Determinants of the mean growth rate of children under the age of six months: a cohort study

Fonseca, Poliana Cristina de Almeida; Carvalho, Carolina Abreu de; Ribeiro, Sarah Aparecida Vieira; Nobre, Luciana Neri; Pessoa, Milene Cristine; Ribeiro, Andreia Queiroz; Priore, Silvia Eloiza; Franceschini, Sylvia do Carmo Castro

doi:10.1590/1413-81232017228.18182015

person Poliana Cristina de Almeida Fonseca

school Departamento de Nutrição e Saúde, Centro de Ciências Biológicas e da Saúde, Universidade Federal de Viçosa. Av. Peter Henry Rolfs s/n, Campus Universitário. 36570-900 Viçosa MG Brasil. poliana.nutri_ufv@yahoo.com.br

person Carolina Abreu de Carvalho

schoolInstituto Federal do Maranhão Campus Barreirinhas. Barreirinhas MA Brasil.

person Sarah Aparecida Vieira Ribeiro

schoolDepartamento de Nutrição, Universidade Federal do Espírito Santo. Vitória ES Brasil.

person Luciana Neri Nobre

schoolPrograma de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. São Luís MA Brasil.

person Milene Cristine Pessoa

schoolDepartamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil.

person Andreia Queiroz Ribeiro

school Departamento de Nutrição e Saúde, Centro de Ciências Biológicas e da Saúde, Universidade Federal de Viçosa. Av. Peter Henry Rolfs s/n, Campus Universitário. 36570-900 Viçosa MG Brasil. poliana.nutri_ufv@yahoo.com.br

person Silvia Eloiza Priore

school Departamento de Nutrição e Saúde, Centro de Ciências Biológicas e da Saúde, Universidade Federal de Viçosa. Av. Peter Henry Rolfs s/n, Campus Universitário. 36570-900 Viçosa MG Brasil. poliana.nutri_ufv@yahoo.com.br

person Sylvia do Carmo Castro Franceschini

school Departamento de Nutrição e Saúde, Centro de Ciências Biológicas e da Saúde, Universidade Federal de Viçosa. Av. Peter Henry Rolfs s/n, Campus Universitário. 36570-900 Viçosa MG Brasil. poliana.nutri_ufv@yahoo.com.br

Collaborations

PCA Fonsêca worked on design, setting objectives, data analysis and interpretation, as well as writing the manuscript. CA Carvalho and SAV Ribeiro assisted in data analysis and critical review of the manuscript. LN Nobre, MC Pessoa, AQ Ribeiro and SE Priore assisted in work co-orientation, data interpretation and critical review of the manuscript. SCC Franceschini worked on work orientation, assisting in the design, outline of the study and definition of objectives, as well as data interpretation, critical review of the manuscript and approval of its final version.

Sample characterization	Monitored (n = 240)	Not monitored (n = 177)	p-value^**
Gender	% (n)	% (n)
Male	55.3 (114)	44.7 (92)	0.366
Female	59.7 (126)	40.3 (85)
Type of delivery
Normal	56.5 (65)	43.5 (50)	0.792
C-section	57.9 (175)	42.1 (127)
Low birth weight (> 2500 < 3000 g)
No	56.6 (179)	43.4 (137)	0.507
Yes	60.4 (61)	39.6 (40)
High birth weight (> 4000 g)
No	57.6 (227)	42.4 (167)	0.918
Yes	56.5 (13)	43.5 (10)
Size at birth (cm)
Mean ± Standard Deviation	49.2 ± 1.8	49.1 ± 1.9	0.671

Variables (%)	WGR1 (g/day)		WGR2 (g/day)

	Median (Min - Max)	p-value¹	Mean ± SD	p-value²
Gender
Male (52.5)	33.6 (-8.3 – 69.3)	< 0.001*	34.2 ± 8.1	<0.001*
Female (47.5)	26.5 (-35.3 – 69.3)		28.8 ± 7.9
Type of delivery
Normal (27.1)	32.8 (1.3 – 63.7)	0.022*	32.1 ± 8.2	0.624
C-section (72.9)	29.2 (-35.3 – 69.3)		31.5 ± 8.6
Low BW
Yes (25.4)	31.0 (-6.7 – 69.3)	0.965	31.6 ± 8.0	0.979
No (74.6)	29.8 (-35.5 – 66.8)		31.6 ± 8.6
High BW
Yes (5.4)	29.1 (-35.3 – 57.3)	0.969	30.6 ± 14.3	0.633
No (94.6)	30.8 (-8.3 – 69.3)		31.7 ± 8.1
Variables (%)	SGR1 (cm/month)		SGR2 (cm/month)

