Effects of an exclusive breastfeeding intervention for six months on growth patterns of 4–5 year old children in Uganda: the cluster-randomised PROMISE EBF trial

摘要

Background Breastfeeding promotion is regarded as one of the most effective interventions to improve child health, and could reduce under-5-mortality by 8?% globally. Few studies have assessed the health outcomes beyond infancy of interventions promoting exclusive breastfeeding. Methods This study assessed growth in under-five children who participated in a cluster-randomised trial in Eastern Uganda (ClinicalTrials.gov.no.NCT00397150). In the intervention arm, peer counsellors promoted exclusive breastfeeding during the first 6?months of infancy. There were no interventions after 6?months of age. Mother-infant pairs were interviewed at visits scheduled at 3, 6, 12 and 24?weeks after birth and follow-up visits at 2 and 5?years, with 765 included in the analyses. Results The mean length/height-for-age and weight-for-age-z-score (HAZ, WAZ) decreased with increasing age in both the intervention and control arms. At the three weeks visit, HAZ in the intervention was ?0.45 (?0.68;?0.21) and ?0.32 (?0.56;?0.07) in the control arm. At the 2?year follow-up, the mean HAZ in the intervention was ?1.85 (95 % CI ?1.97;?1.73) compared to ?1.61 (?1.87;?1.34) in the control. Similarly, at the 5?year follow-up, the mean HAZ in the intervention was ?1.78 (?2.08;?1.47) compared to ?1.53 (?1.79;?1.28) in the control arm. At the 2?year follow-up visit, 139 (45?%) were stunted (HAZConclusion While stunting was widespread at 2 and 5?years of age in both arms, it was more common in the intervention arm. It is questionable whether community-based support from lay people with short training and focussing only on exclusive breastfeeding, is an appropriate strategy to improve child health and development. Trial registration ClinicalTrials.gov.no. NCT00397150 . Registered 7th of November 2006.