Sex differences in nutritional status of HIV-exposed children in Rwanda: a longitudinal study

objective To examine sex differences in nutritional status in relation to feeding practices over time in a cohort of HIV-exposed children participating in a complementary feeding programme in Rwanda. methods We applied a longitudinal design with three measurements 2–3 months apart among infants participating in a complementary feeding programme who were 6–12 months old at baseline. Using early feeding practices and a composite infant and child feeding index (ICFI) as indicators of dietary patterns, we conducted a multivariate analysis using a cross-sectional time series to assess sex differences in nutritional status and to determine whether there was a link to discrepancies in dietary patterns. results Among 222 boys and 258 girls, the mean (SD) Z-score of stunting, wasting and underweight was 2.01 (1.59), 0.15 (1.46), 1.19 (1.29) for boys; for girls they were 1.46 (1.56), 0.22 (1.29), 0.63 (1.19); all sex differences in all three indicators were statistically significant (P < 0.001). However, there were only minor differences in early feeding practices and none in the ICFI by sex. conclusions HIV-exposed male children may be at higher risk of malnutrition in low-resource setting countries than their female counterparts. However, at least in a setting where complementary foods are being provided, explanations may lie outside the sphere of dietary patterns.