PEDIATRICS Vol. 106 No. 5 Supplement November 2000, pp. 1275-1276
Service de Médecine Infantile A. Hôpital d'Enfants Bab Saadoun Tunis 1007, Tunisia, North Africa E-mail: Khaldi.Faouzia@rns.tn
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This paper identifies 3 research questions using our experience with socioeconomic changes in Tunisia as an example.
Tunisia has always adopted the WHO/UNICEF recommendations concerning children's nutrition, especially breastfeeding and complementary feeding. This paper analyses different studies conducted in Tunisia concerning feeding practices and their effects on growth, morbidity, and mortality in childhood. The results obtained during 2 periods are presented: the first 20 years after independence (before 1976) and the second 20-year period (situation in 1996).
Before 1976
Feeding Practices
Most infants were breastfed
84% to 99%,1-3 and
the mean duration was 15 months. The mean length of exclusive
breastfeeding was 6 months. Breastfeeding was less common in urban
communities. This was not explained by mother's occupation but it was
rather because of her ignorance regarding good child feeding practices. Most studies emphasized the lack of complementary feeding starting from
the second semester of life.4 The age of introduction of
the first nutriment was variable according to regions. The first
complementary foods were most commonly (>60%) wheat flour gruels and
watered biscuit. Bread was introduced at 5 months. Legumes were rarely
given. Eggs, meat, and fish were not introduced until 12 months.
Growth
Low birth weight (<2500 g) was present in only 7% to
9%.5,6 Children grew well until the age of