Biomedical subjects

J Canahuati

Publications and source records attributed to J Canahuati.

11 recordsLinked to original sources

PubMed1997

Effects of age at introduction of complementary foods to breast-fed infants on duration of lactational amenorrhea in Honduran women.

Lactational amenorrhea (LA) is associated with postpartum infertility and is known to be related to breast-feeding frequency and duration, but the exact role of complementary feeding of the infant has not been clearly defined. Data on LA were collected during and after a 2-mo intervention trial in which low-income Honduran women who had breast-fed fully for 4 mo were randomly assigned to one of three groups: continued full breast-feeding until 6 mo (FBF, n = 50), introduction of complementary foods at 4 mo with ad libitum breast-feeding from 4 to 6 mo (SF, n = 47), or introduction of complementary foods at 4 mo with maintenance of baseline breast-feeding frequency from 4 to 6 mo (SF-M, n = 44). Women were followed up until the infant was 12 mo of age, or later if menses had not occurred by then. All but six of the women continued to breast-feed for > or = 12 mo. With the exclusion of those whose menses returned before 18 wk postpartum (which could not have been due to the intervention), the proportion of women who were amenorrheic at 6 mo was 64.5% in the SF group, 80.0% in the FBF group, and 85.7% in the SF-M group (chi-square test = 4.13, P = 0.02; one-tailed test with the latter two groups combined). The total duration of LA did not differ significantly among groups. The most significant determinant of LA was time spent breast-feeding (min/d), which was in turn negatively associated (P = 0.06) with the infant's energy intake from complementary foods in regression analyses. These results indicate that there is a significant effect of introducing foods at 4 mo on the likelihood of amenorrhea at 6 mo postpartum, but not thereafter, and that this effect is not seen in mothers who maintain breast-feeding frequency.

Adolescent↗

PubMed1996

Prelacteal feeds are negatively associated with breast-feeding outcomes in Honduras.

The 1991/92 Epidemiology and Family Health Survey (ENESF) from Honduras was examined for associations between prelacteal feeds and breast-feeding outcomes. The ENESF is a self-weighted nationally representative survey that included 2380 women with children under the age of two. Multivariate logistic regression was used to examine the association between prelacteal feeds and breast-feeding practices among 0- to 6-mo-old infants (n = 714), and to identify factors associated with milk-based prelacteal feeds. Providing milk-based prelacteal feeds was negatively associated with both exclusive (odds ratio = 0.18) and any breast-feeding (0.21). Prelacteal water was negatively associated with exclusive breast-feeding (0.19). Both water- and milk-based prelacteal feeds were associated with a delayed milk arrival and a delay in the time at which the child was offered the breast for the first time. Our findings suggest that prelacteal feeds have an adverse effect on breast-feeding outcomes.

Adolescent↗

PubMed1996

Do exclusively breast-fed infants require extra protein?

It has been argued that the growth rate of exclusively breast-fed infants may be limited by their protein intake. This issue was examined using data from an intervention study in Honduras in which infants were randomly assigned to be exclusively breast-fed for the first 6 mo (EBF; n = 50), or to receive preprepared solid foods (including egg yolk) in addition to breast milk beginning at 4 mo (n = 91). Neither weight gain nor length gain from 4 to 6 mo differed between groups despite a 20% higher protein intake (as well as significantly higher intakes of iron, zinc, calcium, vitamin A, and riboflavine) in the latter group. The 20 infants with the highest protein intakes in that group were matched to 20 EBF infants on the basis of energy intake; protein intake was 1.46 +/- 0.09 versus 1.10 +/- 0.17 g/kg/d, respectively (p < 0.001), but growth rate did not differ between groups. Similarly, the 20 infants with the lowest protein intakes in the EBF group were matched (by energy intake) to 20 infants given solid foods; protein intake was very low in the former compared with the latter (0.81 +/- 0.13 versus 1.04 +/- 0.20 g/kg/d; p < 0.001), yet there was still no difference in growth. Infant morbidity was relatively low and did not influence the results. These analyses indicate that protein intake is not likely to be a limiting factor with regard to growth of breast-fed infants from 4 to 6 mo of age.

Body Height↗

PubMed1995

Maternal anthropometric status and lactation performance in a low-income Honduran population: evidence for the role of infants.

