Relationships between the weaning period and the introduction of complementary foods in the transmission of gastrointestinal parasitic infections in children in Honduras.

Purpose: This study was to investigate weaning practices used by mothers when transitioning infants from breast milk to complementary foods and to determine the role these foods have in the transmission of gastrointestinal parasites.

Participants and methods: On average, of the 175 mothers extensively interviewed, 93% said they had breast-fed their infants. Approximately 20.8% of mothers had added some other liquid to their infant's diet at 3 months, while most mothers had added other liquids at 6 months (39.0%) and >6 months (32.1%). Some mothers expanded food offerings to infants before 3 months. The percentage of mothers who had added other liquids to their infants' diet was reported by age of the infant: as early as 1 day (2.5%), <1 week (1.9%), first month (3.1%), 3 months (20.8%), 6 months (39.0%), and >6 months (32.1%). These foods included fruit, vegetables, meat, and grains. The maximum age a child was found to be still breastfeeding was 13 years.

Results: Forty percent of mothers involved in this survey reported that their children were diagnosed and/or treated for gastrointestinal parasitic infection. Routes of infection of protozoan and helminth parasites likely resulted from contaminated complementary foods and water given to infants while still breast-feeding or from contaminated foods after breast-feeding had been completed. Contaminated water is a likely source of protozoan parasites. Contaminated water was fed to infants, mixed with formula or complementary foods, or used to wash bottles for infant feeding. There was an absence of hand-washing by children and mothers before eating or while preparing foods.

Conclusion: The major source of soil-transmitted helminth infections was likely the result of unwashed or uncooked pureed fruit or vegetables used as complementary foods, unpasteurized animal milk, insanitary food storage, poor living conditions with exposed dirt floors, and exposure to roaming domestic animals.