Prolonged breastfeeding without the introduction of supplementary feeding.

A study on the determinants of nutritional marasmus (NM) and kwashiorkor (K) was conducted using Sudanese children aged 6-36 months. The hypotheses tested were related to the specific circumstances leading to the development of NM and K. Subjects consisted of 55 children with NM and 55 with K, admitted to the Children's Emergency Hospital in Khartoum. This paper presents the results of the association between NM and prolonged breastfeeding without introduction of supplementary feeding between the ages of 6 and 24 months. Mothers were interviewed in hospital, and information on duration of breastfeeding, age at introduction of supplementary foods, and weaning foods was obtained. Observations were made in 20 per cent of homes of study children. The results suggest a positive association between prolonged breastfeeding without introduction of supplementary feeding between the ages of 6 and 24 months, and NM. Using multivariate analysis the data show that late introduction of supplementary foods produces an increase of 1.4-fold the odds of developing nutritional marasmus, rather than kwashiorkor. In contrast the odds ratio is 1.9 for the two conditions in terms of age of cessation of breastfeeding, the kwashiorkor children breastfeeding for fewer months. Results suggest strategies to reduce the prevalence of NM and K, plus mild and moderate PEM.