at 3 months, 27/124(21.8%) at 4 months, 88/233(37.8%) at 5 months, respectively. By the age of 6 months, the rate of exclusive breastfeeding was dramatically decreased to 15/283(5.30%). It is not touch the bottle of exclusive breastfeeding for 6 months (180days) which recommend by WHO. The time of introducing complementary food was varied, 8.8% of infant was introduced complementary foods before the age of 4 months, and the percentage was 66.0% during 4-5 months, 12.3% after 6 months, respectively. First food introduce to infant was infant rice powder (65.5%), homemade rice (7.44%), yolk (17.2%), vegetable or fruit (9.3%), meat or fish (0.6%), respectively. The median age of introduce infant rice powder, gruels, yolk, vegetable, fruit, meat, fish, rice, noodle and bean was 4.50, 5.66, 5.19, 5.05, 5.08, 6.73, 6.77, 7.87, 6.60, 7.00 months, respectively. Physical growth of infants investigated was above the WHO reference regardless of the time of complementary feeding during 2-12 months of age. Both infants'weight growth up to the average level of WHO growth curve 2006 (P<0.05), whether or not exclusive breastfed during 4-6 months. Mean and stand deviation of weight-for-length Z-score (WLZ) was 0.70±1.07, 0.66±0.92, 0.62±0.94, 0.62±0.94, 0.65±1.03, 0.55±0.90, 0.61±0.82, 0.38±0.75, 0.55±0.99, 0.98±0.62 that differed significantly from zero (P < 0. 05) during 3-11 months, respectively. We did not find any difference between the feeding practice groups by WAZ, LAZ, WLZ at 4-6 months, respectively.Conclusions: These results indicate that a minority of infants was fed in accordance with the latest infant feeding recommendations which issued by WHO during their first 12 months of age in our study. However, the duration of exclusive breastfeeding is shorter than 6 months that WHO recommended. Exclusive breastfeeding rate was lower and formula feeding was higher during this period. The time of introducing complementary food was earlier than the WHO recommendation. There were few significant differences in growth status associated with early infant feeding practice during the first year in our study.PARTⅡEFFECTS OF FEEDING PRACTICE ON INFANTS GROWTH DURING 1-12 MONTHS OF AGEObjective:ime of introduce complementary food to infants is variable throughout the world. The optimal age at which to introduce complementary foods is a topic of considerable debate. This study was designed to determine whether early of late introduction of complementary foods affects on infants growth in term, normal birth weight health infants in Chongqing, China.Methods:A prospective investigation was conducted in department of primary child care, Children's hospital of Chongqing medical University, which was located in southwest of China, in June 2008 to December 2009.Total 344 health infants were recruited not by randomized, 54.36%( 187/344 ) boys and 45.64%(157/344) girls, aged 1months(234 man-times), 2 months(253 man-times), 3months(268 man-times), 4months(287 man-times), 5months(281 man-times), 6months(259 man-times), 7months(136 man-times), 8months(148 man-times), 9months(76 man-times), 10months(74 man-times), 11months(42 man-times),12months(50 man-times), respectively. A qualitative questionnaire was used to collect information of infants'data and feeding practice that assessed by 24-hours recall from parents or grandparents. The anthropometric data of infants include weight and length was measured by qualified nurses used standard instrument which adjustment regularly. Infants were divided into 2 groups by the introduction solid food at 4-5 months or≥6 months. The infants were followed once a month in the first 6 months,and two months from 6 to 1 2 months. Weight-for-age Z-score (WAZ), length-for-age Z-score (LAZ), and weight-for-length Z-score (WLZ) were calculated with Anthro software (version 3, April 2009). Mean of weight, length, WAZ, LAZ, WLZ at different ages were compared with WHO growth standards using student's t test by different groups. Pair-wise comparisons were performed by Turkey to compare the velocity differences among groups with feeding practice during 1-12 months of age.Results:The mean and stand deviation of weight-for-age Z-score (WAZ) ,weight-for-length Z-score (WLZ) were close to or above the WHO 2006 infant growth references during 1-12 months, respectively. We found some differences among WAZ, WLZ by the feeding practice groups at 4 months of age. Infants who were exclusive breastfeeding grown better than exclusive formula feeding, partial breastfeeding or formula and solid feeding at 4 months of age. All the infants grown well and reach or above the average of WHO 2006 children growth references at 6 months of age. Exclusive breastfeeding can support infants'growth until 6 months. There were no diffenrence in growth patterns among infants by the time of introducted solid food at 4 to 5 months or until 6 months in the first year of life.Conclusion : Exclusive breastfeeding, exclusive formula feeding, partial breastfeeding or formula and solid feeding can support infants'growth in the first 6 months of age in our study. We did not find any growth difference compare with Who 2006 children growth reference between infants groups earlier or later introduction complementary food. The velocity of growth in male who introducted solid food at 4 to 5 months showed higher△WAZ than who fed according to the WHO recommendations from 3 months to 12 months period. Our findings indicate that exclusive breast-feeding can support infant growth during the first 6 months.We did not find any benefits on infant growth during the first year of age.