Quality of food and nutritional condition in infants born with low weight

Abstract

The prevalence of low birth weight (LBW) is used as an indicator of public health and is related directly with the child morbidity and early neonatal mortality. It is also a risk factor for inadequacy of growth, neuropsychomotor development and increased injury risk to chronic non-communicable diseases in the future, such as hypertension, obesity, type 2 diabetes mellitus and cardiovascular disease. The association between LBW and susceptibility to chronic diseases in adults involves not only the adequacy of birth weight, but also the course of postnatal growth that would contribute to the development of metabolic changes during childhood/adolescence. Children with LBW who exhibited excessive weight gain in the early years of life has a greater chance of developing obesity, hypertension, diabetes and cardiovascular disease in adult life. The type of feeding is one of the main factors that defines the growth standard of infants during the first months of life. The recommendations from the World Health Organization (WHO), the Brazilian Society of Pediatrics (SBP) and Ministry of Health (MS) (exclusive breastfeeding for six months, with other foods for up to two years or more and the introduction of complementary feeding from six months including all health food groups), aim to reduce the risk of malnutrition, overweight and lack of micronutrients in the short term, as well as the prevention of chronic diseases in the long term. According to data from the national survey of demography and health (PNDS2006) the median time of exclusive breastfeeding and total in Brazil is of two and nine months, respectively; we also observed a trend in all regions and economic levels, as the early introduction of foods with high fat content, salt, simple carbohydrates and low micronutrients. In infants with LBW the situation seems more serious. The few studies on the subject show the rates of breastfeeding (exclusive and total) are smaller and the introduction of solid foods happens too early. The repercussions of these inadequacies are not completely known. During the monitoring of growth and development (childcare) of infants with LBW, some characteristics are present. These children may be hospitalized for extended period of time, often feature low weight-related complications and/or prematurity (jaundice, infection, respiratory failure) and have less chance of being breastfeed. By the discharge time, these children's family often feels insecure and anxious, because they don't know if the child will grow and develop normally. About the weight gain and height there is, generally, the attempt to compensate, quickly what has been lost, which increases the risk for early and inadequate introduction of certain foods. In addition, several children are discharged from the Neonatal Unit with already mixed or artificial lactation due to neonatal complications, lack of staff's stimulus and family's ignorance about the benefits of breastfeeding for this group. The aim of this study is to describe the nutritional condition and the quality of complementary feeding of the low birth weight infants, between 6 to 24 months in Hospital Sao Paulo's Pediatrics ambulatory; describe the frequency and duration of exclusive breastfeeding, the age to start complementary feeding and vitamins supplementation; evaluate possible associations between nutritional condition and the quality of food and compare the nutritional status and the quality of feeding of infants with LBW with children born with adequate birth weight in ambulatory of General Pediatrics from Unifesp-EPM. (AU)