Abstract
ObjectiveThis study was aimed to examine the effect of feeding patterns on growth and nutritional status of children aged 0~24 months.MethodsWe conducted a cohort study with an initial sample of 927 children. Considering the follow-up losses, 903, 897, 895, 897, 883, 827 and 750 children were followed up at 1, 3, 6, 8, 12, 18 and 24 months, respectively. Children were grouped according to exclusive breastfeeding (EBF) duration in the first 6 months: (1) never EBF; (2) EBF ≤ 3 months: EBF ≤ 3 months and stopped BF after 3 months or EBF ≤ 3 months and BF = 6 months or EBF ≤ 3 months and BF after 3 months, had formula and/or solids; (3) EBF for 3 ~ 6 months: BF < 3 months and EBF for 3 ~ 6 months or EBF for 3 ~ 6 months and BF < 3 months, had formula and/or solids; (4) EBF = 6 months. We used Z-scores to evaluate the growth and nutritional status of children, used the generalized estimation equation to compare the difference between feeding patterns.ResultsThe generalized estimation equation results showed that Weight-for-age Z-score (WAZ), Length-for-age Z-score (LAZ), and Weight-for-length Z-score (WLZ) in different feeding patterns had statistical significance. The WAZ in EBF for 6 months group was higher in the first 8 months, in never EBF group was higher after 12 months old; the LAZ in EBF for 6 month group was lower than other groups; the WLZ in EBF for 6 months group was higher than EBF for 3 ~ 6 months group. The EBF ≤ 3 months group had higher underweight, stunting, and wasting rates. The EBF for 6 months had a higher stunting rate; the never EBF and EBF for 6 months groups had higher overweight and obesity rates.ConclusionsIn conclusion, different feeding patterns affect growth and nutritional status in children, so proper guidelines should be implemented to improve nutritional status and promote the growth of children.
Highlights
Human milk is a critical source of nutrients for the first 6 months of life and a significant component of nutritional requirements for the first 2 years of life[1,2]
The generalized estimation equation results showed that Weight-for-age Z-score (WAZ), Length-for-age Z-score (LAZ), and Weight-for-length Z-score (WLZ) in different feeding patterns had statistical significance
The WAZ in exclusive breastfeeding (EBF) for 6 months group was higher in the first 8 months, in never EBF group was higher after 12 months old; the LAZ in EBF for 6 month group was lower than other groups; the WLZ in EBF for 6 months group was higher than EBF for 3 ~ 6 months group
Summary
Human milk is a critical source of nutrients for the first 6 months of life and a significant component of nutritional requirements for the first 2 years of life[1,2]. The position of the Academy of Nutrition and Dietetics is that exclusive breastfeeding provides optimal nutrition and health protection for the first six months of life and that breastfeeding with complementary foods from 6 months until at least 12 months of age is the ideal feeding pattern for children[4]. Compared to children who did not breastfeed, children who were exclusively breastfed until four-month-old, followed by mixed breastfeeding had better communication, social interaction, and cognition[11]. The WHO and the United Nations Children’s Fund recommended that children initiated breastfeeding within the first hour of birth[12] and were exclusively breastfed for the first 6 months of life, from the age of 6 months, children should begin eating safe and adequate complementary food while continuing to breastfeed for up to two years and beyond[13]. The early nutritional status of the children is related to their feeding pattern; a study demonstrated that the Infant and Child Feeding Index had a significant association with height, weight, height-for-age Z-score and weight-for-age Z-score[14]
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