Birthweights and growth of infants in five Aboriginal communities.
OBJECTIVE
To improve, by culturally appropriate means, birthweights and growth of children up to three years of age over 14 months in five Aboriginal communities in north-western Australia.


METHODS
Frequent individual nutritional assessment of infants and children with counselling of mothers and carers and of pregnant women and the introduction of the Aboriginal-controlled Strong Women, Strong Babies, Strong Culture maternal support program. Outcomes compared with those in the same communities for the five years preceding intervention.


RESULTS
By international standards, pre-intervention birthweights of full-term infants (37-42 weeks) were only moderately depressed and recovered to exceed standard weight-for-age within two weeks of birth. Growth of full-term infants slowed abruptly after six months. Prevalence and duration of breastfeeding were very high. Prevailing low average birthweight was chiefly attributable to a prevalence of pre-term birth approaching 20%. Intervention was not accompanied by any change in full-term birth weight but was associated with increased weight gain after six months. From 12 to 36 months growth rose by 30 g per month (p = 0.001). Average birthweights of pre-term infants were < 2,500 g and average weight-for-age did not improve during intervention.


CONCLUSIONS
Both low birthweight and a disproportionate part of intransigent failure to grow by Aboriginal infants were associated with pre-term birth. Depressed average growth of full-term infants appeared to respond to nutritional counselling accompanied by a community support program.


CONCLUSIONS
Investigation of the causes of the exceptionally high rate of Aboriginal pre-term birth in the region is urgently required.
Smith
R M
RM
Miln Walker and Associates Pty Ltd, Belair, South Australia. smithric@tpgi.com.au
Smith
P A
PA
McKinnon
M
M
Gracey
M
M
D001724:Birth Weight; D002662:Child Health Services / Q000458:organization & administration*; D015362:Child Nutrition Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control*; D053198:Child Nutrition Sciences / Q000193:education*; D002675:Child, Preschool; D003153:Community Health Services / Q000458:organization & administration*; D003256:Community Participation; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control*; D006130:Growth Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009035:Mothers / Q000193:education*; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D015397:Program Evaluation; D014904:Western Australia / Q000453:epidemiology