Feeding practices and growth patterns of moderately low birthweight infants in resource-limited settings: results from a multisite, longitudinal observational study
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 &...
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/2/e067316.full |
| _version_ | 1797894925024493568 |
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| author | Christopher R Sudfeld Karim Manji Rodrick Kisenge Mohamed Bakari Tisungane Mvalo Irving Hoffman Stuart Lipsitz Melda Phiri Christopher Duggan Anne C C Lee Griffith Bell Lauren Spigel Bethany A Caruso Nahya Salim Katherine E A Semrau Yogesh Kumar Shivaprasad S Goudar Linda Vesel Melissa Young Esther Velasquez Friday Saidi Roopa M Bellad Leena Das Sangappa Dhaded Gowdar Guruprasad Sujata Misra Sanghamitra Panda Latha G Shamanur Sunil S Vernekar Sarah Somji Linda Adair Kiersten Israel-Ballard Stephanie L Martin Kimberly L Mansen Krysten North Eliza Fishman Katelyn Fleming Danielle E Tuller Katharine Miller Kristina Lugangira Kingsly Msimuko Fadire Nyirenda Veena Herekar M B Koujalagi Manjunath Somannavar Rana R Mokhtar Arthur Pote |
| author_facet | Christopher R Sudfeld Karim Manji Rodrick Kisenge Mohamed Bakari Tisungane Mvalo Irving Hoffman Stuart Lipsitz Melda Phiri Christopher Duggan Anne C C Lee Griffith Bell Lauren Spigel Bethany A Caruso Nahya Salim Katherine E A Semrau Yogesh Kumar Shivaprasad S Goudar Linda Vesel Melissa Young Esther Velasquez Friday Saidi Roopa M Bellad Leena Das Sangappa Dhaded Gowdar Guruprasad Sujata Misra Sanghamitra Panda Latha G Shamanur Sunil S Vernekar Sarah Somji Linda Adair Kiersten Israel-Ballard Stephanie L Martin Kimberly L Mansen Krysten North Eliza Fishman Katelyn Fleming Danielle E Tuller Katharine Miller Kristina Lugangira Kingsly Msimuko Fadire Nyirenda Veena Herekar M B Koujalagi Manjunath Somannavar Rana R Mokhtar Arthur Pote |
| author_sort | Christopher R Sudfeld |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-10T07:18:16Z |
| format | Article |
| id | doaj.art-2ea9ada0e12d43389a01c819f2b66a0a |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-10T07:18:16Z |
| publishDate | 2023-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-2ea9ada0e12d43389a01c819f2b66a0a2023-02-24T23:00:11ZengBMJ Publishing GroupBMJ Open2044-60552023-02-0113210.1136/bmjopen-2022-067316Feeding practices and growth patterns of moderately low birthweight infants in resource-limited settings: results from a multisite, longitudinal observational studyChristopher R Sudfeld0Karim Manji1Rodrick Kisenge2Mohamed Bakari3Tisungane Mvalo4Irving Hoffman5Stuart Lipsitz6Melda Phiri7Christopher Duggan8Anne C C Lee9Griffith Bell10Lauren Spigel11Bethany A Caruso12Nahya Salim13Katherine E A Semrau14Yogesh Kumar15Shivaprasad S Goudar16Linda Vesel17Melissa Young18Esther Velasquez19Friday Saidi20Roopa M Bellad21Leena Das22Sangappa Dhaded23Gowdar Guruprasad24Sujata Misra25Sanghamitra Panda26Latha G Shamanur27Sunil S Vernekar28Sarah Somji29Linda Adair30Kiersten Israel-Ballard31Stephanie L Martin32Kimberly L Mansen33Krysten North34Eliza Fishman35Katelyn Fleming36Danielle E Tuller37Katharine Miller38Kristina Lugangira39Kingsly Msimuko40Fadire Nyirenda41Veena Herekar42M B Koujalagi43Manjunath Somannavar44Rana R Mokhtar45Arthur Pote46Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USADepartment of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, TanzaniaDepartment of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, TanzaniaDepartment of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, TanzaniaUniversity of North Carolina Project Malawi, Lilongwe, MalawiInstitute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USAAriadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women`s Hospital, Boston, Massachusetts, USAUniversity of North Carolina Project Malawi, Lilongwe, MalawiCenter for Nutrition, Boston Children’s Hospital, Boston, Massachusetts, USADepartment of Pediatric Newborn Medicine, Brigham and Women`s Hospital, Boston, Massachusetts, USAAriadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women`s Hospital, Boston, Massachusetts, USAAriadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women`s Hospital, Boston, Massachusetts, USAHubert Department of Global Health, Emory University School of Public Health, Atlanta, Georgia, USADepartment of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, TanzaniaAriadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women`s Hospital, Boston, Massachusetts, USAJawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, IndiaJawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, IndiaAriadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women`s