Preschool child feeding, health and nutritional status in Gualaceo, Ecuador.

Anthropologic, survey, dietary recall and anthropometric techniques were used to study the correlates of nutritional status of preschool children under five years of age in Gualaceo Ecuador. A widespread stunting was found among the children. Nutritional status was worst among infants comprised between 12 and 23 months old but it improved between April and August, thus suggesting seasonality changes of nutritional status. The correlates of nutritional status (expressed as Z score of weight-for-age) were dietary diversity, birth-spacing, fertility, migration, household income, material goods owned, and parental education. A regression model with these variables predicted 63% of the variability in weight-for-age. The prediction of height-for-age was similar, but only predicted 43% of the variability in height-for-age. Correlates of dietary diversity, birth-spacing, fertility, and migration were child age, maternal age and arm circumference, parental education, use of birth control, household food expenditure, material goods owned, and the raising of animals. Parental education was a correlate of dietary diversity, fertility and migration. Parental education was related to change in weight-for-age in the longitudinal subset. Pre-harvest time and a pathway of illness leading to decreased dietary diversity and to decreased nutritional status in April, were suggested as important to preschool child nutritional status. Hot-cold ideology--resulting in food withdrawal during illness and restriction of high-protein and high-calorie foods--appears to be an important mechanism determining preschool child nutritional status. Breast-feeding, sanitary, higienic, birth control, and drinking (alcohol) practices were suggested as areas that could be improved, in order to improve preschool child nutritional status. Communication between parents and western health care providers was also suggested as an area for improvement.

Breast milk consumption in rural Costa Rica.

Breast milk consumption was measured in 20 breast-feeding infants, aged two days to six months. This was achieved by test-weighing infants before and after every feeding over a 24-hour period. Infant length, weight, number of breast-feedings, and time spent sucking were also measured. The mean consumption among 10 full breast-feeders (no supplementation) was 639 +/- 214 ml/day at a mean age of 42 +/- 36 days, and 396 +/- 249 ml/day at a mean age of 95 +/- 53 days for ten breast-feeders receiving supplements (partial breast-feeders). Significant correlations were found between the number of feedings per day and breast milk consumption (ml/day) when examining all twenty infants (r = 0.788, p less than 0.01) and the ten partial breast-feeders (r = 0.903, p less than 0.01), but not the ten full breast-feeders (r = 0.431). Correlations between the time sucking per day (min/day), and breast milk consumption (ml/day), were again significant for all twenty infants (r = 0.576 p less than 0.01) and partial breast-feeders (r = 0.728, p less than 0.02), but not for full breast-feeders (r = 0.357). The weight-for-length ratio for full breast-feeders ranged from 94 to 135% of the 50th percentile of the National Center for Health Statistics (NCHS) curves, while for partial breast-feeders it ranged from 103 to 141%. Both groups show adequate growth in this poor, rural area of Costa Rica.