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  • Title: Early growth faltering of rural Mesoamerindian breast-fed infants.
    Author: Hernandez-Beltran M, Butte N, Villalpando S, Flores-Huerta S, Smith EO.
    Journal: Ann Hum Biol; 1996; 23(3):223-35. PubMed ID: 8807040.
    Abstract:
    Early growth faltering has been described in breast-fed infants 4-6 months of age from less-developed communities. The timing and magnitude of growth faltering, however, depends on the appropriateness or comparability of the reference used to evaluate growth performance. In this paper we compared the growth performance of a group of rural Mesoamerindian breast-fed infants from birth through 6 months of age to that of a reference group of breast-fed infants reared under favourable nutritional and environment conditions in the United States. The validity of this assessment is based upon the comparability of infant feeding mode. Mean weights and lengths and corresponding weight-for-age and length-for-age percentiles and z-scores were significantly lower among the Mesoamerindian (Otomi Indian) infants (p = 0.001). Mean weight-for-length percentiles and z-scores did not differ between groups. Weight gain (g/day) was significantly lower among the Otomi infants throughout the entire 6 months (p = 0.001). Length velocities of the Otomi infants were lower than reference infants at 3-6 months (p = 0.001). The growth pattern of the Otomi infants differed from that of the reference group: decreases in growth velocities and weight-for-age and length-for-age z-scores were significantly more precipitous for the Otomi infants between 4 and 6 months of age (p = 0.001). We conclude that growth faltering was evident among the Otomi infants between 4 and 6 months of age, relative to a reference growth of breast-fed infants. During 1986-89, for the first 6 months of life biweekly measurements were taken of the weight and length of 114 breast fed, healthy Mesoamerindian (Otomi) infants living in rural Capulhuac, Mexico, and their mothers were asked about infant feeding. Results were compared with a reference sample of 45 predominantly breast fed infants from Houston, Texas. The Otomi infants had birth weights and lengths lower than the National Center for Health Statistics (NCHS) medians, perhaps due to suboptimal gestational weight gains. They had significantly lower growth velocities (i.e., weight gain/day throughout entire 6 months and length gain/month for 3-6 months) than the reference infants (p = 0.001). They also had significantly lower NCHS percentiles and NCHS z-scores for weight-for-age and length-for-age than the Texas infants (p = 0.001). For example, at 6 months, the weight and length velocities of the Otomi were about 70% of the reference infants. The mean weight-for-length percentiles and z-scores were not significantly different between the 2 groups, however. Between 4 and 6 months of age, the decreases in growth velocities and NCHS weight-for-age and NCHS length-for-age z-scores of the Otomi infants were much more steep than those for the reference group (p = 0.001); for example, the decrease in weight-for-age was 0.44 for Otomi infants compared to 0.29 for the reference group, and the decrease in length-for-age was 0.43 and 0.18, respectively. In conclusion, the Otomi Indian breast fed infants experienced growth faltering between 4 and 6 months.
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