Navegando por Autor "Caulfield, Laura E."
Agora exibindo 1 - 9 de 9
- Resultados por página
- Opções de Ordenação
Artigo Characteristics associated with the transition to partial breastfeeding prior to 6-months of age: data from seven sites in a birth cohort study(Wiley, 2021) Maciel, Bruna Leal Lima; Richard, Stephanie A.; McCormick, Benjamin J. J.; Murray-Kolb, Laura E.; Patil, Crustal L.; Chandyo, Ram K.; Mahopo, Cloupas; Bose, Anuradha; Mahfuz, Mustafa; Ambikapathi, Ramya; Olortegui, Maribel Paredes; Caulfield, Laura E.The WHO recommends exclusive breastfeeding for the first 6 months of life. However, the transition of the infants' diet to partial breastfeeding with the addition of animal milks and/or solids typically occurs earlier than this. Here, we explored factors associated with the timing of an early transition to partial breastfeeding across seven sites of a birth cohort study in which twice weekly information on infant feeding practices was collected. Infant (size, sex, illness and temperament), maternal (age, education, parity and depressive symptoms), breastfeeding initiation practices (time of initiation, colostrum and pre-lacteal feeding) and household factors (food security, crowding, assets, income and resources) were considered. Three consecutive caregiver reports of feeding animal milks and/or solids (over a 10-day period) were characterized as a transition to partial breastfeeding, and Cox proportional hazard models with time (in days) to partial breastfeeding were used to evaluate associations with both fixed and time-varying characteristics. Overall, 1470 infants were included in this analysis. Median age of transition to partial breastfeeding ranged from 59 days (South Africa and Tanzania) to 178 days (Bangladesh). Overall, higher weight-forlength z-scores were associated with later transitions to partial breastfeeding, as were food insecurity, and infant cough in the past 30 days. Maternal depressive symptoms (evaluated amongst 1227 infants from six sites) were associated with an earlier transition to partial breastfeeding. Relative thinness or heaviness within each site was related to breastfeeding transitions, as opposed to absolute z-scores. Further research is needed to understand relationships between local perceptions of infant body size and decisions about breastfeedingArtigo Dietary intake from complementary feeding is associated with intestinal barrier function and environmental enteropathy in Brazilian children from the MAL-ED cohort study(British Journal of Nutrition, 2020-05) Maciel, Bruna Leal Lima; Costa, Priscila Nunes; Soares, Alberto Melo; Silva Filho, José Quirino da; Sousa Júnior, Francisco; Ambikapathi, Ramya; McQuade, Elizabeth T. Rogawski; Guerrant, Richard L.; Caulfield, Laura E.; Lima, Aldo Ângelo MoreiraA child’s diet contains nutrients and other substances that influence intestinal health. The present study aimed to evaluate the relations between complementary feeding, intestinal barrier function and environmental enteropathy (EE) in infants. Data from 233 children were obtained from the Brazilian site of the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project cohort study. Habitual dietary intake from complementary feeding was estimated using seven 24-h dietary recalls, from 9 to 15 months of age. Intestinal barrier function was assessed using the lactulose–mannitol test (L–M), and EE was determined as a composite measure using faecal biomarkers concentrations – α-1-antitrypsin, myeloperoxidase (MPO) and neopterin (NEO) at 15 months of age. The nutrient adequacies explored the associations between dietary intake and the intestinal biomarkers. Children showed adequate nutrient intakes (with the exception of fibre), impaired intestinal barrier function and intestinal inflammation. There was a negative correlation between energy adequacy and L–M (ρ = −0·19, P < 0·05) and between folate adequacy and NEO concentrations (ρ = −0·21, P < 0·01). In addition, there was a positive correlation between thiamine adequacy and MPO concentration (ρ = 0·22, P < 0·01) and between Ca adequacy and NEO concentration (ρ = 0·23; P < 0·01). Multiple linear regression models showed that energy intakes were inversely associated with intestinal barrier function (β = −0·19, P = 0·02), and fibre intake was inversely associated with the EE scores (β = −0·20, P = 0·04). Findings suggest that dietary intake from complementary feeding is associated with decreased intestinal barrier function and EE in childrenArtigo Evolution of infant feeding practices in children from 9 to 24 months, considering complementary feeding indicators and food processing: results from the brazilian cohort of the mal-ed study(Wiley, 