Full-term, peri-urban South African infants under 6 months of age are at risk for early-onset anaemia

• Published in: Public health nutrition Vol. 7; no. 6; pp. 813 - 820
• Main Authors: Sibeko, LN, Dhansay, MA, Charlton, KE, Johns, T, Van Stuijvenberg, ME, Gray-Donald, K
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01-09-2004
• Subjects: Adolescent; Adult; Age; Anaemia; Anemia; anemia (disease); Anemia, Iron-Deficiency - epidemiology; Anemia, Iron-Deficiency - etiology; Babies; blood chemistry; blood serum; breast feeding; Breast Feeding - statistics & numerical data; Breast milk; Breast milk vitamin A; Breastfeeding & lactation; complementary foods; Councils; Cross-Sectional Studies; dietary surveys; Female; Haemoglobin; Hemoglobin; Hemoglobins - metabolism; Humans; Infant; infant feeding; Infant, Newborn; Infants; Iron; Lactating women; lactation; Male; Maternal & child health; Medical research; Milk; Mortality; Mothers; Nutrition; Nutritional Status; Peri-urban South Africa; Poverty; Pregnancy; Prevalence; Public health; risk factors; Serum retinol; South Africa - epidemiology; Urban Health; urban population; Vitamin A; Vitamin A - blood; Vitamin A Deficiency - epidemiology; Vitamin A Deficiency - etiology; vitamin content; vitamin deficiencies; Weaning; weaning foods; Womens health; South Africa; Canada; Cape Town South Africa; Lactating women; Anaemia; Haemoglobin; Breast milk vitamin A; Infants; Serum retinol; Peri-urban South Africa
• ISSN: 1368-9800; 1475-2727
• DOI: 10.1079/PHN2004612

There is a paucity of data on the micronutrient status of low-income, lactating South African women and their infants under 6 months of age. The aim of this study was to elucidate the level of anaemia and vitamin A deficiency (VAD) in peri-urban breast-feeding women and their young infants.
Cross-sectional study including anthropometric, biochemical and infant feeding data.
Peri-urban settlement in Cape Town, South Africa.
Breast-feeding women (n=113) and their infants (aged 1-6 months) attending a peri-urban clinic.
Mean (standard deviation (SD)) haemoglobin (Hb) of the lactating mothers was 12.4 (1.3) g dl(-1), with 32% found to be anaemic (Hb<12 g dl(-1)). Maternal serum retinol was 49.8 (SD 13.3) microg dl(-1), with 4.5% VAD. Using breast milk, mean (SD) retinol concentration was found to be 70.6 (24.6) microg dl(-1) and 15.7 (8.3) microg/g milk fat, with 13% below the cut-off level of <8 microg/g fat. There was no correlation found between breast milk retinol and infant serum retinol. Z-scores (SD) of height-for-age, weight-for-age and weight-for-height were -0.69 (0.81), 0.89 (1.01) and 1.78 (0.83), respectively. Mean (SD) infant Hb was 10.9 (1.1) g dl(-1), with the prevalence of anaemia being 50%, 33% and 12% using Hb cut-offs below 11 g dl(-1), 10.5 g dl(-1) and 9.5 g dl(-1), respectively. Mean (SD) infant serum retinol was 26.9 (7.2) microg dl(-1), with 10% being VAD. None of the infants was exclusively breast-fed, 22% were predominantly breast-fed and 78% received complementary (mixed) breast-feeding. Thirty-two per cent of infants received weaning foods at an exceptionally young age (< or =1 month old).
A high rate of anaemia is present in lactating women residing in resource-poor settings. Moreover, their seemingly healthy infants under 6 months of age are at an elevated risk of developing early-onset anaemia and at lower risk of VAD.