Breast-feeding and the nutritional status of nursing children in Chile

Abstract

The work reported here sought to describe the feeding patterns of Chilean children up to 18 months old and their relation to nutritional status. To this end, a survey was conducted in 1993 of 9330 Chilean children under 18 months old who were receiving care through the National Health Service System-which provides care for 75% of all children under age 6. The children, whose mothers or caretakers were interviewed, constituted 94% of a sample selected at random from 102 of the 320 urban health clinics located throughout the country. The interview served to identify the type of feeding (exclusive breast-feeding, breast-feeding plus bottle-feeding, breast-feeding plus solid food, exclusive bottle-feeding, or bottle-feeding plus solid food) and to determine the nutritional status of the participants in terms of standards used by the United States National Center for Health Statistics and the World Health Organization. Children were deemed at risk of malnutrition if they had z scores on the weight-for-age distribution between 1.0 and 2.0 standard deviations below the US/WHO standard and as actually malnourished if they had z scores of over 2.0 standard deviations below the standard. The survey found exclusive breast-feeding prevalences of 86.5%, 66.7%, and 25.3% among infants 1, 3, and 6 months old. Some 12.1% of the participants were found to have a weight-for-age deficiency, 30.7% exhibited a height-for-age deficiency, and 35.7% were found to be over-weight. The prevalence of weight-for-age and height-for-age deficiencies were found to be considerably higher among bottle-fed children than among breast-fed children. In general, the results demonstrated the benefits of exclusive breast-feeding through the first 6 months of life, the need to complement exclusive breast-feeding with solid food after that time, and the superior nutritional status of breast-fed children within the age groups studied.

PIP: In September 1993 in Chile nationwide, 9330 mothers or caretakers of children 18 months or younger were interviewed and the children's weight and height measured to examine the breast feeding patterns of these children and their nutritional status. The children attended 102 Ministry of Health-supervised urban primary health care facilities. Exclusive breast feeding was prevalent up to 4 months of age (86.5% at 0-0.9 months and 59.4% at 3-3.9 months), then fell rapidly to 1.6% at 7 months of age. 83%, 59%, and 31% of the children 3, 6, and 12 months old, respectively, still received breast milk. 12.1% of all children showed a weight-for-age deficiency, 30.7% showed a height-for-age deficiency, and 35.7% were overweight. Overall, the percentage of malnourished children in terms of height-for-age increased steadily with age (p 0.001). In terms of weight-for-age, it was low in the first 6 months but increased in the next 6 months (p 0.001). In terms of weight-for-height, few children showed any severe nutritional deficiency but many showed excess weight (not significant). Among children younger than 6 months, the level of nutritional deficiency ( -1 standard deviation for weight-for-age) was higher among children who received breast milk and infant formula than among children who were exclusively breast fed (p 0.01 for 0-2 months and p 0.001 for 3-5 months). On the other hand, among children 6-8 months old, those who were exclusively breast fed and had never received solid foods were more likely to be malnourished than those who had received both breast milk and solid foods (p 0.01). In the first 6 months of life, exclusively bottle fed children faced a 1.6-1.8 times significantly higher risk of height-for-age deficiency than exclusively breast fed children. Among children older than 3 months, excess weight-for-height was significantly more common among exclusively breast fed children than other children. These findings revealed benefits of exclusive breast feeding during the first 6 months, the need to supplement it with solid food thereafter, and the superior nutritional status of breast fed children.