IMPACT OF BREASTFEEDING ON THE GROWTH OF CHILDREN WITH MICROCEPHALY ASSOCIATED WITH CONGENITAL ZIKA VIRUS SYNDROME: A COHORT FROM BIRTH TO 60 MONTHS
Microcephalus; breast-feeding; growth delay; Low weight; child.
Congenital Zika Virus Syndrome (CZS) encompasses a series of malformations in children exposed during the intrauterine phase, such as microcephaly that affects physical and cognitive development, triggering complications in the feeding and growth process. Despite being recommended as the first source of nutrition, it is not known whether breastfeeding has a protective effect on the growth of these children, which is why this research aims to analyze the association between breastfeeding and the growth of children with microcephaly associated with SCZ. To this end, a longitudinal, prospective and observational cohort investigation was carried out with children with microcephaly associated with SCZ living in Rio Grande do Norte, Brazil. For this analysis, information from 0, 6, 24, 36, 48 and 60 months of age was developed. Breastfeeding was assessed using the second indicators proposed by the World Health Organization and growth using the z scores of the weight/age, height/age, weight/height and BMI/age indices. Associations were explored using covariate-adjusted logistic regression equations. Of the 73 children monitored, the average birth weight was 2621.81 g (± 69.34 SD), length was 44.99 cm (± 3.49 SD), and the average time of Exclusive Breastfeeding (EBF) was 3.27 months. 91.80% of the children were breastfed at some point in their lives, 31.5% were breastfed in the second year of life. Children generally presented a growth pattern below that expected for their age and sex, with a progressive increase in nutritional deviations over time. Those who received EBF for more than 4 months had higher z-scores for height/age and weight/age. Using logistic regression, we obtained that the presence of EBF in the first two days of life prevented the child's chance of being short at 24 months by 99% (OR = 0.007; 95% CI = 0- 0.44; p= 0.019), and 97% at 36 months (OR = 0.033; 95% CI = 0-0.80; p=0.036). Using the same method, exclusive breastfeeding for more than 4 months reduces by 80% (OR = 0.200; 95% CI = 0.04-0.98; p=0.047) the chance of developing low weight and low length, simultaneously, at 24 months. The results confirm the magnitude of the importance of breast milk for preventing the double burden of malnutrition also in children with SCZ.