Feeding practices and growth patterns of moderately low birthweight infants in resource-limited settings: results from a multisite, longitudinal observational study. Issue 2 (15th February 2023)

• Record Type: Journal Article
• Authors: Vesel, Linda; Bellad, Roopa M; Manji, Karim; Saidi, Friday; Velasquez, Esther; Sudfeld, Christopher R; Miller, Katharine; Bakari, Mohamed; Lugangira, Kristina; Kisenge, Rodrick; Salim, Nahya; Somji, Sarah; Hoffman, Irving; Msimuko, Kingsly; Mvalo, Tisungane; Nyirenda, Fadire; Phiri, Melda; Das, Leena; Dhaded, Sangappa; Goudar, Shivaprasad S; Herekar, Veena; Kumar, Yogesh; Koujalagi, M B; Guruprasad, Gowdar; Panda, Sanghamitra; Shamanur, Latha G; Somannavar, Manjunath; Vernekar, Sunil S; Misra, Sujata; Adair, Linda; Bell, Griffith; Caruso, Bethany A; Duggan, Christopher; Fleming, Katelyn; Israel-Ballard, Kiersten; Fishman, Eliza; Lee, Anne C C; Lipsitz, Stuart; Mansen, Kimberly L; Martin, Stephanie L; Mokhtar, Rana R; North, Krysten; Pote, Arthur; Spigel, Lauren; Tuller, Danielle E; Young, Melissa; Semrau, Katherine E A;
• Is Part Of: BMJ open. Volume 13:Issue 2(2023)
• Publication Date: 2023-02-15
• Subjects: epidemiology -- neonatology -- nutrition & dietetics -- community child health -- public health; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2022-067316
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To describe the feeding profile of low birthweight (LBW) infants in the first half of infancy; and to examine growth patterns and early risk factors of poor 6-month growth outcomes. Design: Prospective observational cohort study. Setting and participants: Stable, moderately LBW (1.50 to <2.50 kg) infants were enrolled at birth from 12 secondary/tertiary facilities in India, Malawi and Tanzania and visited nine times over 6 months. Variables of interest: Key variables of interest included birth weight, LBW type (combination of preterm/term status and size-for-gestational age at birth), lactation practices and support, feeding profile, birthweight regain by 2 weeks of age and poor 6-month growth outcomes. Results: Between 13 September 2019 and 27 January 2021, 1114 infants were enrolled, comprising 4 LBW types. 363 (37.3%) infants initiated early breast feeding and 425 (43.8%) were exclusively breastfed to 6 months. 231 (22.3%) did not regain birthweight by 2 weeks; at 6 months, 280 (32.6%) were stunted, 222 (25.8%) underweight and 88 (10.2%) wasted. Preterm-small-for-gestational age (SGA) infants had 1.89 (95% CI 1.37 to 2.62) and 2.32 (95% CI 1.48 to 3.62) times greater risks of being stunted and underweight at 6 months compared with preterm-appropriate-for-gestational age (AGA) infants. Term-SGA infants had 2.33 (95% CI 1.77 to 3.08), 2.89 (95% CI 1.97 to 4.24) and 1.99 (95% CI 1.13 to 3.51) times higher risks of being stunted, underweight and wasted compared with preterm-AGA infants. Those not regaining their birthweight by 2 weeks had 1.51 (95% CI 1.23 to 1.85) and 1.55 (95% CI 1.21 to 1.99) times greater risks of being stunted and underweight compared with infants regaining. Conclusion: LBW type, particularly SGA regardless of preterm or term status, and lack of birthweight regain by 2 weeks are important risk identification parameters. Early interventions are needed that include optimal feeding support, action-oriented growth monitoring and understanding of the needs and growth patterns of SGA infants to enable appropriate weight gain and proactive management of vulnerable infants. Trial registration number: NCT04002908 .