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Mexico has implemented a number of food and nutri-

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The purpose of this study was to assess the factors associated with exclusive breastfeeding (EBF) during the first 6 months of life. A prospective, cohort study was conducted in 291 newborn children in 3 semirural localities in Mexico. Data were collected on infant-feeding practices, anthropometry, morbidity, and maternal and household characteristics. Two-stage multivariate regression models were used for statistical analysis. Prevalence of EBF was 50% at day 5. Average duration of EBF was 2.18 months. According to the 2-stage model, maternal age, maternal work, and better socioeconomic conditions were associated with EBF at day 5. Infant nutritional status, prevalence of diarrhea, giving colostrum to the newborn, and maternal experience in breastfeeding were associated with duration of EBF. The prevalence of EBF and its duration were much shorter than recommended internationally. EBF during the early days of life and EBF duration are 2 different processes that are determined by different factors.

Several patients with the Silver-Russell syndrome (SRS) attending our Genetics Clinic were diagnosed as having persistent metabolic acidosis. Since this abnormality has not been reported previously in the SRS, we reexamined 33 SRS patients to evaluate the frequency and type of metabolic acidosis, the clinical and laboratory findings, and the growth pattern in SRS patients with and without metabolic acidosis. Among them, 14 had a consistent decrease in HCO3- levels. Renal studies in acidotic patients showed urine pH of 5.8 and 24 h urine calcium of < 2.4 mg/kg/24 h; serum creatinine, excretion of glucose, and amino acids were normal, as were renal ultrasound and excretory urography findings. These data supported the diagnosis of renal tubular acidosis, probably type II; the patients were treated with oral bicarbonate and acidosis was corrected successfully. Clinical manifestations were similar in acidotic and non-acidotic patients. The nutritional indices at diagnosis and at last evaluation (at least 8 months after diagnosis) were abnormally low in all patients; however, acidotic patients, treated with bicarbonate, showed an improvement of nutritional status particularly in the weight/height index, although the difference between groups after follow-up did not reach statistical significance. We suggest that metabolic acidosis due to renal tubular acidosis, probably type II, may occur in children with the SRS and should be looked for and treated in all patients.