Effectiveness of a nutrition program in reducing symptoms of respiratory morbidity in children: a randomized field trial.

Abstract

To assess the effectiveness of home visits advising mothers about breast feeding and weaning in reducing symptoms of respiratory morbidity at the age of 12 months. A randomized field trial was conducted with mothers who gave birth within the public health system in the Brazilian city of Sao Leopoldo (2001/2002). The intervention group received dietary advice during the first year based on a Brazilian national health policy for primary care, which is based on WHO guidelines. Morbidity data was assessed in 397 children at 12 months. A total of 23.3% of the children in the intervention group and 39.7% of the controls had one or more of the following symptoms during the month preceding assessment: cough, stuffy nose, runny nose, or breathlessness. The risk of respiratory morbidity symptoms was 41% lower for the intervention group (RR: 0.59; 95% CI: 0.43-0.81). The number of families needed to be visited to avoid one children presenting symptoms of respiratory morbidity (Number Needed to Treat) was 6.1. The intervention-group status was also associated with a longer duration of exclusive (RR:1.59; 95% CI: 1.21-2.07; p=0.001) and total breastfeeding (RR: 1.25; 95% CI:1.02-1.55; p=0.032) later introduction of solid foods (RR:1.11; 95% CI: 1.02-1.21; p=0.023), and a lower proportion of current medication use (RR:0.56; 95% CI:0.34-0.91;p=0.016). A nutrition education program during the first year of life has a positive impact on reducing respiratory symptoms in infants.