Age at introduction of complementary food and physical growth from 2 to 9 months in rural Senegal

Objective: To compare nutritional status and physical growth among infants according to age at introduction of complementary food (CF). Design: A longitudinal observational study. Setting: Three health clinics in a rural area of Senegal. Subjects: During immunization sessions, 522 infants were recruited at 2-3 months. Complete data on three visits were available for 420 infants (4 visits: n = 361); 73 were lost to follow-up and 29 had incomplete data. Main outcome measures: Increments in length and weight between adjacent visits. Results: Infants complemented at 2-3 months (n = 50) had significantly lower length-for-age (P = 0.014), weight-for-length (P < 0.001) and arm circumference (P c 0.0001) at 2-3 months than predominantly breastfed infants (n = 370), after adjustment for residence, mother's age and education of parents. The growth in weight and length from 2-3 to 9-10 months did not differ. The infants complemented by 4-5 months, but not yet at 2-3 months, (n = 94) had a slightly lower length increment from 4-5 to 6-7 months (1.42 vs 1.53 crdmo, p c 0.05) compared to infants predominantly breastfed at 4-5 months (n = 276). The infants fist complemented by 6-7 months (n = 122) had increments from 6-7 to %IO months similar to those of predominantly breastfed infants (n = 154). Conclusion: Introduction of CF by 2-3 months was associated with a low nutritional status, but not with slow growth from 2-3 to 9-10 months. Introduction of CF by 4-5 months was associated with slightly slower linear growth compared to later introduction. Sponsorship: The Niakhar study area was supported by Pasteur-Méneux, Pans. Descriptors: infant feeding practices; breast-feeding; growth; weight; recumbent length