2022-08) Maciel, Bruna Leal Lima; Andrade, Eva Débora de Oliveira; Rebouças, Amanda de Sousa; Silva Filho, José Quirino da; Ambikapathi, Ramya; Caulfield, Laura E.; Lima, Aldo Ângelo MoreiraInfant feeding practices impact children's nutritional and health status, influencing growth and development. This study aimed to analyse the evolution of infant feeding practices from 9 to 24 months of age, considering infant and young child feeding (IYCF) indicators and food processing. The infant feeding practices in children from the Brazilian site of the MAL‐ED study were evaluated at 9 (n = 193), 15 (n = 182) and 24 months (n = 164) using 24‐h dietary recalls. IYCF indicators were evaluated, and the extent of food processing was evaluated, using the NOVA classification. Breastfeeding declined significantly over time, from 77.6% at 9 months to 45.1% at 24 months. Although dietary diversity did not significantly change during the study period (80.5% at 24 months), the minimum acceptable diet significantly increased from 67.9% to 76.1% at 24 months (p < 0.0005). All the studied children consumed sweetened beverages from 9 months. Unhealthy food consumption and zero vegetable or fruit consumption significantly increased over time (p < 0.0005). Unprocessed food consumption decreased from 9 to 24 months of age (p < 0.0005), while ultra‐processed food consumption increased (p < 0.0005) during the study period. Logistic regressions showed that, at 9 months, breastfed children presented a lower risk for ultra‐processed food consumption (odds ratio [OR] = 0.31; 95% confidence interval [CI] = 0.13–0.77); and children reaching the minimum acceptable diet presented more risk for ultra‐processed food consumption (OR = 2.31; 95% CI = 1.01–5.27). In conclusion, data showed a reduction in the quality of infant feeding practices over the first 2 years of life, with a decrease in breastfeeding and an increase in the consumption of unhealthy and ultra‐processed foodsArtigo Higher energy and zinc Intakes from complementary feeding are associated with decreased risk of undernutrition in children from South America, Africa, and Asia(Journal of Nutrition, 2020-09) Maciel, Bruna Leal Lima; Costa, Priscila Nunes; Silva Filho, José Quirino da; Ribeiro, Samilly A.; Rodrigues, Francisco Adelvane de Paulo; Soares, Alberto Melo; Sousa Júnior, Francisco; Ambikapathi, Ramya; McQuade, Elizabeth T. Rogawski; Kosek, Margaret; Ahmed, Tahmee; Bessong, Pascal; Kang, Gangadeep; Shresthra, Sanjaya; Mduma, Estomih; Bayo, Eliwaza; Guerrant, Richard L.; Caulfield, Laura E.; Lima, Aldo Ângelo MoreiraBackground: Few studies have focused on quantitatively analyzing nutrients from infant diets, compromising complementary feeding evaluation and health promotion worldwide. Objectives: This study aimed to describe dietary intake in infants from 9 to 24 mo of age, determining nutrient intakes associated with the risk of underweight, wasting, and stunting. Methods: Usual nutrient intakes from complementary feeding were determined by 24-h recalls collected when infants were 9–24 mo of age in communities from 7 low- and middle-income countries: Brazil (n = 169), Peru (n = 199), South Africa (n = 221), Tanzania (n = 210), Bangladesh (n = 208), India (n = 227), and Nepal (n = 229), totaling 1463 children and 22,282 food recalls. Intakes were corrected for within- and between-person variance and energy intake. Multivariable regression models were constructed to determine nutrient intakes associated with the development of underweight, wasting, and stunting at 12, 18, and 24 mo of age. Results: Children with malnutrition presented significantly lower intakes of energy and zinc at 12, 18, and 24 mo of age, ranging from −16.4% to −25.9% for energy and −2.3% to −48.8% for zinc. Higher energy intakes decreased the risk of underweight at 12 [adjusted odds ratio (AOR): 0.90; 95% CI: 0.84, 0.96] and 24 mo (AOR: 0.91; 95% CI: 0.86, 0.96), and wasting at 18 (AOR: 0.91; 95% CI: 0.83, 0.99) and 24 mo (AOR: 0.83; 95% CI: 0.74, 0.92). Higher zinc intakes decreased the risk of underweight (AOR: 0.12; 95% CI: 0.03, 0.55) and wasting (AOR: 0.19; 95% CI: 0.04, 0.92) at 12 mo, and wasting (AOR: 0.05; 95% CI: 0.00, 0.76) at 24 mo. Conclusions: Higher intakes of energy and zinc in complementary feeding were associated with decreased risk of undernutrition in the studied children. Data suggest these are characteristics to be improved in children’s complementary feeding across countriesArtigo How multiple episodes of exclusive breastfeeding impact estimates of exclusive breastfeeding duration: report from the eight-site MAL-ED birth cohort study(Maternal and Child Nutrition, 2016-08) Maciel, Bruna Leal Lima; Ambikapathi, Ramya; Kosek, Margaret