	Mean ±SD	p-value ²	Median (Min - Max)	p-value ¹
Gender
Male (52.5)	4.0 ± 1.5	0.016*	3.9 (2.3 – 18.0)	0.001*
Female (47.5)	3.5 ± 1.5		3.5 (1.1 – 5.5)
Type of delivery
Normal (27.1)	3.9 ± 1.6	0.245	3.5 (1.6 – 18.0)	0.879
C-section (72.9)	3.7 ± 1.5		3.8 (1.1 – 5.6)
Low BW
Yes (25.4)	3.7 ± 1.5	0.743	3.8 (1.6 – 5.9)	0.564
No (74.6)	3.8 ± 1.5		3.6 (1.1 – 18.0)
High BW
Yes (5.4)	3.0 ± 1.5	0.070	3.5 (1.1 – 18.0)	0.224
No (94.6)	3.8 ± 1.5		3.7 (1.6 – 5.9)
Variables (%)	WGR4 (g/day)		WGR6 (g/day)

	Median (Min - Max)	p-value ¹	Median (Min-Max)	p-value ¹
Gender
Male (52.5)	29.5 (17.4 – 54.6)	< 0.001*	25.3 (15.7 – 47.4)	0.001*
Female (47.5)	25.4 (7.2 – 43.4)		22.2 (12.2 – 36.7)
Type of delivery
Normal (27.1)	26.8 (17.5 – 45.5)	0.315	22.7 (16.8 – 42.8)	0.144
C-section (72.9)	28.1 (7.3 – 54.6)		24.7 (12.2 – 47.4)
Low BW
Yes (25.4)	28.4 (18.7 – 43.4)	0.566	24.0 (15.7 – 41.2)	0.964
No (74.6)	27.3 (7.3 – 54.6)		24.1 (12.2 – 47.4)
High BW
Yes (5.4)	25.4 (11.6 – 41.3)	0.671	21.8 (12.2 – 35.2)	0.619
No (94.6)	27.7 (7.3 – 54.6)		24.2 (15.7 – 47.4)
Variables (%)	SGR4 (cm/month)		SGR6 (cm/month)

	Median (Min - Max)	p-value ¹	Mean ± SD	p-value ²
Gender
Male (52.5)	3.4 (2.4 – 4.6)	<0.001*	2.9 ± 0.3	< 0.001*
Female (47.5)	3.1 (1.4 – 4.6)		2.7 ± 0.3
Type of delivery
Normal (27.1)	3.2 (2.2 – 4.6)	0.354	2.8 ± 0.4	0.222
C-section (72.9)	3.3 (1.3 – 4.6)		2.8 ± 0.3
Low BW
Yes (25.4)	3.3 (2.3 – 4.6)	0.373	2.9 ± 0.3	0.035*
No (74.6)	3.3 (1.4 – 4.5)		2.8 ± 0.4
High BW
Yes (5.4)	3.1 (1.8 – 3.7)	0.152	2.6 ± 0.5	0.006*
No (94.6)	3.2 (1.3 – 4.6)		2.8 ± 0.3

Variables (%)	WGR1 (g/day)		SGR1 (cm/month)

	Median (Min - Max)	p-value¹	Mean ± SD	p-value²
Breastfeeding type
Exclusive (47.8)	32.8 (7.6 – 65.3)^a		3.9 ± 1.4
Predominant (30.3)	31.0 (-35.3 – 66.8)^a	< 0.001*	3.9 ± 1.6	0.050
Mixed (16.6)	24.5 (-8.3 – 52.5)^b		3.3 ± 1.4
Artificial (5.3)	19.0 (10.5 – 38.5)^b		3.2 ± 1.6
Difficulty in breastfeeding
No (79.0)	31.7 (-3.0 – 69.3)	< 0.001*	3.8 ± 1.5	0.086
Yes (21.0)	25.2 (-35.3 – 51.8)		3.4 ± 1.4
Formula consumption
No (78.5)	31.8 (-7.0 – 69.3)	< 0.001*	3.9 ± 1.5	0.006*
Yes (21.5)	24.3 (-35.3 – 52.5)		3.3 ± 1.5
Cow milk consumption
No (98.0)	30.6 (-35.3 – 69.3)	0.129	3.8 ± 1.5	0.065
Yes (2.0)	22.3 (15.0 – 32.7)		2.5 ± 1.6
Water consumption
No (87.8)	31.0 (-7.0 – 65.3)	0.049*	3.8 ± 1.5	0.100
Yes (12.2)	27.0 (-8.3 – 45.0)		3.3 ± 1.8
Tea consumption
No (63.2)	29.7 (-6.7 – 65.3)	0.427	3.8 ± 1.4	0.982
Yes (36.8)	30.7 (-8.3 – 66.8)		3.8 ± 1.6
Use of pacifier
No (54.3)	31.7 (2.8 – 66.8)	0.023*	3.8 ± 1.4	0.926
Yes (45.7)	28.3 (-8.3 – 65.3)		3.8 ± 1.6

Variables (%)	WGR2 (g/day)		SGR2 (cm/month)

