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Objectives: Infant growth is recognized to vary over the short term, with periods of greater and lesser linear growth velocity. Our objectives were to (1) examine the potential differences in overall growth profiles between children who experienced cumulative growth faltering in the first year of life consistent with that seen by many children living in poverty in low‐ and middle‐income countries, versus children without growth faltering and (2) test whether biological factors were associated with the timing of magnitude of growth saltations. Methods: Thrice‐weekly measurements of length were recorded for n = 61 Peruvian infants (28 boys and 33 girls) enrolled from birth to 1 year. A total of 6040 measurements were analyzed. We tested for the evidence of saltatory growth and used hurdle models to test whether the timing and magnitude of saltations varied between children with greater or lesser growth faltering. Results: There were no differences in the duration of stasis periods or magnitude of growth saltations between children who were stunted at 1 year old (N = 18) versus those who were not stunted (N = 43). Children who experienced greater declines in LAZ in the first year of life trended toward longer periods between saltations than those with less of a decline (14.5 days vs. 13.4 days, p =.0512). A 1‐unit increase in mid upper arm circumference for age Z‐score in the 21 days prior was associated with 35% greater odds of a saltation occurring (p <.001), and a 0.128 cm greater saltation (p <.001). Conclusions: After characterizing infant growth into periods of saltation and stasis, our results suggest that increases in weight preceded increases in length. [ABSTRACT FROM AUTHOR]

The WHO recommends exclusive breastfeeding for the first 6 months of life. However, the transition of the infants' diet to partial breastfeeding with the addition of animal milks and/or solids typically occurs earlier than this. Here, we explored factors associated with the timing of an early transition to partial breastfeeding across seven sites of a birth cohort study in which twice weekly information on infant feeding practices was collected. Infant (size, sex, illness and temperament), maternal (age, education, parity and depressive symptoms), breastfeeding initiation practices (time of initiation, colostrum and pre‐lacteal feeding) and household factors (food security, crowding, assets, income and resources) were considered. Three consecutive caregiver reports of feeding animal milks and/or solids (over a 10‐day period) were characterized as a transition to partial breastfeeding, and Cox proportional hazard models with time (in days) to partial breastfeeding were used to evaluate associations with both fixed and time‐varying characteristics. Overall, 1470 infants were included in this analysis. Median age of transition to partial breastfeeding ranged from 59 days (South Africa and Tanzania) to 178 days (Bangladesh). Overall, higher weight‐for‐length z‐scores were associated with later transitions to partial breastfeeding, as were food insecurity, and infant cough in the past 30 days. Maternal depressive symptoms (evaluated amongst 1227 infants from six sites) were associated with an earlier transition to partial breastfeeding. Relative thinness or heaviness within each site was related to breastfeeding transitions, as opposed to absolute z‐scores. Further research is needed to understand relationships between local perceptions of infant body size and decisions about breastfeeding. [ABSTRACT FROM AUTHOR]

The duration of exclusive breastfeeding (EBF) is often defined as the time from birth to the first non‐breast milk food/liquid fed (EBFLONG), or it is estimated by calculating the proportion of women at a given infant age who EBF in the previous 24 h (EBFDHS). Others have measured the total days or personal prevalence of EBF (EBFPREV), recognizing that although non‐EBF days may occur, EBF can be re‐initiated for extended periods. We compared breastfeeding metrics in the MAL‐ED study; infants' breastfeeding trajectories were characterized from enrollment (median 7 days, IQR: 4, 12) to 180 days at eight sites. During twice‐weekly surveillance, caretakers were queried about infant feeding the prior day. Overall, 101 833 visits and 356 764 child days of data were collected from 1957 infants. Median duration of EBFLONG was 33 days (95% CI: 32–36), compared to 49 days based on the EBFDHS. Median EBFPREV was 66 days (95% CI: 62–70). Differences were because of the return to EBF after a non‐EBF period. The median number of returns to EBF was 2 (IQR: 1, 3). When mothers re‐initiated EBF (second episode), infants gained an additional 18.8 days (SD: 25.1) of EBF, and gained 13.7 days (SD: 18.1) (third episode). In settings where women report short gaps in EBF, programmes should work with women to return to EBF. Interventions could positively influence the duration of these additional periods of EBF and their quantification should be considered in impact evaluation studies. © 2016 John Wiley & Sons Ltd [ABSTRACT FROM AUTHOR]

1. The spread of vector-borne diseases into new areas, commonly attributed to environmental change or increased trade and travel, could be exacerbated if novel vector species in newly invaded areas spread infection beyond the range of traditional vectors. 2. By analysing the differential degree of overlap between the environmental envelopes for bluetongue, a devastating livestock disease, and its traditional (Afro-Asian) and potential new (Palearctic) midge vectors, we have implicated the latter in the recent dramatic northward spread of this disease into Europe. 3. The traditional vector of bluetongue virus, the Afro-Asian midge Culicoides imicola, was found to occur in warm (annual mean 12–20 °C), thermally stable locations that were dry in summer (< 400 mm precipitation). The Palearctic C. obsoletus and C. pulicaris complexes were both found to occur in cooler (down to 7 °C annual mean), thermally more variable and wetter (up to 700 mm summer precipitation) locations. 4. Of 501 recorded outbreaks from the 1998–2004 bluetongue epidemic in southern Europe, 40% fall outside the climate envelope of C. imicola, but within the species’ envelopes of the C. obsoletus and C. pulicaris complexes. 5. The distribution in multivariate environmental space of bluetongue virus is closer to that of the Palaearctic vectors than it is to that of C. imicola. This suggests that Palearctic vectors now play a substantial role in transmission and have facilitated the spread of bluetongue into cooler, wetter regions of Europe. 6. Synthesis and applications. The risk to Northern Europe now depends on how much of the distributions of the widespread, abundant Palearctic midge vectors (the C. obsoletus and C. pulicaris complexes) bluetongue can occupy, perhaps determined by thermal constraints on viral replication. This was highlighted by the sudden appearance in summer 2006 of bluetongue virus at latitudes of more than 50° North – approximately 6° further North than previous outbreaks in southern Europe. Future surveillance for bluetongue and for related Culicoides-borne pathogens should include studies to record and explain the distributional patterns of all potential Palearctic vector species. [ABSTRACT FROM AUTHOR]