Abstract
The aims of this study were (i) to determine the dietary intake of women in a poor rural area during pregnancy and lactation, and (ii) to determine the nutritional status and dietary intake of their infants at age 6 months. We recruited 46 women, below 40 years old, in their 2nd trimester of pregnancy. The subjects were living in a rural area of Limpopo Province. Their heights and weights were recorded, as were their diets during pregnancy and for the first 6 months after delivery. We also recorded weights, lengths, and dietary intake of the infants at 3 and 6 months after birth. The subjects were living in severe poverty: none had running water and almost all did their cooking over an open fire. None of the subjects smoked and only one consumed alcohol. The diets of the subjects consisted mainly of maize, brown bread, sweetened beverages (cold drink and tea), and small amounts of vegetables and chicken. The diets were adequate in protein but were marginal in energy and in dietary fibre, and may be deficient in numerous micronutrients, particularly calcium, iron, zinc, niacin, folate, and vitamins A, C, E, and B6. This was seen during pregnancy and lactation. Blood analysis 6 months after birth revealed normal levels of vitamins A and E and an absence of anaemia. Body mass index (BMI) of the women was 23.9 +/- 5.3 kg/m2 (mean +/- SD) when measured 6 months after birth. Those above 25 years old had a higher BMI than did younger subjects (25.5 vs. 22.2; p = 0.028). Overall, 24% were overweight (BMI 25-30) while 9% were obese (BMI > 30). Most infants (93%) were breastfed for at least 6 months but exclusive breastfeeding was only done by 65% of mothers. One-third of breastfed infants also received formula. The use of formula while breastfeeding was twice as common among mothers aged above 25 years (46% vs. 23%). Early introduction of solid foods was very common in this group. Younger mothers introduced solids in the first month (51%) more often compared with older mothers who tended to introduce solids at 2-3 months (64%). The most common solid food given was maize meal porridge (by 78% of all mothers). Mean BMI was low at birth (< 15), but this reached a normal value by 6 months. A significant fraction of the infants was underweight or short (i.e., stunted), based on being below the 3rd percentile compared with NCHS standards. Underweight was short length in girls. This study found that pregnant and lactating women had diets low in energy and micronutrients as reflected by the high prevalence of underweight at birth. Most infants were exclusively breastfed, but the benefit of this was offset by the early introduction of solid foods having a low energy and nutrient density. By 6 months, the prevalence of stunting had more than doubled.
Highlights
Several studies have furnished strong evidence that nutritional problems are frequently found in infants and children in South Africa
Most infants were exclusively breastfed, but the benefit of this was offset by the early introduction of solid foods having a low energy and nutrient density
Mean Body mass index (BMI) was low at birth (< 15), but this reached a normal value by 6 months
Summary
As a manifestation of chronic malnutrition, is highly prevalent in children aged 1-3 years (26%) and decreases to 13% at ages 7-9 years (Labadarios et al, 2000:194). The higher prevalence at ages 1-3 years was found in a national anthropometric study of pre-school children in 1994 (SAVACG, 1995:106). Stunting was seen in 17% of those aged 6-11 months, and in 23% of children at both 1-2 years and 2-3 years of age. These findings indicate, that stunting was already evident in many children by 6 months and that this number increased from there until 3 years where after it decreased in school-going children. It is postulated that this may be an outcome of poor diet
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