Growth and nutritional status of formula-fed infants aged 2-10 weeks in the Prevention of Mother-to-Child Transmission (PMTCT) Programme at the Dr George Mukhari Hospital, Gauteng, South Africa

MacDougall, Caida (2008-12)

Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--Stellenbosch University, 2008.

Thesis

INTRODUCTION: Since the start of the Prevention of Mother-to-Child Transmission (PMTCT) Programme at Dr George Mukhari Hospital in 2001, there has been no evaluation of the effect of formula feeding on the growth and dietary intakes of enrolled infants. AIM: The aim of this study was to determine the short-term growth, anthropometry and dietary intake of infants from two to ten weeks of age were entered into the PMTCT Programme at the Department of Human Nutrition at Dr George Mukhari Hospital from two to ten weeks of age. METHODS: This was a descriptive, longitudinal (eight weeks duration) study. Anthropometric assessment including length and head circumference was performed at two weeks of age and thereafter at ten weeks of age. Weight measurement was performed at age two weeks (visit 1), six weeks (visit 2) and ten weeks (visit 3). Anthropometric measurements were compared with CDC 20003 growth charts. Feeding practices and dietary intake (24 hour diet recall interview) were assessed at each of the four week interval visits and evaluated according to the DRIs59. At the third visit, a socio-demographic interview and a usual food intake interview were performed. RESULTS: A total of 151 [male (N = 75) and female (N = 76)] infants completed the study. A total of 110 (72%) mothers resided in the Soshanguve area and 138 (91%) of the mothers had attended high school. The majority (75%) of mothers was not generating an income from employment. Generally, mothers had access to safe drinking water and all (99%) but two mothers used pre-boiled water before preparing infant formula. The accuracy and correctness of reconstituting infant formula decreased with each visit as feeds were increasingly made too dilute. A total of 124 (82%) infants were exclusively formula fed. The remainder received water, water with sugar and/or complementary feeds. Mean energy and macronutrient intakes of both males (N = 65, 87%) and females (N = 61, 80%) were below recommendations at age two weeks. Of all the macronutrients, fats were consumed the least by both males (N = 67, 89%) and females (N = 66, 87%) at visit 1. Catch up growth was evident and nutrient intakes improved as the study progressed. The mean weight gain of all infants from visit 1 to 2 was 1.2 (SD 0.3) kg and 0.9 (SD 0.3) kg from visit 2 to 3 (exceeding the CDC 20003 recommendation for both male and female infants). The incidence of underweight, wasting and head circumference-for-age below the third percentile decreased from visit 1 to 3, but the number of stunted infants increased towards visit 3. The majority of infants in this study grew well in their first ten weeks of life. Growth accelerated as infants became older and growth faltering improved by ten weeks of age. CONCLUSION: Overall, the growth of the infants referred to the PMTCT Programme at the Department of Human Nutrition at Dr George Mukhari Hospital would appear to be adequate but mothers’ approach to formula feeding practices needs to be improved in some aspects of feeding their infants.

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