Counseling adolescent mothers and maternal grandmothers in Brazil delays premature feeding of foods other than breast milk

Despite the numerous disadvantages of introducing foods other than breast milk before 6 months of age, this practice is still common. A recent survey of infant feeding practices in Brazil revealed that about one fourth of infants aged 3-6 months receive salty foods and/or fruit, about half of infants aged 4-6 months receive processed foods, and about one fifth receive processed foods in the first month of life.

The objective of this study was to evaluate the effect of multiple counseling sessions on the timing of the introduction of foods other than breast milk.

In this randomized controlled trial, 323 adolescent mothers and 169 maternal grandmothers living with their daughters were randomized to receive five counseling sessions on breastfeeding (one while in the hospital and four at home at 7, 15, 30, and 60 days) and one session on complementary feeding at 4 months in the mothers’ homes. Counseling sessions included information on the appropriate time to introduce complementary foods (at 6 months), what foods should be offered or avoided, how to offer foods (slow and gradual introduction of new foods and, according to infant age, the use of common family foods specially prepared for the infant), and feeding varied and colorful foods. Support materials for the counseling sessions included a flip chart to illustrate several breastfeeding and complementary feeding topics, and booklets on optimal feeding practices distributed to the families at the end of the sessions. Data on infant feeding were collected monthly up to 6 months after birth.

Living with the grandmother did not affect the timing of introduction of other types of milk or foods. Mothers who received counseling introduced animal milks and/or formula about 2 months later than mothers in the control group (153 vs. 95 days) and were less likely to feed their infants complementary foods at 4 months of age (23% vs. 41%). By 6 months, the percentage of infants receiving complementary foods was similar between groups (intervention: 87%, control: 88%).

Although further study is needed to assess the effectiveness of this type of intervention in programmatic (rather than research) conditions and in different populations, counseling sessions on infant nutrition for adolescent mothers and their mothers is a promising intervention in settings where there is a large number of adolescent pregnancies and in places where home visits are feasible.

Romulus-Nieuwelink JJ, Doak C, Albernaz E, Victora CG, Haisma H. Breast milk and complementary food intake in Brazilian infants according to socio-economic position. Int J Pediatr Obes. 2011 Jun;6(2-2):e508-14. Epub 2010 Sep 6.

Summary written by A&T to highlight key infant and young child feeding findings as well as program implications.

To read author's abstract, visit PubMed.