The Children of Santa María Cauqué: A Prospective Field Study of Health and Growth

Abstract

This book describes the health and growth of children in a typical highland village of Guatemala in the 1960s. The data used for births deaths and population estimates for the years 1936-1963 were gathered from village municipal registers while data for the years 1964-72 were obtained directly from the field staff of the study. Specific target groups for the study were all pregnant women and their newborn infants. A total of 205 women experienced 469 pregnancies during the study; 203 women were used for the study with a total of 465 pregnancies. Measurements of the mothers and their children were either done in the home or in clinics and mostly interviews were used for the study. The study revealed that over 40% of infants are of low birth weight and that 80% of them experience fetal growth retardation. This reflects an inadequate maternal environment and has implications for both childhood survival and growth and development. Also the marked deficit in observed physical growth correlated with birth weight and gestational age of the newborn and even more strongly with the exceedingly high rates of infection and dietary deficiencies. Mild and chronic maluntrition is a common findgin at all stages of growth including those of pregnancy and lactation. No increase in maternal food intake was observed during pregnancy and lactation and infection was frequent during gestation. Cultural and ecological factors determined that all children are breastfed for 2 or more years and supplementation of the diet of breastfed babies begins at 2-6 months with provision of fluids and gruels of poor biological value and questionable hygiene. It was also shown that children who grow more slowly during the 1st months of life are weaned earlier; biological factors such as maternal nutrition and rate of child growth seem to influence duration of breastfeeding and cultural factors are also important accounting for the limited maternal knowledge of food preparation and food hygiene. Infection especially gastrointestinal stands out as a main factor in damaging the intestinal mucosa and in malabsorption nutrient wastage and related phenomena. This study did not reveal a remarkably deficient diet except for calories but their amount and quality were not markedly inadequate when related to the weight of the child. In a village such as this health interventions must be done carefully and education is the first and most pressing need in community development. Also important are improved food availability and health services. Improved health services will need to be preceded by increased availability of household water immunization agrarian reform family planning and food price control.