N.; Lee, Gwenyth O.; Mahopo, Cloupas; Patil, Crystal L.; Turab, Ali; Islam, M. Munirul; Ulak, Manjeswori; Bose, Anuradha; Olortegui, Maribel Paredes; Pendergast, Laura L.; Murray-Kolb, Laura E.; Lang, Dennis; Mccormick, Benjamin J. J.; Caulfield, Laura E.The duration of exclusive breastfeeding (EBF) is often defined as the time from birth to the first non-breast milk food/liquid fed (EBFLONG), or it is estimated by calculating the proportion of women at a given infant age who EBF in the previous 24 h (EBFDHS). Others have measured the total days or personal prevalence of EBF (EBFPREV), recognizing that although non-EBF days may occur, EBF can be re-initiated for extended periods. We compared breastfeeding metrics in the MAL-ED study; infants’ breastfeeding trajectories were characterized from enrollment (median 7 days, IQR: 4, 12) to 180 days at eight sites. During twice-weekly surveillance, caretakers were queried about infant feeding the prior day. Overall, 101 833 visits and 356 764 child days of data were collected from 1957 infants. Median duration of EBFLONG was 33 days (95% CI: 32–36), compared to 49 days based on the EBFDHS. Median EBFPREV was 66 days (95% CI: 62–70). Differences were because of the return to EBF after a non-EBF period. The median number of returns to EBF was 2 (IQR: 1, 3). When mothers re-initiated EBF (second episode), infants gained an additional 18.8 days (SD: 25.1) of EBF, and gained 13.7 days (SD: 18.1) (third episode). In settings where women report short gaps in EBF, programmes should work with women to return to EBF. Interventions could positively influence the duration of these additional periods of EBF and their quantification should be considered in impact evaluation studiesArtigo Infant feeding practices and determinant variables for early complementary feeding in the first 8 months of life: results from the brazilian MAL-ED cohort site(Public Health Nutrition, 2018-04) Maciel, Bruna Leal Lima; Moraes, M.L.; Soares, Alberto Melo; Cruz, I.F.S.; Andrade, Maria I. R. de; Silva Filho, José Quirino da; Sousa Júnior, Francisco; Costa, Priscila Nunes; Abreu, C. B.; Ambikapathi, Ramya; Guerrant, Richard L.; Caulfield, Laura E.; Lima, Aldo Ângelo MoreiraObjective: The present study aimed to describe breast-feeding, complementary feeding and determining factors for early complementary feeding from birth to 8 months of age in a typical Brazilian low-income urban community. Design: A birth cohort was conducted (n 233), with data collection twice weekly, allowing close observation of breast-feeding, complementary feeding introduction and description of the WHO core indicators on infant and young child feeding. Infant feeding practices were related to socio-economic status (SES), assessed by Water/ sanitation, wealth measured by a set of eight Assets, Maternal education and monthly household Income (WAMI index). Two logistic regression models were constructed to evaluate risk factors associated with early complementary feeding. Results: Based on twice weekly follow-up, 65 % of the children received exclusive breast-feeding in the first month of life and 5 % in the sixth month. Complementary feeding was offered in the first month: 29 % of the children received water, 15 % infant formulas, 13 % other milks and 9·4 % grain-derived foods. At 6 months, dietary diversity and minimum acceptable diet were both 47% and these increased to 69 % at 8 months. No breast-feeding within the first hour of birth was a risk factor for the early introduction of water (adjusted OR=4·68; 95 % CI 1·33, 16·47) and low WAMI index a risk factor for the early introduction of other milks (adjusted OR=0·00; 95 % CI 0·00, 0·02). Conclusions: Data suggest local policies should promote: (i) early breast-feeding initiation; (ii) SES, considering maternal education, income and household conditions; (iii) timely introduction of complementary feeding; and (iv) dietary diversityArtigo Micronutrient intake and the probability of nutrient adequacy among children 9–24 months of age: results from the mal-ed birth cohort study(Public Health Nutrition, 2020-07) Maciel, Bruna Leal Lima; Antiporta, Daniel; Ambikapathi, Ramya; Bose, Anuradha; Mahopo, Cloupas; Patil, Crustal L.; Turab, Ali; Olortegui, Maribel Paredes; Islam, Munirul; Bauck, Aubrey; McCormick, Benjamin J. J.; Caulfield, Laura E.Objective: To estimate the total energy and micronutrient intakes of children 9– 24 months of age and evaluate the probability of adequacy (PA) of the diet in seven MAL-ED sites. Design: Cohort study. Food intake was registered monthly using 24-h recalls beginning at 9 months. We estimated PA for thirteen nutrients and overall mean PA (MPA) by site and 3-month