Improving nutritional status of children with cystic fibrosis at Red Cross War Memorial Children's Hospital.

AIM: To determine the nutritional status of children attending a cystic fibrosis clinic in a tertiary hospital in South Africa and compare it to previously reported 10-year rates. METHODS: Weights and heights were measured of 69 (37 male and 32 female) children aged between 1 year and 18 years. Expected weight-for-age, expected height-for-age, expected weight-for-height and body mass index (BMI) were compared with international standards for underweight, stunting, wasting and BMI goal. RESULTS: The nutritional status of the patients has improved over the last 10 years, most significantly for wasting, which decreased from 58.3% in 1996 to 15.9% in 2006 (95% confidence interval (CI), 1.315-14.09, P < 0.05). Fifty-two percent of the children were underweight in 2006, compared with 66.7% in 1996 (95% CI, 0.044-13.96, P < 0.05). Stunting was found in 31.9% of the current sample. Females over 15 years had expected weight-for-age 25.9% lower than those between 10 years and 15 years, while no difference was found between the male age groups. Female height-for-age was 7.06 percentage points greater than males between 10 years and 15 years (95% CI, 2.16-11.96, P < 0.01). Males between 10 years and 15 years had significantly lower BMIs than the corresponding female group. Coloured patients had significantly lower BMIs than white patients in all age groups. CONCLUSIONS: These children demonstrated continuing improvement in nutritional status, although deficits remain. The normalisation of mean weight-for-age and weight-for-height with far fewer wasted patients is encouraging. Interventions are needed in some areas to ensure that all children show progress.

The rationale for adopting current international breastfeeding guidelines in South Africa.

Current international breastfeeding guidelines recommend exclusive breastfeeding for 6 months, followed by the appropriate and adequate introduction of complementary foods at 6 months, with continued breastfeeding for 2 years and beyond. This guideline is based on evidence to support exclusive and extended breastfeeding as the optimal method of feeding infants and young children. Not only do these breastfeeding practices meet the nutrition needs of infants and children for optimal growth and development, but they also offer a host of other health and socio-economic benefits at all levels of society. The poor breastfeeding rates and increase in infant and child morbidity and mortality in South Africa have led to increased prioritized attention towards the promotion, protection and support of breastfeeding. In 2000, the National Department of Health formally adopted the international breastfeeding guidelines for exclusive and extended breastfeeding practices. Therefore, it remains a priority to implement these guidelines in all current and future breastfeeding programmes and interventions, including the South African paediatric food-based dietary guidelines.