BREAST-FEEDING AND SEASONAL DETERMINANTS OF CHILD GROWTH IN WEIGHT INEAST-BHUTAN

In a prospective study of 113 children in rural Bhutan, morbidity, nut ritional status and feeding practices were recorded monthly over a per iod of 32 months. This information was related to seasonal variations in rainfall. Diarrhoea had a negative impact on growth, as measured in monthly intervals, during the second and third years of life, reducin g daily weight gain by 4.4 +/- 2.0 g (p < 0.0001). This impact was lar gest during the monsoon season. For respiratory tract infections the v alue was 2.6+/-1.7g (p < 0.01). Growth in weight was lowest during the monsoon period (p < 0.0001). Continued breast feeding was associated with an odds ratio for diarrhoea of 0.51 (95% CI 0.34-0.78), and for r espiratory tract infections of 0.63 (95% CI 0.40, 0.99). Growth in wei ght was less reduced during the monsoon season for children who were b reast fed (2.5 +/- 1.7 g/day) than for those not breast fed (7.5 +/- 3 .5 g/day) (p < 0.01). We conclude that breast feeding is of particular importance throughout the warm and rainy season.