Allaitement maternel, alimentation et croissance de nouveaux nés et nourrissons de 1j a 18 mois, algériens sains (Skikda, 2014-2017).

Abstract

Regular assessment of the growth and nutrition of infants are essential elements of health care in order to detect problems related to their nutritional status early before they are seriously compromised. The main objective of our study is to describe the dietary profile and the growth of a model population of healthy Algerian infants, respecting the dietary recommendations of the WHO (2004), followed from birth to 18 months in north- eastern Algeria (Skikda). A prospective (longitudinal) descriptive epidemiological study of observational type was carried out over 3 years (2014-2017) at the level of the maternal and child protection service of the public health establishment in Skikda. The sample consisted of couples of mothers and their infants (1-3 months) who presented for the first or second vaccination visit and were followed up to 18 months. The data were collected using the questionnaire adapted from the WHO (2004) according to the visits of the Algerian vaccination schedule. The couples (mother-infant) retained in the study met the inclusion criteria according to the WHO multicentre study (2004). The data collected concerned the follow-up of infants from 0 to 18 months in terms of breastfeeding (AM), complementary feeding, health and growth as well as all information from mothers and their households. Growth monitoring from birth was carried out by taking anthropometric measurements (weight, height and head circumference), evaluation of motor development and calculation of anthropometric growth indices according to WHO standards (2006, 2007): weight /age (W/A), height/age (T/A), weight/height (W/A), body mass index/age (BMI/A) and head circumference/age (HC/A). Our study concerned a total population of 2783 registered mother/infant pairs, of which only 309 were included and able to begin the longitudinal follow-up. At the end of the study, a total of 159 infants were completely followed from 0 to 18 months of which 83 (52.2%) are girls, a sex ratio of 0.92. The main results are as follows: Longitudinal follow-up of 159 infants showed that from 1 to 5 months, exclusive and predominant breastfeeding did not differ by gender (p>0.05). Exclusive breastfeeding was observed in 15.7% of infants at the first month against 7.5% at 5 months. The predominant breastfeeding increased from 84.3% during the first month to 92.5% at 5 months, while complementary feeding started from 4 months. This consisted of infant milk, infant flour, swiss-cheese, water, herbal teas, vegetables, cheese, cookies and fruit. All infants had normal motor development. Weight status (4-18 months) did not differ by gender (p>0.05). The mean BMI Z-score values are close to the standards (0-18 months) for both sexes. Microcephaly affected 2.5% infants at 3 months and 3.1% at 9 months and the severe case (1st and 4th month) 0.6% of them. At the end of the study, the nutritional profile of infants (0-18 months) showed 5.8% wasting, 4.8% thinness, 2.7% stunted, 3.1% overweight while 83.8% were of normal weight. To improve the nutritional status of Algerian infants, it is important to educate parents on the benefits of breastfeeding and adequate complementary feeding. It is also very important to ensure regular monitoring of growth during and outside vaccination visits in order to better control the nutritional status of infants by acting instantly on the various problems encountered at each age.