Navegando por Autor "Patil, Crustal L."
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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 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 zinc