	Mean ± SD	p-value¹	Median (Min - Max)	p-value²
Breastfeeding type
Exclusive (51.8)	33.5 ± 7.6^a		3.8 (2.1 – 5.4)^a
Predominant (22.3)	31.8 ± 8.7^a	< 0.001*	3.8 (1.1 – 18.0)^a	0.015*
Mixed (17.0)	27.3 ± 9.1^b		3.5 (2.1 – 5.9)^b
Artificial (8.9)	29.0 ± 7.8 ^(a.b)		3.4 (2.3 – 5.3)^b
Difficulty in breastfeeding
No (85.0)	32.3 ± 8.2	0.004*	3.8 (1.6 – 5.6)	0.047*
Yes (15.0)	27.9 ± 9.2		3.4 (2.3 – 5.9)
Formula consumption
No (75.7)	32.9 ± 8.1	< 0.001*	3.8 (1.6 – 5.9)	< 0.001*
Yes (24.3)	27.9 ± 8.8		3.4 (2.1 – 5.3)
Cow milk consumption
No (95.9)	31.7 ± 8.6	0.517	3.7 (1.6 – 5.6)	0.544
Yes (4.1)	29.9 ± 6.3		3.8 (2.9 – 5.9)
Porridge consumption
No (97.6)	31.6 ± 8.6	0.564	3.7 (1.6 – 5.7)	0.960
Yes (2.4)	33.6 ± 4.7		3.8 (2.3 – 4.2)
Water consumption
No (76.5)	32.4 ± 8.4	0.019*	3.8 (1.6 – 5.7)	0.033*
Yes (23.5)	29.4 ± 8.3		3.5 (1.6 – 18.0)
Tea consumption
No (71.3)	32.1 ± 8.5	0.220	3.7 (2.0 – 5.7)	0.677
Yes (28.7)	30.6 ± 8.5		3.6 (1.0 – 5.9)
Juice consumption
No (94.7)	31.7 ± 8.6	0.555	3.8 (1.6 – 5.7)	0.254
Yes (5.3)	30.3 ± 6.8		3.5 (2.3 – 5.9)
Use of pacifier
No (52.2)	33.4 ± 7.6	< 0.001*	3.7 (1.6 – 5.6)	0.326
Yes (47.8)	29.8 ± 9.0		3.6 (1.9 – 5.7)

Variables (%)	WGR4 (g/day)		SGR4 (cm/month)

	Median (Min - Max)	p-value¹	Median (Min - Max)	p-value¹
Breastfeeding type
Exclusive or Predominant (49.8)	28.3 (17.9 – 44.5)		3.3 (2.3 – 4.4)
Mixed (17.8)	27.1 (7.3 – 41.3)	0.178	3.2 (1.4 – 4.4)	0.449
Artificial (8.9)	29.1 (18.2 – 45.5)		3.3 (2.6 – 4.6)
Supplemented (23.5)	26.4 (11.6 – 42.1)		3.4 (1.8 – 4.6)
Formula consumption
No (69.2)	28.1 (17.5 – 45.5)	0.301	3.3 (2.3 – 4.5)	0.938
Yes (30.8)	26.8 (7.2 – 43.4)		3.2 (1.3 – 4.6)
Cow milk consumption
No (87.5)	27.9 (16.0 – 43.4)	0.105	3.3 (2.2 – 4.5)	0.476
Yes (12.5)	25.3 (17.5 – 45.5)		3.2 (2.3 – 4.2)
Porridge consumption
No (93.5)	27.9 (16.0 – 43.4)	0.014*	3.3 (2.2 – 4.5)	0.003*
Yes (6.5)	23.3 (18.0 – 45.5)		3.0 (2.3 – 3.4)
Use of pacifier
No (55.1)	29.0 (17.4 – 44.4)	0.006*	3.3 (2.2 – 4.3)	0.234
Yes (44.9)	26.6 (11.6 – 43.4)		3.2 (2.3 – 4.6)
Variables (%)	WGR6 (g/day)		SGR6 (cm/month)

	Median (Min - Max)	p-value ¹	Mean ± SD	p-value ²
Breastfeeding type
Breastfeeding and SF (45.3)	24.2 (15.9 – 36.7)		2.8 ± 0.3
Mixed and SF (32.4)	23.9 (12.2 – 41.2)	0.675	2.8 ± 0.3	0.820
Artificial and SF (22.3)	23.3 (15.7 – 42.8)		2.8 ± 0.3
Formula consumption
No (68.8)	24.4 (15.9 – 42.7)	0.047*	2.8 ± 0.3	0.445
Yes (31.2)	23.1 (12.2 – 41.2)		2.8 ± 0.3
Cow milk consumption
No (72.1)	24.0 (15.8 – 41.2)	0.940	2.8 ± 0.3	0.637
Yes (27.9)	24.2 (12.2 – 42.7)		2.8 ± 0.4
Porridge consumption
No (81.0)	24.2 (15.8 – 38.9)	0.324	2.8 ± 0.3	0.179
Yes (19.0)	23.4 (12.2 – 42.8)		2.7 ± 0.3
Use of pacifier
No (53.8)	24.3 (15.9 – 37.4)	0.107	2.8 ± 0.3	0.982
Yes (46.2)	23.4 (15.7 – 41.2)		2.8 ± 0.3

[TFN1001] ^* Totals may not add up to 417 (monitored and not monitored) across all variables due to some missing values; ^** Pearson’s chi-square test or Student’s t-test.

Determinants of the mean growth rate of children under the age of six months: a cohort study

Abstract