periods considering estimated breast milk intake. Setting: Seven sites in Asia, Africa and Latin America. Participants: 1669 children followed from birth to 24 months of age. Results: Median estimated %energy from breast milk ranged from 4 to 70 % at 9–12 months, and declined to 0–39 % at 21–24 months. Iron bioavailability was low for all sites, but many diets were of moderate bioavailability for zinc. PA was optimal for most nutrients in Brazil and South Africa, except for iron and vitamin E (both), calcium and zinc (South Africa). PA for zinc increased only for children consuming a diet with moderate bioavailability. MPA increased 12–24 months as the quantity of complementary foods increased; however, PA for vitamin A remained low in Bangladesh and Tanzania. PA for vitamins D and E and iron was low for most sites and age groups. Conclusions: MPA increased from 12 to 24 months as children consumed higher quantities of food, while nutrient density remained constant for most nutrients. Ways to increase the consumption of foods containing vitamins D, E and A, and calcium are needed, as are ways to increase the bioavailability of iron and zincArtigo Modeling environmental influences on child growth in the MAL-ED cohort study: opportunities and challenges(Clinical Infectious Diseases, 2014-11) Maciel, Bruna Leal Lima; Richard, Stephanie Ann; McCormick, Benjamin J. J.; Miller, Mark Andrew; Caulfield, Laura E.; Checkley, WilliamAlthough genetics, maternal undernutrition and low birth weight status certainly play a role in child growth, dietary insufficiency and infectious diseases are key risk factors for linear growth faltering during early childhood. A primary goal of the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study is to identify specific risk factors associated with growth faltering during the first 2 years of life; however, growth in early childhood is challenging to characterize because growth may be inherently nonlinear with age. In this manuscript, we describe some methods for analyzing longitudinal growth to evaluate both short- and long-term associations between risk factors and growth trajectories over the first 2 years of life across 8 resource-limited settings using harmonized protocols. We expect there will be enough variability within and between sites in the prevalence of risk factors and burden of linear growth faltering to allow us to distinguish some of the key pathways to linear growth faltering in the MAL-ED studyArtigo Relationships among common illness symptoms and the protective effect of breastfeeding in early childhood in MAL-ED: an eight-country cohort study(American Journal of Tropical Medicine and Hygiene, 2018-03) Maciel, Bruna Leal Lima; Petri, William; Bhutta, Zulfiqar; Bessong, Pascal; McCormick, Benjamin J. J.; Caulfield, Laura E.; Mduma, Estomih; Turab, Ali; Richard, Stephanie Ann; Mahfuz, Mustafa; Rasmussen, Zeba; Seidman, Jessica Couvillion; Chandyo, Ram Krishna; Rogawski, Elizabeth T.; Bose, Anuradha; Kosek, Margaret N.Children in low-income countries experience multiple illness symptoms in early childhood. Breastfeeding is protective against diarrhea and respiratory infections, and these illnesses are thought to be risk factors of one another, but these relationships have not been explored simultaneously. In the eight-site MAL-ED study, 1,731 infants were enrolled near birth and followed for 2 years. We collected symptoms and diet information through twice-weekly household visits. Poisson regression was used to determine if recent illness history was associated with incidence of diarrhea or acute lower respiratory infections (ALRI), accounting for exclusive breastfeeding. Recent diarrhea was associated with higher risk of incident diarrhea after the first 6 months of life (relative risk [RR] 1.10, 95% confidence interval [CI] 1.04, 1.16) and with higher risk of incident ALRI in the 3- to 5-month period (RR 1.23, 95% CI 1.03, 1.47). Fever was a consistent risk factor for both diarrhea and ALRI. Exclusive breastfeeding 0–6 months was protective against diarrhea (0–2 months: RR 0.39, 95% CI 0.32, 0.49; 3–5 months: RR 0.83, 95% CI 0.75, 0.93) and ALRI (3–5 months: RR 0.81, 95% CI 0.68, 0.98). Children with recent illness who were exclusively breastfed were half as likely as those not exclusively breastfed to experience diarrhea in the first 3 months of life. Recent illness was associated with greater risk of new illness, causing illnesses to cluster within children, indicating that specific illness-prevention programs may have benefits for preventing other childhood illnesses. The results also underscore the importance of exclusive breastfeeding in the first 6 months of life for disease prevention