As part of a study on the optimal timing of complementary feeding in Honduras, we assessed breast milk volume and composition at 4, 5, and 6 mo in 141 low-income women who were randomly assigned to exclusively breast-feed for the first 6 mo or to complement breast milk with prepared solid foods beginning at 4 mo. Milk volume averaged 797 +/- 139 g/d at 4 mo. Maternal body mass index was positively associated with infant birth weight and milk energy density. In multivariate analyses in which group assignment was controlled for, milk volume was positively associated with birth weight but negatively associated with milk energy density. Infant breast milk energy intake was positively associated with birth weight and milk energy density. Maternal anthropometric status was not a significant predictor of milk volume or infant energy intake when birth weight and milk energy density were included in the models. These results indicate that infant characteristics, such as birth weight and the ability to self-regulate intake in response to milk energy density, mediate the relationship between maternal anthropometric status and lactation performance.

Anthropometry↗

PubMed1995

Delaying the introduction of complementary food until 6 months does not affect appetite or mother's report of food acceptance of breast-fed infants from 6 to 12 months in a low income, Honduran population.

Low income, primiparous mothers who had exclusively breast-fed for 4 mo were randomly assigned to one of three groups: 1) continued exclusive breast-feeding to 6 mo (EBF), 2) introduction of complementary foods at 4 mo, with ad libitum nursing 4-6 mo (SF), and 3) introduction of complementary foods at 4 mo, with maintenance of base-line nursing frequency 4-6 mo (SF-M). After the intervention phase (4-6 mo; n= 141), home visits were conducted for a subsample at 9 (n = 60) and 12 (n = 123) mo. At each visit, an observer recorded infant food intake at the midday meal and interviewed the mother regarding usual feeding patterns and the infant's acceptance of 20 common food items. All but two infants (1.5%) were breast-fed to 9 mo and all but eight (6%) to 12 mo. There were no significant differences among groups in breast-feeding frequency, amount or number of foods consumed at the midday meal, percentage of food offered that was consumed, usual daily number of meals and snacks, number of food groups consumed, or overall food acceptance score. Frequency of consumption of foods from eight different food groups (dairy, meats, eggs, grains, beans, fruits, vegetables, tubers) was not significantly different among groups except that, at 9 mo only, the SF group (but not the SF-M group) consumed more vegetables than did the EBF group. These results indicate that delaying the introduction of complementary foods until 6 mo does not adversely affect appetite or food acceptance among breast-fed infants.

Adolescent↗

PubMed1995

Determinants of growth from birth to 12 months among breast-fed Honduran infants in relation to age of introduction of complementary foods.

OBJECTIVES: To evaluate the impact of introducing complementary foods to exclusively breast-fed infants at 4 vs 6 months on growth from 6 to 12 months, and to compare growth patterns of Honduran infants with those of breast-fed infants in the United States. DESIGN: Randomized intervention trial from 4 to 6 months and longitudinal study of infants from birth to 12 months. SETTING: Low-income communities in San Pedro Sula, Honduras. SUBJECTS: Primiparous, breast-feeding mothers and their infants (n = 141) recruited from public maternity hospitals. INTERVENTION: Infants were randomly assigned to exclusive breast-feeding to 6 months, or exclusive breast-feeding with addition of hygienically prepared, nutritionally adequate complementary foods at 4 months, with or without maintenance of baseline breast-feeding frequency. After 6 months, mothers continued to breast-feed and also fed their infants home-prepared foods after receiving instruction in appropriate feeding practices. OUTCOME MEASURES: Infant weight was measured monthly during the first year of life and infant length monthly from 4 to 12 months. STATISTICAL ANALYSIS: Growth parameters were compared between the Honduran and US cohorts using multiple-regression and repeated-measures analysis of variance. Stepwise multiple regression was used to identify determinants of infant growth. RESULTS: There were no differences in growth patterns by intervention group. Mean birth weight of the Honduran infants was significantly less than that of a cohort of breast-fed infants in an affluent US population (n = 46) (2889 +/- 482 vs 3611 +/- 509 g), but the Honduran infants exhibited rapid catch up in weight in the first few months of life, and the cohorts were similar in weight by 3 months. Mean weight and length gain were similar to those of the US cohort from 4 to 9 months but were lower from 9 to 12 months. Mean length for age was significantly less than that of the US cohort from 4 to 12 months; this was attributable to the difference in maternal height (12 cm shorter in Honduras on average). Within the Honduran cohort, growth velocity of low birth weight infants (< 2500 g; n = 28) was similar to that of their normal birth weight peers; thus, the former subgroup remained smaller than the latter throughout the first year of life. CONCLUSIONS: In poor populations, when breast-feeding is exclusive for the first 4 to 6 months, continues from 6 to 12 months, and is accompanied by generally adequate complementary foods, faltering in weight does not occur before 9 months among infants born with birth weights of more than 2500 g.

