title: Nutrition factors predict earlier acquisition of motor and language milestones among young children in Haiti.
abstract: OBJECTIVE
  To examine the nutrition-related factors associated with motor and language development among young children living in a poor urban area of Haiti.
  
  
  METHODS
  Children aged 6-11 months (n = 583) were enrolled and followed monthly for one year. World Health Organization motor developmental milestones and vowel and consonant counts were assessed. Longitudinal regression models were applied to assess the association of anthropometric, dietary intake, infectious disease morbidity and socio-economic and demographic factors on developmental outcomes.
  
  
  RESULTS
  At baseline, 9.4% were stunted or length-for-age Z score < -2, and 30.2% were mild-to-moderately stunted or length-for-age Z score < -1. Stunting status was significantly associated with motor and phonetic language acquisition at each time point during infancy. Several nutrition factors significantly predicted earlier achievement of motor and language development outcomes in longitudinal models: child anthropometry; breastfeeding and complementary feeding frequencies; dietary diversity; egg and oil intake; and reduced infectious disease morbidities. Increases in the length-for-age Z score significantly predicted all motor and language outcomes and yielded the best fit models compared to other anthropometric indicators (p < 0.001).
  
  
  CONCLUSIONS
  Child development interventions may be enhanced by incorporating nutrition strategies such as improved diet quality, breastfeeding promotion and diarrhoeal disease mitigation.
authors.affiliation: Institute for Public Health, Brown School, St. Louis, MO, USA.
authors.forename: Lora
authors.initials: L
authors.lastname: Iannotti
authors.affiliation: Institute for Public Health, Brown School, St. Louis, MO, USA.
authors.forename: Sherlie
authors.initials: S
authors.lastname: Jean Louis Dulience
authors.affiliation: Washington University Medical School, St. Louis, MO, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Wolff
authors.affiliation: Institute for Public Health, Brown School, St. Louis, MO, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Cox
authors.affiliation: Institute for Public Health, Brown School, St. Louis, MO, USA.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Lesorogol
authors.affiliation: Institute for Public Health, Brown School, St. Louis, MO, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Kohl
mesh_terms: D002657:Child Development; D002658:Developmental Disabilities / Q000209:etiology; D003967:Diarrhea / Q000150:complications / Q000523:psychology*; D005260:Female; D006130:Growth Disorders / Q000150:complications / Q000523:psychology*; D006205:Haiti; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007804:Language Development; D008137:Longitudinal Studies; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000523:psychology*; D009048:Motor Skills
keywords: Anthropometry; Child feeding practices; Diarrhoea; Motor and language developmental milestones