title: Infant feeding practices in the Peruvian Amazon: implications for programs to improve feeding.
abstract: OBJECTIVE
  To characterize feeding practices in a community in the Peruvian Amazon and to consider how this information could be used to strengthen programs and policies designed to improve nutrition and reduce child malnutrition in vulnerable communities.
  
  
  METHODS
  Data from three structured questionnaires were combined to produce a comprehensive depiction of feeding in a sample of 246 infants from birth through 8 months of life in the community of Santa Clara de Nanay near Iquitos, Peru. Breastfeeding initiation practices, exclusive breastfeeding in the first 180 days of life, the introduction of solids, and complementary feeding practices from 6-8 months, were described and related to maternal, infant, and household characteristics, including food insecurity.
  
  
  RESULTS
  The median duration of exclusive breastfeeding was 19 days. However, over the first 180 days of life, children were exclusively breastfed on 46.1% of days. Overall, 68.3% of infants received some semi-solid or solid food between 0-6 months and all had received semi-solids by the end of 8 months of age. The proportion of infants consuming a minimally acceptable (frequent and diverse) complementary diet was 2.9%, 7.9%, and 16.1% at 6, 7, and 8 months respectively.
  
  
  CONCLUSIONS
  Although breastfeeding is nearly universal, promotion programs are needed in Santa Clara to 1) delay the introduction of plain water, other non-breast milk liquids, and semi-solid foods; 2) extend the period of exclusive breastfeeding; and 3) increase food diversity and the frequency of feeding during the period of complementary feeding. These results can be used to guide programs and policies to improve nutrition and reduce child malnutrition.
authors.affiliation: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America, lcaulfi1@jhu.edu.
authors.forename: Gwenyth
authors.initials: G
authors.lastname: Lee
authors.affiliation: Biomedical Investigations Unit, Asociación Benéfica Prisma, Iquitos, Peru.
authors.forename: Maribel
authors.initials: M
authors.lastname: Paredes Olortegui
authors.affiliation: Biomedical Investigations Unit, Asociación Benéfica Prisma, Iquitos, Peru.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Rengifo Pinedo
authors.affiliation: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America, lcaulfi1@jhu.edu.
authors.forename: Ramya
authors.initials: R
authors.lastname: Ambikapathi
authors.affiliation: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America, lcaulfi1@jhu.edu.
authors.forename: Pablo
authors.initials: P
authors.lastname: Peñataro Yori
authors.affiliation: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America, lcaulfi1@jhu.edu.
authors.forename: Margaret
authors.initials: M
authors.lastname: Kosek
authors.affiliation: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America, lcaulfi1@jhu.edu.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Caulfield
mesh_terms: D001942:Breast Feeding / Q000706:statistics & numerical data*; D004032:Diet; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000379:methods* / Q000706:statistics & numerical data; D007225:Infant Food; D007228:Infant Nutrition Disorders / Q000453:epidemiology / Q000517:prevention & control*; D007231:Infant, Newborn; D008297:Male; D008425:Maternal Behavior; D010568:Peru; D011446:Prospective Studies; D012424:Rural Population; D011795:Surveys and Questionnaires