Complementary feeding: a Global Network cluster randomized controlled trial

Background: Inadequate and inappropriate complementary feeding are major factors contributing to excess morbidity and mortality in young children in low resource settings. Animal source foods in particular are cited as essential to achieve micronutrient requirements. The efficacy of the recommendation for regular meat consumption, however, has not been systematically evaluated. Methods/Design: A cluster randomized efficacy trial was designed to test the hypothesis that 12 months of daily intake of beef added as a complementary food would result in greater linear growth velocity than a micronutrient fortified equi-caloric rice-soy cereal supplement. The study is being conducted in 4 sites of the Global Network for Women\u27s and Children\u27s Health Research located in Guatemala, Pakistan, Democratic Republic of the Congo (DRC) and Zambia in communities with toddler stunting rates of at least 20%. Five clusters per country were randomized to each of the food arms, with 30 infants in each cluster. The daily meat or cereal supplement was delivered to the home by community coordinators, starting when the infants were 6 months of age and continuing through 18 months. All participating mothers received nutrition education messages to enhance complementary feeding practices delivered by study coordinators and through posters at the local health center. Outcome measures, obtained at 6, 9, 12, and 18 months by a separate assessment team, included anthropometry, dietary variety and diversity scores, biomarkers of iron, zinc and Vitamin B(12) status (18 months), neurocognitive development (12 and 18 months), and incidence of infectious morbidity throughout the trial. The trial was supervised by a trial steering committee, and an independent data monitoring committee provided oversight for the safety and conduct of the trial. Discussion: Findings from this trial will test the efficacy of daily intake of meat commencing at age 6 months and, if beneficial, will provide a strong rationale for global efforts to enhance local supplies of meat as a complementary food for young children

Revisitando o desmame precoce através de recortes da história Revisando el destete precoz a través de recortes de la historia Revisiting early weaning through historical analysis

A ação básica de saúde requer estratégia direcionada quanto à tomada de consciência da importância do aleitamento materno, principalmente para redução da morbi-mortalidade infantil. A história da amamentação mostra um hiato sobre como os povos lidaram com o desmame precoce. Objetiva-se, neste estudo, revisitar o desmame precoce através de recortes históricos. A revisão bibliográfica foi a estratégia utilizada para este estudo. A amostra constou de livros, monografias, teses, dissertações, textos publicados em revistas científicas e artigos captados via Internet, no período de 1978 a 1998, os quais retratam histórias desde a época mitológica até os séculos atuais. A revisão apontou que o desmame é sócio-culturalmente construído e determinado e que a mulher, para manter o aleitamento materno, necessita não só de suporte/apoio familiar e social, mas também governamental.<br>La acción básica de salud requiere estrategias dirigidas hacia la toma de conciencia de la importancia del amamantamiento materno principalmente para la disminución de la morbi-mortalidad infantil. La historia del amamantamiento muestra un vacío acerca de cómo los pueblos lidiaron con el destete precoz. El presente estudio pretende revisar el destete precoz a través de recortes históricos. La revisión bibliográfica fue la estrategia utilizada para el estudio. La muestra estuvo compuesta por libros, monografías, tesis, disertaciones, textos publicados en las revistas científicas capturados a través de Internet en el periodo de 1978 a 1998, los cuales retratan la historia desde la época mitológica hasta los siglos más actuales. La revisión mostró que el destete es socialmente construido y determinado y que la mujer para mantener la lactancia materna necesita no solo de soporte familiar y social si no también del apoyo gubernamental.<br>Basic health actions require strategies towards awareness development concerning the importance of breastfeeding, particuarly aiming at the reduction of child morbi-mortality The history of breastfeeding presents a gap of information about how people have dealt with early weanin. This study aimed at revisiting early weaning the historical analysis of breastfeeding. The literture review methodology was used. The samples consisted of books, monographs, theses, dissertations, texts published in scientific journals and scientific articles obtained through the internet in the period of 1978 to 1998. These sources portray stories from mythological times up to this day. The review pointed out that weaning is socially and culturally constructed and determined and that, in order to maintain breastfeeding, women require not only social and family support, but also governmental support