Age at introduction of complementary food and physical growth from 2 to 9 months in rural Senegal

Abstract

Objective: To compare nutritional status and physical growth among infants according to age at introduction of complementary food (CF). Design: A longitudinal observational study. Setting: Three health clinics in a rural area of Senegal. Subjects: During immunization sessions, 522 infants were recruited at 2–3 months. Complete data on three visits were available for 420 infants (4 visits: n=361); 73 were lost to follow-up and 29 had incomplete data. Main outcome measures: Increments in length and weight between adjacent visits. Results: Infants complemented at 2–3 months (n=50) had significantly lower length-for-age (P=0.014), weight-for-length (P<0.001) and arm circumference (P<0.0001) at 2–3 months than predominantly breastfed infants (n=370), after adjustment for residence, mother's age and education of parents. The growth in weight and length from 2–3 to 9–10 months did not differ. The infants complemented by 4–5 months, but not yet at 2–3 months, (n=94) had a slightly lower length increment from 4–5 to 6–7 months (1.42 vs 1.53 cm/mo, p<0.05) compared to infants predominantly breastfed at 4–5 months (n=276). The infants first complemented by 6–7 months (n=122) had increments from 6–7 to 9–10 months similar to those of predominantly breastfed infants (n=154). Conclusion: Introduction of CF by 2–3 months was associated with a low nutritional status, but not with slow growth from 2–3 to 9–10 months. Introduction of CF by 4–5 months was associated with slightly slower linear growth compared to later introduction. Sponsorship: The Niakhar study area was supported by Pasteur-Mérieux, Paris. Descriptors: infant feeding practices; breast-feeding; growth; weight; recumbent length