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Information on the effects of government nutrition programmes provided to socially vulnerable children to improve their nutritional status is scarce. We analysed the effectiveness of a nutritional programme, including food supplementation with infant formula, on the evolution of the weight and height of socially vulnerable children from Manaus in the Brazilian Amazon. This study included 7752 children aged 12–24 months admitted to the programme between 2017 and 2020. Weight and height measurements at admission and every three months thereafter were extracted from the programme database. Weight-for-age, weight-for-height, body mass index-for-age (BMI/A), and height-for-age z-scores were analysed using a multilevel linear regression model, which showed a statistically significant decrease in nutritional deficits toward nutritional recovery at follow-up. The programme's effectiveness was evaluated in 1617 children using a paired analysis comparing data from between 12 and 15 months of age at admission and follow-up after 6–9 months. Children admitted with wasting presented an increase in the BMI/A z-score, whereas children admitted with a risk of being overweight and obese had a statistically significant decrease in the BMI/A z-score. Children admitted with stunted growth also showed increased height-for-age z-scores. The nutrition programme was effective for children experiencing wasting and reducing excess weight. [ABSTRACT FROM AUTHOR]

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Background and aims. Early childhood is the period when food preferences and dietary habits are established. This study assessed Brazilian infants' consumption by food group and top sources of total energy intake (TEI). Methods. The FITS is a cross-sectional survey of caregivers of Brazilian infants aged <1 year (n=218). 24-h dietary recalls were collected to investigate dietary patterns including. percentage of children consuming foods and food groups on a given day (%), amount consumed (g) and percent contribution to TEI. Results. The most highly consumed food group in the infant diet was milk/milk products, consumed by 100% and 95% of infants (0-5.9 months and 6-11.9 months, respectively), followed by grain/grain products. While around 40% of the infants (6-11.9 months) did not consume fruits and vegetable on the day of the survey, almost half consumed sweets. Milk/milk products contributed 94.7% TEI at 0-5.9 months, and 58.9% TEI at 6-11.9 months. Breast milk and infant formula together contributed 89.0% TEI for young infants (0-5.9 months). Other foods (cow's milk, infant cereals/other grains and toddler milks) consumed by 0-5.9 months infants contributed 10.4% TEI. Among infants aged 6-11.9 months, the top food source of energy was human milk (27.3%), followed by cow's milk and infant formula (15.7% and 12.6%, respectively). At this transitional age, infant cereal/other grains contributed a sizable proportion of daily energy (14.2%). Conclusions. Introduction of foods are occurring before 6 months of age impacting the consumption of adequate calories from breast milk or formula alone. These findings indicate an opportunity to guide caregivers on food choices to improve infants' diet quality for a healthy development of food habits. [ABSTRACT FROM AUTHOR]

Background and aims. Adequate nutrient intake is critical for healthy infant development. Our objective was to assess nutrient intakes and the top food sources of key nutrients among Brazilian infants. Methods. The Feeding Infants and Toddlers Study (FITS) 2019 assessed adequacy of dietary intake of Brazilian infants aged <1 year (n=218). Infants' caregivers completed one 24-h dietary recall and a random subsample (25%) completed a second recall to estimate usual intakes. Nutrient intakes were compared with Estimated Average Requirements (EAR) and Adequate Intakes (AI), and top food sources of key nutrients were identified. Results. Only 5% of infants 0-5.9 mo and 21% of 6-11.9 mo olds were above the AI for vitamin D. For vitamin E, 13% of 0-5,9 mo and 48% of 6-11,9 mo olds were above the AI. Intakes of folate, thiamin, zinc and niacin were generally adequate for 6-11,9 mo olds, but only about half of younger infants exceeded the AI for these nutrients (48-57% infants above the AI). Iron intakes were below the EAR for 44% infants 6-11,9 mo. With high breastfeeding rates among 0-5.9 mo olds, human milk provided 70-76% of nutrients, followed by infant formula (13-15%). As the diet diversified among 6-11.9 mo olds, other food sources became important. In addition to breastmilk and infant formula, fortified infant cereal was among top food sources for B-vitamins, vitamins D and E, and iron. Other grain foods were also important contributors to vitamin E, folate and iron. Conclusions. Brazilian infants' diets are inadequate in many micronutrients of nutritional importance for optimal development especially iron for 6-11.9 mo olds and vitamins D and E for all ages. Promotion of feeding infants' nutrient dense foods should be emphasized. [ABSTRACT FROM AUTHOR]

Background and aims. Infants may be exposed to various food protein sources during the first 1000 days. This study describes protein and protein-food source consumption of Brazilian infants. Methods. The Feeding Infants and Toddlers Study (FITS) 2019 is a cross-sectional dietary survey of caregivers of Brazilian infants aged <1 year (n=218) using 24-hour recalls. A random subsample (25%) completed a second recall to estimate usual protein intakes which was compared to reference values. Food sources of protein and their percent contribution to total protein intakes (TPI) were calculated. Results. Infants aged 0-5.9 months consumed 11.7 g/d of protein (mean intake) and increased to 29.1 g/day among 6-11.9 months infants. According to the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN), protein consumption should be limited to 15% of total energy at 12 months. Around 12% of the total energy came from proteins among 6-11.9 months infants. At 90th percentile infants were on this upper limited proposed by ESPGHAN, suggesting that the number of children exceeding the protein intake is less than 10% of infants (6-11.9 months). Human milk is the main food source of protein among 0-5.9 months infants (76.2% of TPI) and around 19.3% of daily protein is coming from infant formula and whole cow's milk. Food intake diversifies with age and whole cow's milk becomes the primary source of protein of older infants, followed by human milk, meats, infant formula and other grains. Conclusions. Infants consumed other types of milk than breast milk or infant formula before 6 months, which raises the importance of evidence-based complementary feeding guidance for this population. Diverse protein foods should be encouraged in diets of older children to ensure adequate protein quality in early childhood. [ABSTRACT FROM AUTHOR]

Objective: To analyze the relationship between habits and attitudes of mothers and the types of milk offered to their children in their first two years of life., Methods: Retrospective study including 773 interviews of mothers from 11 Brazilian cities with children under 2 years of age. Interviews were conducted in 11 cities of Brazil. The following factors were analyzed: breastfeeding method planned during pregnancy and the method actually applied after birth; type(s) of milk(s) used on the day of the interview and earlier; age at which the child was introduced to whole milk; and source of advice used to choose a certain type of milk., Results: Breast milk was offered to 81.7% of infants during their first six months of life, to 52.2% of infants during their second semester (p<0.001) and to 32.9% of infants during their second year of life (p<0.001). In contrast, cow's milk consumption increased from 31.1 to 83.8% (p<0.001) and 98.7% (p=0.05), respectively, for these three age groups. Infant (15.0%) and follow-on (also known as toddler's) (2.3%) formulas were used by a much smaller number of infants than whole cow's milk. Most mothers were not prescribed whole cow's milk. Pediatricians were the health care professionals who most often recommended infant formulas., Conclusions: Rates of breastfeeding in Brazil remain below recommended levels. Brazilian mothers often decide to feed their infants with whole cow's milk on their own initiative. The use of infant formulas after weaning is still too low.