RESUMO
This longitudinal study was designed to examine reciprocal relationships between feeding practices and infant growth over the first 6 mo of life. The following three hypotheses were tested: 1) early feeding practices predict later infant growth; 2) early infant growth predicts later feeding practices; and 3) these relationships occur after controlling for related background variables. The sample included 226 healthy, well-nourished infants born at the Queen Elizabeth Hospital, Bridgetown, Barbados. Assessments were made at birth, 7 wk, and 3 and 6 mo of age. Factor analysis of a feeding practices questionnaire for those mothers who attended all three postnatal visits yielded five uncorrelated factors. Three of these factors, preference for breast-feeding, feeding intensity and feeding difficulty, declined with infant age. Two of these factors, father helps and relatives help, increased with infant age. Several background variables, including maternal age, anthropometry and reproductive history, and reliance on outside sources of information were correlated with infant growth. Multivariate analyses confirmed all three hypotheses. The group of feeding practices (particularly the preference for breast-feeding) at 7 wk predicted increases in infant lengths at subsequent ages. Conversely, infant weights at 3 and 6 mo predicted subsequent feeding practices, especially feeding intensity. These reciprocal relationships remained even after statistically controlling for the influence of the background variables. Implications for public policy include the need for comprehensive programs advocating breast-feeding and supporting the general health of mothers and infants.
Assuntos
Crescimento , Alimentos Infantis , Fenômenos Fisiológicos da Nutrição do Lactente , Envelhecimento , Barbados , Estatura , Peso Corporal , Aleitamento Materno , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , MasculinoRESUMO
This is one of a series of studies on the long-term effects of early childhood malnutrition in Barbadian school children. This is the first report of the relationship between early malnutrition and later performance on a national examination administered to all 11-y-old children in Barbados to assign high school seats. We compared scores achieved on the 11-plus examination by 103 boys and girls with histories of marasmus or kwashiorkor with those obtained by 63 healthy comparison children and also with scores obtained by the total island population of children during the same years. We report that children with histories of either type of malnutrition confined to infancy had significantly lower scores on the national high school examination than healthy comparison children. Reduced 11-plus scores were closely associated with teacher reports of attention deficits in the classroom documented when the children were as young as 5 to 8 y of age and also with IQ and academic performance. Early malnutrition had independent effects on performance on the 11-plus examination even when home environmental conditions were controlled for. These findings have important implications for future opportunities available to children with histories of infantile malnutrition.
Assuntos
Escolaridade , Kwashiorkor/psicologia , Desnutrição Proteico-Calórica/psicologia , Barbados/epidemiologia , Criança , Comportamento Infantil , Pré-Escolar , Avaliação Educacional , Feminino , Humanos , Lactente , Inteligência , Kwashiorkor/epidemiologia , Estudos Longitudinais , Masculino , Desnutrição Proteico-Calórica/epidemiologia , Fatores Sexuais , Fatores SocioeconômicosRESUMO
A self-rating scale was used to assess the presence or absence of depressive symptoms among mothers of 129 Barbadian school children, ages 5 to 11 years, who had experienced marasmus in the first year of life. They were matched with the same number of mothers of comparison children who had no documented histories of malnutrition. Depressive symptoms, especially feelings of hopelessness, occurred more often among the mothers of previously malnourished children than among mothers of comparison children. Depressive symptoms were also more common in association with disadvantaged socioeconomic and home conditions. Maternal depressive symptoms were significantly correlated with the behavioral and cognitive functioning of the child during the school years. When both nutritional history and environmental conditions were controlled, maternal hopelessness had significant effects on school attendance and grades in reading, but there was no association with IQ. This led us to hypothesize that maternal depressive feelings may be an independent factor contributing to long-term behavioral and cognitive deficits in children with histories of early malnutrition.