Appropriate infant feeding practices result in better growth of infants and young children in rural Bangladesh

BACKGROUND: The World Health Organization and the United Nations International Children's Emergency Fund recommend a global strategy for feeding infants and young children for proper nutrition and health. OBJECTIVE: We evaluated the effects of following current infant feeding recommendations on the growth of infants and young children in rural Bangladesh. DESIGN: The prospective cohort study involved 1343 infants with monthly measurements on infant feeding practices (IFPs) and anthropometry at 17 occasions from birth to 24 mo of age to assess the main outcomes of weight, length, anthropometric indexes, and undernutrition. We created infant feeding scales relative to the infant feeding recommendations and modeled growth trajectories with the use of multilevel models for change. RESULTS: Mean (+/-SD) birth weight was 2697 +/- 401 g; 30% weighed < 2500 g. Mean body weight at 12 and 24 mo was 7.9 +/- 1.1 kg and 9.7 +/- 1.3 kg, respectively. More appropriate IFPs were associated (P < 0.001) with greater gain in weight and length during infancy. Prior IFPs were also positively associated (P < 0.005) with subsequent growth in weight during infancy. Children who were in the 75th percentile of the infant feeding scales had greater (P < 0.05) attained weight and weight-for-age z scores and lower proportions of underweight compared with children who were in the 25th percentile of these scales. CONCLUSIONS: Our results provide strong evidence for the positive effects of following the current infant feeding recommendations on growth of infants and young children. Intervention programs should strive to improve conditions for enhancing current infant feeding recommendations, particularly in low-income countries.