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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Complementary feeding adequacy in relation to nutritional status among early weaned breastfed children who are born to HIV-infected mothers: ANRS 1201/1202 Ditrame Plus, Abidjan, Côte d'Ivoire
Pediatrics, Volume 117, No. 4, Year 2006
Notification
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Description
OBJECTIVE. In high HIV prevalence resource- constrained settings, exclusive breastfeeding with early cessation is one of the conceivable interventions aimed at the prevention of HIV through breast milk. Nevertheless, this intervention has potential adverse effects, such as the inappropriateness of complementary feeding to take over breast milk. The purpose of our study first was to describe the nature and the ages of introduction of complementary feeding among early weaned breastfed infants up to their first birthday and second was to assess the nutritional adequacy of these complementary foods by creating a child feeding index and to investigate its association with child nutritional status. METHODS. A prospective cohort study in Abidjan, Côte d'Ivoire, was conducted in HIV-infected pregnant women who were willing to breastfeed and had received a perinatal antiretroviral prophylaxis. They were requested to practice exclusive breastfeeding and initiate early cessation of breastfeeding from the fourth month to reduce breast milk HIV transmission. Nature and ages of introductory complementary feeding were described in infants up to their first birthday by longitudinal compilation of 24-hour and 7-day recall histories. These recalls were done weekly until 6 weeks of age, monthly until 9 months of age, and then quarterly. We created an index to synthesize the nutritional adequacy of infant feeding practices (in terms of quality of the source of milk, dietary diversity, food, and meal frequencies) ranging from 0 to 12. The association of this feeding index with growth outcomes in children was investigated. RESULTS. Among the 262 breastfed children included, complete cessation of breastfeeding occurred in 77% by their first birthday, with a median duration of 4 months. Most of the complementary foods were introduced within the seventh month of life, except for infant food and infant formula that were introduced at age 4 months. The feeding index was relatively low (5 of 12) at age 6 months, mainly as a result of insufficient dietary diversity, but was improved in the next 6 months (8.5 of 12 at 12 months of age). Inadequate complementary feeding at age 6 months was associated with impaired growth during the next 12 months, with a 37% increased probability of stunting. CONCLUSION. Adequate feeding practices around the weaning period are crucial to achieving optimal child growth. HIV-infected women should turn to early cessation of breastfeeding only when they are counseled properly to provide adequate complementary feeding to take over breast milk. Our child feeding index could contribute to the assessment of the nutritional adequacy of complementary feeding around the weaning period and therefore help to detect children who are at risk for malnutrition. Copyright © 2006 by the American Academy of Pediatrics.
Authors & Co-Authors
Becquet, Renaud
France, Paris
Inserm
Leroy, Valeriane
France, Paris
Inserm
Ékouévi, Didier Koumavi
Cote D'ivoire, Abidjan
Centre Hospitalier Universitaire de Treichville
Viho, Ida
Cote D'ivoire, Abidjan
Centre Hospitalier Universitaire de Treichville
Castetbon, Katia
France, Paris
Conservatoire National Des Arts et Metiers
Fassinou, Patricia
Cote D'ivoire, Abidjan
Centre Hospitalier Universitaire de Yopougon
Dabis, Franćois Ç.Ois
France, Paris
Inserm
Timité-Konan, Marguerite
Cote D'ivoire, Abidjan
Centre Hospitalier Universitaire de Yopougon
Welffens-Ekra, Christiane
Unknown Affiliation
Béquet, Laurence
Unknown Affiliation
Tonwe-Gold, Besigin
Unknown Affiliation
Allou, Gérard
Unknown Affiliation
Dequae-Merchadou, Laurence
Unknown Affiliation
Sakarovitch, Charlotte
Unknown Affiliation
Touchard, Dominique
Unknown Affiliation
Amani-Bossé, Clarisse
Unknown Affiliation
Ayékoé, Ignace Adou
Unknown Affiliation
Bédikou, Gédéon
Unknown Affiliation
Coulibaly, Nacoumba
Unknown Affiliation
Danel, Christine
Unknown Affiliation
Horo, Apollinaire Gninlgninrin
Unknown Affiliation
Likikouët, Ruffin
Unknown Affiliation
Toure, Hassan
Unknown Affiliation
Inwoley, André
Unknown Affiliation
Rouet, François
Unknown Affiliation
Touré, Ramata
Unknown Affiliation
Agbo, Hélène
Unknown Affiliation
Aka-Dago, Hortense
Unknown Affiliation
Brou, Hermann
Unknown Affiliation
Desgréesdu-Loû, Annabel
Unknown Affiliation
Sihé, Alphonse
Unknown Affiliation
Tijou-Traoré, Annick
Unknown Affiliation
Zanou, Benjamin
Unknown Affiliation
Blanche, Stéphane
Unknown Affiliation
Delfraissy, Jean François
Unknown Affiliation
Lepage, Philippe
Unknown Affiliation
Mandelbrot, Laurent
Unknown Affiliation
Rouzioux, Christine
Unknown Affiliation
Salamon, Roger L.
Unknown Affiliation
Statistics
Citations: 69
Authors: 39
Affiliations: 4
Identifiers
Doi:
10.1542/peds.2005-1911
ISSN:
00314005
e-ISSN:
02105721
Research Areas
Food Security
Infectious Diseases
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Study Locations
Ivory Coast
Participants Gender
Female