Survey on infant feeding in Uruguay

Survey on breastfeeding, nutritional status and complementary feeding in children under two years old attended in both public and private health facilities in Uruguay

-The survey was carried out by RUANDI (IBFAN Uruguay) in agreement with the Ministry of Health and with the support of UNICEF. It took place in Montevideo (main city and capital of Uruguay) and 12 other cities of the country. 3039 mothers in 51 health facilities were interviewed at the moment of a health control. Data were collected by field nutritionists belong to the project who were previously trained on anthropometry skills and on 24 h dietary recall techniques. They were given photographic models of a variety of local foods in different concentrations and portions.

The main nutritional problems found were stunting (length for age less than 2 SD below the new OMS
reference median) (11%) and obesity (8%). Despite stunting was higher among children attended in public health facilities (15%) it was surprisingly high among children in private health facilities (7%). It suggests that the problem is not only a matter of poverty, poor quality of life or food availability, but a matter of
micronutrient intake, such as iron and zinc. The prevalence of obesity was similar in both groups. Boys were always in worse nutritional status than girls. Stunting get worse from 8 months on, suggesting again that the time of complementary feeding is a critical window to improve nutritional status.

Breastfeeding indicators were evaluated and compared with three previous national surveys. Breastfeeding
is initiated by 98% of mothers, but after 6 months only 28% of children are being exclusively breastfed.
Almost one of two and one of three children continue to be breastfed at 12-15 months and 20-23 months respectively. The comparison with previous surveys shows that the main improvement regarding
breastfeeding indicators was achieved between 1996 and 1999, the time when Baby Friendly Hospital
Initiative was launched in Uruguay. From that time to the present, the situation of breastfeeding kept improving, but in a moderate way. Universal and continued policies and programmes on breastfeeding promotion should be developed and maintained.

From the 24-h dietary recall, consumption of complementary foods of 463 children was evaluated. It was alarming the low proportion of children that satisfied their iron needs (23%). More than one third of the
children didn’t eat during the day of the survey a single food rich on iron. Zinc needs were only achieved by 79% of the children, and calcium needs were only achieved by 65% of the breastfed children. The worse situation regarding these three micronutrients was found among breastfed children and among those
between 6 and 11 months. It may suggest that the value of breastfeeding is being overestimated after the
age of 6 months, so there is an urgent need to give families appropriate nutritional counseling for complementary feeding, using nutritious foods that are available to almost all families, at the time that governments should implement the fortification of local foods commonly eaten by children under 2 years old to help satisfy nutrient needs, particularly iron and zinc.