Liyanapatabadige Umani Shiranga Senavirathne¹, Guwani Liyanage², Shreenika De Silva Weliange³, Yasaswi Walpita³, Upul Senarath³, Dhammica Rowel⁴, Abner Daniel⁴, Indika Siriwardena⁵, Hiranya S Jayawickrama⁶, V Pujitha Wickramasinghe¹, Sri Lanka Child Growth Cohort
1- Department of Paediatrics, Faculty of Medicine, University of Colombo, Sri Lanka
2- Department of Paediatrics, University of Sri Jayawardhenapura, Sri Lanka
3- Department of Community Medicine, Faculty of Medicine, University of Colombo, Sri Lanka
4- UNICEF, Colombo, Sri Lanka
5- South Asia Infant Feeding Research Network, Sri Lanka
6- Family Health Bureau, Ministry of Health, Sri Lanka
Corresponding Author:
Liyanapatabadige Umani Shiranga Senavirathne (
umasenevirathne@gmail.com)
Abstract Body
Introduction: Growth faltering is defined as ≥0.35SD deviation of Weight for age Z score (WAZ) from that of birth.
Objectives: To describe the impact of complementary feeding initiation age on growth recovery of children with growth faltering at 4 months
Methods: A community based retrospective cohort study was conducted (Oct-Nov 2023) among term born children aged 12- 24 months in 45 MOH areas of in 8 districts. An enumeratoradministered questionnaire was used and data was collected via direct interview of the caregiver and via CHDR.
Results: Out of 1875 participants (50.8% male), mean birth weight was 2.92kg and mean birth WAZ was -0.86. By 4 months of age, 30.6%(n=574) children showed weight faltering. Within this faltered group, 87 .1%(n=500) was exclusively breast fed by 4 months and 59.4%(n=341) remained exclusively breast fed even at 6 months of age. Among the faltered group, 13.2%(n=76) had started complementary feeding at 4-5 months of age and 77 .3%(n=444) had started complementary feeding at 6 months of age. A complete case analysis revealed that the children who started complementary feeding at 4-5 months demonstrated numerically greater mean improvement of WAZ by 6 months(+0.32SD vs +0.24SD), 9 months(+0.39SD vs +0.37SD) and 12 months(+0.42SD vs +0.32SD) compared to children who started complementary feeding by 6 months. However, the magnitude of recovery did not differ significantly between the two groups at any time point.
Conclusion: Early initiation of complementary feeding in those who have growth faltering, improves outcome than late introduction, although not statistically significant.