Feeding patterns, diarrhoeal illness and linear growth in 0-24-month-old children.

The aim was to study the impact of simple healthcare interventions in 0-24-month-old children living in rural communities outside Lahore, Pakistan. Newborns belonging to four birth cohorts were followed monthly from 0-24 months of age living in rural communities. Three cohorts were from the same village: Cohort A (1984-1987), n = 485; Cohort B (1990-1992), n = 544; and Cohort C (1995-1997), n = 518. A fourth, Cohort D, was from neighbouring villages (1995-1997), n = 444. Findings from Cohort A formed the basis of a healthcare programme, including promotion of optimal breastfeeding practices, advice on oral rehydration therapy, and continued feeding during diarrhoea. The outcome measures studied were time of initiation of breastfeeding, feeding of prelacteals, exclusive breastfeeding, diarrhoeal illnesses, and postnatal linear growth. The median time of initiation of breastfeeding decreased from 47 to 3 h and exclusive breastfeeding increased from 5 per cent in Cohort A to more than 80 per cent in the subsequent cohorts, at 1 month of age. No prelacteals were given to 34 per cent of newborns in later cohorts compared with 100 per cent in Cohort A. Diarrhoeal illnesses during the first 6 months had reduced significantly. Postnatal linear growth improved by about 3 cm in the later cohorts. Appropriate changes in breastfeeding practices through integrated and focused healthcare, especially antenatally, can reduce diarrhoeal illnesses, and sustain and improve linear growth in young children.