Age Factors↗

PubMed1994

Effects of age of introduction of complementary foods on infant breast milk intake, total energy intake, and growth: a randomised intervention study in Honduras.

In developing countries, the age at which breastfed infants are first given complementary foods is of public health importance because of the risk of diarrhoeal disease from contaminated weaning foods, and the potential risk of growth faltering if foods are inappropriately delayed. To evaluate whether there are any advantage of complementary feeding prior to 6 months, low-income primiparous mothers who had exclusively breastfed for 4 months were randomly assigned to one of 3 groups: continued exclusive breastfeeding to 6 months (EBF) (n = 50); introduction of complementary foods at 4 months with ad libitum nursing from 4-6 months (SF) (n = 47); and introduction of complementary foods at 4 months, with maintenance of baseline nursing frequency from 4-6 months (SF-M) (n = 44). Baby foods in jars were provided to the SF and SF-M groups from 4 to 6 months. Subjects were visited weekly and provided with lactation guidance; at 4, 5, and 6 months measurements were made of infant intake and breast milk composition. At 4 months, breast milk intake averaged 797 (139) g per day (no difference among groups). Between 4 and 6 months, breast milk intake was unchanged in EBF infants (+6) but decreased in the SF (-103), and SF-M (-62) groups (p < 0.001). Change in total energy intake (including solid foods) and infant weight and length gain did not differ significantly between groups. Weight and length gain from 4-6 months were comparable to those of breastfed infants in an affluent USA population. The results indicate that breastfed infants self-regulate their total energy intake when other foods are introduced. As a result, there is no advantage in introducing complementary foods before 6 months in this population, whereas there may be disadvantages if there is increased exposure to contaminated weaning foods.

Adult↗

PubMed1994

Every mother is a working mother: breastfeeding and women's work.

Working and breastfeeding can be very complicated because of the kinds of work women are doing; the settings in which they are working; recent changes which have made breastfeeding and work less compatible; trade-offs that working mothers must make; the importance of breastfeeding for the working woman; and the range of feeding options for working mothers. To adequately address these and other issues, several initiatives are needed: (1) additional research on breast pumping and breastmilk storage, and the social and emotional benefits of breastfeeding for working mothers and their infants; (2) protective legislation and strategies for its implementation and monitoring; (3) information and support for breastfeeding mothers and families, policy markers, and the general public; and (4) an alliance between breastfeeding advocates and feminists to promote this intrinsically female issue.

Breast Feeding↗

PubMed1991

An evaluation of a national breast-feeding promotion programme in Honduras.

A significant increase occurred in the initiation and duration of breast-feeding among Honduran women between 1981 and 1987. Changes in population characteristics (e.g. level of education of women) would be expected to lead to a decrease in breast-feeding at each infant age, but these were offset by behavioural changes that led to an increase in the likelihood of initiation and continuation of breast-feeding. An exploration of relevant factors suggests that the PROALMA breast-feeding promotion programme has had a profound effect on the breast-feeding behaviour of Honduran mothers.

Breast Feeding↗

PubMed1990

One country's story: the PROALMA program in Honduras.

The first phase of the PROALMA project in Honduras resulted in changed hospital breastfeeding practices within as little as 2 years. These changes affected the community, lengthening the duration of exclusive breastfeeding to 1-2 months and the duration of any breastfeeding to 12 months. The second phase of the project sought to extend the program nationwide. One of the original pilot hospitals in San Pedro Sula was well along in breastfeeding promotion but felt there were still problems in breastfeeding education and the integration with family planning services. Following retraining of staff and the opening of a Breastfeeding Clinic and a Temporary Methods Family Planning Clinic, there have been improvements in both areas.

Breast Feeding↗

PubMedDate not supplied

Supporting breastfeeding: current status and future challenges.

Although breastfeeding is an optimal source of nutrition that promotes the health and development of infants, rates of breastfeeding have been declining. International conventions and strategies, such as the Innocenti Declaration and the 10 Steps to Successful Breastfeeding, are helping to educate society about the benefits of breastfeeding and to create supports for mothers and their children, but advocacy and education are still needed

Breast Feeding↗