SEASONAL-VARIATION IN WEIGHT-FOR-AGE IN A PEDIATRIC EMERGENCY ROOM

Objective. The authors assess seasonal variations in the prevalence of low weight-for-age among young children visiting the pediatric emerge ncy room of a city hospital, Methods. We analyzed data on 11,118 child ren ages 6 to 24 months who visited the Boston City Hospital Pediatric Emergency Department between July 1989 and June 1992. Medical diagnos es were documented on a randomly selected subsample of 1569 children, In addition, a questionnaire about food insecurity was administered to a convenience subsample of 269 families with children under 3 years o f age. Results. The percentage of children visiting the emergency room with weight-for-age below the fifth percentile was significantly high er for the three months following the coldest months than for the rema ining months of the year, controlling for year of measurement In the s ubsample, gastrointestinal illness was correlated with both season of measurement and weight-for-age, but the seasonal effect remained for t he entire sample after controlling ibr dehydration. The questionnaire data suggested a relationship between economic stress and food insecur ity that might help explain the seasonal effect. Families who were wit hout heat or who were threatened with utility turnoff in the previous winter were twice as likely as other families to report that their chi ldren were hungry or at risk for hunger. Conclusions. Winter and early spring constituted periods of increased nutritional risk in the in th is sample of predominantly low-income children, probably because of th e increased caloric associated with cold stress and infections. Furthe r research is needed to assess whether decreased caloric availability due to high heating costs, a ''heat or eat'' effect, also contributes to this phenomenon.