Hospital, Boston, Massachusetts, USAHubert Department of Global Health, Emory University School of Public Health, Atlanta, Georgia, USADepartment of Epidemiology and Population Health, Stanford University, Palo Alto, California, USAUniversity of North Carolina Project Malawi, Lilongwe, MalawiJawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, IndiaDepartment of Paediatrics, SCB Medical College & Hospital, Cuttack, Orissa, IndiaJawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, IndiaDepartment of Paediatrics, JJM Medical College, Davangere, Karnataka, IndiaDepartment of Paediatrics, SCB Medical College & Hospital, Cuttack, Orissa, IndiaDepartment of Paediatrics, City Hospital, Cuttack, Orissa, IndiaDepartment of Paediatrics, SS Institute of Medical Sciences and Research Center, Davangere, Karnataka, IndiaJawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, IndiaDepartment of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, TanzaniaDepartment of Nutrition, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina, USAMaternal, Newborn, Child Health and Nutrition Program, PATH, Seattle, Washington, USADepartment of Nutrition, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina, USAMaternal, Newborn, Child Health and Nutrition Program, PATH, Seattle, Washington, USADepartment of Pediatric Newborn Medicine, Brigham and Women`s Hospital, Boston, Massachusetts, USAAriadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women`s Hospital, Boston, Massachusetts, USAAriadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women`s Hospital, Boston, Massachusetts, USAAriadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women`s Hospital, Boston, Massachusetts, USAAriadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women`s Hospital, Boston, Massachusetts, USADepartment of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, TanzaniaUniversity of North Carolina Project Malawi, Lilongwe, MalawiUniversity of North Carolina Project Malawi, Lilongwe, MalawiJawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, IndiaDepartment of Paediatrics, JJM Medical College, Davangere, Karnataka, IndiaJawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, IndiaAriadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women`s Hospital, Boston, Massachusetts, USAAriadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women`s Hospital, Boston, Massachusetts, USAObjectives 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.https://bmjopen.bmj.com/content/13/2/e067316.full |
| spellingShingle | Christopher R Sudfeld Karim Manji Rodrick Kisenge Mohamed Bakari Tisungane Mvalo Irving Hoffman Stuart Lipsitz Melda Phiri Christopher Duggan Anne C C Lee Griffith Bell Lauren Spigel Bethany A Caruso Nahya Salim Katherine E A Semrau Yogesh Kumar Shivaprasad S Goudar Linda Vesel Melissa Young Esther Velasquez Friday Saidi Roopa M Bellad Leena Das Sangappa Dhaded Gowdar Guruprasad Sujata Misra Sanghamitra Panda Latha G Shamanur Sunil S Vernekar Sarah Somji Linda Adair Kiersten Israel-Ballard Stephanie L Martin Kimberly L Mansen Krysten North Eliza Fishman Katelyn Fleming Danielle E Tuller Katharine Miller Kristina Lugangira Kingsly Msimuko Fadire Nyirenda Veena Herekar M B Koujalagi Manjunath Somannavar Rana R Mokhtar Arthur Pote Feeding practices and growth patterns of moderately low birthweight infants in resource-limited settings: results from a multisite, longitudinal observational study BMJ Open |
| title | Feeding practices and growth patterns of moderately low birthweight infants in resource-limited settings: results from a multisite, longitudinal observational study |
| title_full | Feeding practices and growth patterns of moderately low birthweight infants in resource-limited settings: results from a multisite, longitudinal observational study |
| title_fullStr | Feeding practices and growth patterns of moderately low birthweight infants in resource-limited settings: results from a multisite, longitudinal observational study |
| title_full_unstemmed | Feeding practices and growth patterns of moderately low birthweight infants in resource-limited settings: results from a multisite, longitudinal observational study |
| title_short | Feeding practices and growth patterns of moderately low birthweight infants in resource-limited settings: results from a multisite, longitudinal observational study |
| title_sort | feeding practices and growth patterns of moderately low birthweight infants in resource limited settings results from a multisite longitudinal observational study |
| url | https://bmjopen.bmj.com/content/13/2/e067316.full |
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