Morbidity, Growth and Food Intake among the Underfives in Madura, Indonesia

The relation between common illnesses, growth and breast milk and food intake was assessed in a-longitudinal population based study, covering 300 children, age 0-36 months. Morbidity was quite prevalent with a peak at age 4-24 months. It did, however, not affect the intake of breast milk and the consumption of additional foods in infancy. On the other hand, the daily intake of energy and protein was significantly reduced in older and particularly non-breastfed children. Morbidity explained about 28% of the variance in weight- and height-for-age in children, age 6-18 months. One can conclude that growth faltering early in infancy is primarily of nutritional origin, while at older age it is due to a synergistic effect of inadequate nutrition and morbidity. Anorexia rather than bad feeding habits is the main cause of poor dietary intake during and after illness

Effects of maternal multiple micronutrient supplementation on fetal growth: A double-blind randomized controlled trial in rural Burkina Faso

Background: Intrauterine growth retardation is a major predictor of child health in developing countries. Objective: We tested whether providing pregnant women with the UNICEF/WHO/UNU international multiple micronutrient preparation (UNIMMAP), rather than iron and folic acid alone, improved fetal growth and its correlates. Design: An intention-to-treat, double-blind, randomized controlled trial including 1426 pregnancies was carried out in rural Burkina Faso. Tablet intake was directly observed. Results: Pregnancy outcome was known in 96.3% of the participants. After adjustment for gestational age at delivery, both birth weight (52 g; 95% CI: 4, 100; P = 0.035) and birth length (3.6 mm; 95% CI: 0.8, 6.3; P = 0.012) were significantly higher in the UNIMMAP group. UNIMMAP had a differential effect by percentiles of birth weight and length distributions: the risk of large-forgestational-age infants was higher in the UNIMMAP group (OR: 1.58; 95% CI: 1.04, 2.38; P = 0.03), although the risk of low birth weight remained unchanged. The effect of UNIMMAP on birth size was modified by maternal body mass index at enrollment and could be more important in multiparous women and women taking sulfadoxine-pyrimethamine. Unexpectedly, the risk of perinatal death was marginally significantly increased in the UNIMMAP group (OR: 1.78; 95% CI: 0.95, 3.32; P = 0.07), and this seemed to affect mainly primiparous women (OR: 3.44; 95% CI: 1.1, 10.7; P for interaction = 0.11). Conclusions: Maternal UNIMMAP modestly but significantly increased fetal growth. The resulting benefit on infant growth and survival needs to be assessed. The possible lack of benefit and potential harm in primiparous women should be further investigated. This trial was registered at clinicaltrials.gov as NCT00642408. © 2008 American Society for Nutrition.SCOPUS: ar.jinfo:eu-repo/semantics/publishe