ABSTRACT: Parental HIV infection may affect even those exposed children who remain uninfected. We investigated early growth, an indicator of overall health, of infants born to Zambian mothers recruited for a study of breastfeeding and postpartum health.
HIV-infected and uninfected women in Lusaka were followed regularly from late pregnancy to 16 weeks postpartum. Infant weight and length were measured at birth, 6 and 16 weeks. Infant HIV status could not be specifically determined in this cohort so comparisons were between all infants of HIV-uninfected mothers (n = 184) and those infants of HIV-infected mothers who were known to be alive and showed no clinical evidence of HIV infection at age 2-4 years (n = 85).
Most infants were exclusively or predominantly breastfed until 16 weeks. At all time points infants of HIV-infected mothers tended to have lower weight and length standard deviation (Z) scores (significant for weight at 6 weeks; P = 0.04), even after adjustment for their lower gestational age at birth, compared with infants of uninfected mothers. In multivariate analyses the major factors affecting weight or length at 6 or 16 weeks of age were birth weight or length, and maternal subclinical mastitis, primiparity and weight during pregnancy.
Early growth of infants of HIV-infected mothers is less than that of uninfected mothers, in part associated with subclinical mastitis, and this effect cannot be overcome with intensive support of mothers to follow international recommendations regarding exclusive breastfeeding.
Tropical Medicine & International Health 06/2007; 12(5):594-602. · 2.80 Impact Factor
ABSTRACT: To investigate the effects on maternal micronutrient status and infant growth of the increased maize prices that resulted from the southern African drought of 2001-2002.
Longitudinal cohort study.
A maternal and child health clinic in Lusaka, Zambia.
Maternal and infant health and nutrition data and maternal plasma were being collected for a study of breast-feeding and postpartum health. Samples and data were analysed according to whether they were collected before (June to December 2001), during (January 2002 to April 2003) or after (May 2003 to January 2004) the period of increased maize price. Season and maternal HIV status were controlled for in analyses.
Maize price increases were associated with decreased maternal plasma vitamin A during pregnancy (P = 0.028) and vitamin E postpartum (P = 0.042), with the lowest values among samples collected after May 2003 (vitamin A: 0.96 micromol l(-1), 95% confidence interval (CI) 0.84-1.09, n = 38; vitamin E: 30.8 micromol mmol(-1) triglycerides, 95% CI 27.2-34.8, n = 64) compared with before January 2002 (vitamin A: 1.03 micromol l(-1), 95% CI 0.93-1.12, n = 104; vitamin E: 38.9 micromol mmol(-1) triglycerides, 95% CI 34.5-43.8, n = 47). There were no significant effects of sampling date on maternal weight, haemoglobin or acute-phase proteins and only marginal effects on infant weight. Infant length at 6 and 16 weeks of age decreased progressively throughout the study (P-values for time of data collection were 0.51 at birth, 0.051 at 6 weeks and 0.026 at 16 weeks).
The results show modest effects of the maize price increases on maternal micronutrient status. The most serious consequence of the price increases is likely to be the increased stunting among infants whose mothers experienced high maize prices while pregnant. During periods of food shortages it might be advisable to provide micronutrient supplements even to those who are less food-insecure.
Public Health Nutrition 11/2005; 8(7):837-43. · 2.17 Impact Factor
ABSTRACT: Poor quality complementary foods with low nutrient density and inappropriate feeding practices have been identified among the major causes of malnutrition in young children. In many developing countries, complementary foods are introduced too early or too late and the quality and quantity of the foods are insufficient, leading to a great risk of nutritional deficiencies during the second half of infancy. Most of the habitually used complementary foods in developing countries are unfortified cerealbased gruels characterised by low energy and nutrient density and are often inadequate in iron, zinc and pyridoxine and in some populations may be deficient in riboflavin, niacin, calcium, thiamine, folate, ascorbic acid and vitamin A. The aim of this study was to establish current complementary feeding practices of mothers/caretakers living in a medium income urban community in Lusaka, Zambia. The study was the first phase of a larger study designed to develop improved complementary foods based on already-in-use cereals and legumes for the improvement of infant health in urban settings characterised by high HIV prevalence. Complementary feeding practices and nutrient intakes of children 6-18 months old in Lusaka were assessed by qualitative and quantitative methods. Themes generated from three focus group discussions (9 health workers, 7 mothers and 8 fathers) were used to design a semi-structured questionnaire to interview 34 mothers, 20 of whom were observed for 12 hours at home and their infant’s dietary intake measured by 12-h weighed food record and 24-h recall, (assuming medium breast milk intake). The results showed that although mothers had wide knowledge of optimal infant feeding, actual practices were constrained by food cost, maternal HIV status and time availability. Compared with the recommended daily allowance (RDA) at 6-8, 9-11 and 12-18 months of age, the daily nutrient intakes were 88%, 121% and 94% for energy; 33%, 52% and 59% for iron and 30%, 33% and 38% for calcium, respectively. Fortification of complementary foods is necessary to meet infants’ needs for iron and calcium.
African Journal of Food, Agriculture, Nutrition and Development (ISSN: 1684-5358) Vol 8 Num 1.