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[Maternal and infant nutrition in developing countries].

This work 1) examines the scientific bases of knowledge regarding maternal nutrition and feeding practices for infants and small children especially those aspects that would be appropriate foundations for nutrition programs 2) identifies gaps in knowledge and 3) suggests priority areas for research. The synthesis of existing knowledge considers nutrition of fertile aged women nutritional preparation for reproduction nutrition during pregnancy and in adolescent pregnancy lactation the nutritional status of the lactating mother nutrition of breastfeeding infants and of small children breastfeeding and supplementary feeding and diarrhea during weaning. An annex assesses knowledge of the effects of lactation on the energy protein vitamin and mineral balances of the mother. 4 research problems were identified as particularly urgent: 1) study of interaction between physical activity and weight gain during pregnancy pregnancy outcomes and lactation 2) identification of causes of perinatal complications including cultural practices especially in relation to insufficient growth 3) identification and application of risk factors for pregnancy outcomes and 4) evaluation of complementary feeding and weaning methods to identify those which avoid risks and are acceptable. Although epidemiologic data are often inadequate in developing countries it was concluded that measures could be taken to improve the health and nutrition of mothers and small children in developing countries. Interventions in general should involve community participation be oriented to families and be part of a primary health care strategy be integrated with the fight against infection and with family planning and be adapted to local ecologic and other conditions. Several risk factors are proposed to identify individuals families or communities who would most benefit from such interventions. Measures to improve the health and nutrition of women before and during pregnancy should be taken along with encouragement of family planning to avoid early pregnancies and to ensure optimal birth intervals. Nutrition programs during pregnancy should aid rather than replace longterm interventions designed to improve socioeconomic wellbeing health status and food availability and consumption. Everything possible should be done to encourage breastfeeding. Appropriate supplementary feeding should be initiated before milk alone becomes nutritionally inadequate but not so early that it interferes with breastfeeding. Prevention of infantile diarrhea requires good nutrition before supplementary feeding is begun health education of the mother and others caring for the child and good sanitary conditions. Growth surveillance should be given high priority as a means of early detection and correction of nutritional deficits and poor health.