J O Mora

Nutritional supplementation, maternal education, and cognitive development of infants at risk of malnutrition.

Infants born to families at risk of malnutrition were studied prospectively from the beginning of the 3rd trimester of the mothers pregnancy until the child reached 3 yr of age to ascertain the effects of nutritional supplementation and/or a maternal education program on their cognitive development. Four hundred thirty-three families were assigned randomly to six groups: group A served as a control; group B received the supplement from the age of 6 months to 3 yr; group C received the supplement during the 3rd trimester of pregnancy and the first 6 months of the childs life; and group D received the supplement throughout the entire study period. In addition, group A1 was enrolled in a maternal education program but received no nutritional supplement and group B1 received both treatments. The Griffiths test of infant development was administered at 4, 6, 12, 18, 24, and 36 months of age, and the Corman-Escalona Einstein scale was administered at each age up to 18 months. Children who received food supplementation performed better than those who did not, especially on subtests that were primarily motoric. The effect of food supplementation on behavior appeared to be contemporaneous. In addition, the treatment effects were more pronounced for girls than for boys in this sample. Although these interventions reduced the gap in cognitive performance between lower and upper socioeconomic classes, a disparity nevertheless remained by the end of the study.

Family social characteristics related to physical growth of young children.

Altogether 164 poor families who had children of normal and subnormal weight and height were studied in Bogota, Colombia. Physical growth was found to be positively associated with expenditure on food, sanitary conditions in the home, mothers age, birth interval between surviving children, level of parental newspaper reading, aspirations for children, and socioeconomic status. Physical growth was negatively associated with crowded living conditions and family size. Only mothers age, family size, spacing of births, and sanitary conditions were related to weight and height, independent of socioeconomic status. Food expenditure, crowding, parental newspaper reading, and aspirations for children all reflected the influence of socioeconomic status upon physical growth. The findings emphasized the importance of within-class social differences as they affect the physical growth of young children.

Sex related effects of nutritional supplementation during pregnancy on fetal growth.

Nutritional supplementation of low income women during pregnancy increased birth weight significantly only in the male offspring. No differences by sex were apparent in the amount of supplementation, length of gestation or maternal characteristics known to be associated with birth weight. Regression analysis revealed a significant supplementation by sex interaction. The fetal growth curve of the supplemented males was higher and roughly parallel to the curve of females, and showed an effect of supplementation prior to 35 weeks of gestation. These findings and those of other authors support the hypothesis that fetal growth of males towards the end of pregnancy is more rapid and hence more susceptible to adverse environmental influences than that of females. This is reflected in a reduction of the difference in birth weight in favor of males observed in well-nourished populations. It is postulated that male subjects therefore exhibit sensitivity to nutritional supplementation of their mothers during pregnancy.

Food supplementation of pregnant women at risk of malnutrition and their newborns' responsiveness to stimulation.

Pregnant women at risk of malnutrition were enrolled in a health care programme in Colombia, South America, and were randomly assigned to a group receiving supplementary food or to a control group at the beginning of the third trimester of pregnancy. There were no differences between the groups in social or nutritional variables.

The impact of supplementary feeding and home education on physical growth of disadvantaged children

Abstract Urban Colombia families with malnourished children were randomly assigned to treatment groups receiving either or both of a diet supplement and a home education program. The effectiveness of these interventions, both separately and interactively, in augmenting the physical growth of children during the first 36 months of life was assessed longitudinally. Children receiving the supplement were significantly taller and heavier than nonsupplemented controls after three months. Proportional weight for height over age was similar in all groups, while the supplement ameliorated the trend toward stunting. Home education moderately enhanced the supplementation effect, but alone did not improve growth. It is concluded that stunting without concomitant wasting may result from long-term deficiencies in calorie and protein intake and/or frequent disease episodes. Under such circumstances, measures of wasting (weight for height) would not be sensitive to the impact of long-term programs. Height for age would be a preferable outcome variable.