Nutritional correlates of frequency and length of breastfeeds in rural Bangladesh

Abstract In this rural Bangladeshi sample of 165 mothers and their breastfed infants aged 5–23 months, mean maternal body mass index (BMI) was 18, and 12-month infant height-for-age z-scores (HAZ), −2.35. Structured observations were conducted over 6 months on 1649 breastfeeds during 3324 weekly daytime observations. Infants' and mothers' 24-h dietary recalls, weights, lengths/heights and mothers' arm circumferences were taken monthly. When plotted with age, infants' anthropometric z-scores, food energy, and minutes observed breastfeeding revealed three patterns in age periods: 5–12, 13–18, and 19–23 months. In periods one (breastfeeding high) and three (breastfeeding low), food energy increased with age, linear growth paralleled the World Health Organization (WHO) reference standard, and the children grew thinner. In two, (breastfeeding declining), food energy did not increase and growth stasis occurred. Longer observed breastfeeding accompanied in period one, low maternal arm circumference, low infant energy intake from complementary foods and infant shortness and plumpness in period two, infant shortness, thinness, and underweight; and in period three, infants energy and thinness. In conclusion, the paper suggests that growth stasis occurs primarily during the second period, which should have highest priority for culturally sensitive interventions.