The purpose of the study is to prevent the early introduction of added sugar and ultra-processed foods and evaluate the impact on breastfeeding duration, complementary feeding quality, growth and prevalence of caries during the first year of life.
This randomized field trial will be performed at the maternity wards of Friendly Hospitals Initiative in three regions of Brazil: North, Northeast and South. After delivery, mothers who accepted to participate in the study will be randomized into control and intervention groups.It will be performed a weekly block randomization to prevent the contamination of information among mothers of different groups in the same facility. The intervention mothers will be advised not to give added sugar and ultra-processed foods during the first year of life, including a leaflet with colored images as a reminder for mothers. The control group mothers will not receive the study intervention but will be have all the routine health assistance of the maternity. At 6 months and 12 months, mothers of both groups will be visited in their homes and dietary evaluation and anthropometric measurements of their babies will be assessed. At 12 months of age the infants will have dental examinations and hemoglobin concentration through a capillary blood test. .
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
516
The intervention will consist of an individualized, face-to-face, 20 to 30 minute counseling session to mothers by trained health workers who will address healthy eating practices during the first two years of life. A printed, colorful and illustrated material will be used to assist mothers in appropriate food choices, mainly to avoid the introduction of sugar and ultra-processed foods. In addition, they will receive a booklet which addresses the "Ten Steps of Healthy Feeding for children from Birth to Two years of life". The research team will focus on Step2: "Do not give added sugar or foods with added sugar", and Step8:"Do not offer ultra-processed foods as candies and soft drinks". To reinforce the intervention, mothers will receive telephone calls up to the infant reach six months.
Federal University of Health Science of Porto Alegre
Porto Alegre, Centro Histórico, Brazil
Amount of Added Sugar and ultra-processed foods consumed at 6 months
Information will be obtained through two not consecutive dietary 24 hour recall
Time frame: 6 months
Amount of Added Sugar and ultra-processed foods consumed at 12 months
Information will be obtained through two not consecutive dietary 24 hour recall
Time frame: 12 months
weight gain pattern at 6 months
Weight at birth and six months will be obtained and the weight gain velocity will be calculated
Time frame: 6 months
weight gain pattern at 12 months
Weight at six months and 12 months will be obtained and the weight gain velocity will be calculated
Time frame: 12 months.
Number of Participants with dental caries
The dental examination will be performed by dentists
Time frame: 12 months
Anemia prevalence
The hemoglobin levels will be obtained by capillary blood tests
Time frame: 12 months
Exclusive breastfeeding duration
Proportion of infants from 0-6 months at age who are fed exclusively with breastfeeding
Time frame: 6 months
Prevalence of continued breastfeeding at 1 year
Proportion of children 12 months of age who are breastfed
Time frame: 12 months
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Minimally processed foods, processed foods and total energy intake consumed at 6 months
Information will be obtained through two not consecutive dietary 24 hour recall
Time frame: 6 months
Minimally processed foods, processed foods and total energy intake consumed at 12 months
Information will be obtained through two not consecutive dietary 24 hour recall
Time frame: 12 months
Offer of added sugar and ultra-processed foods at 6 months
Information will be obtained through a food introduction questionnaire
Time frame: 6 months
Offer of added sugar and ultra-processed foods at 12 months
Information will be obtained through a food introduction questionnaire
Time frame: 12 months
Proportion of infants from 0-12 months of age who are fed with infant formula, cow's milk and toddler milk
Information will be obtained through a food introduction questionnaire
Time frame: 12 months