title: Birthweights and growth of infants in five Aboriginal communities.
abstract: 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.
authors.affiliation: Miln Walker and Associates Pty Ltd, Belair, South Australia. smithric@tpgi.com.au
authors.forename: R M
authors.initials: RM
authors.lastname: Smith
authors.forename: P A
authors.initials: PA
authors.lastname: Smith
authors.forename: M
authors.initials: M
authors.lastname: McKinnon
authors.forename: M
authors.initials: M
authors.lastname: Gracey
mesh_terms: 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