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Objetivo: Avaliar os marcadores de consumo alimentar e a diversidade alimentar mínima em lactentes de 12 meses de vida expostos a diferentes métodos de introdução alimentar. Métodos: Ensaio clínico randomizado com pares mãe-lactente submetidos à intervenção sobre introdução alimentar em três métodos: Método tradicional (MT), Baby-led Introduction to SolidS (BLISS) e misto (combinação das duas técnicas). Os marcadores de consumo alimentar foram avaliados por questionário online aos 12 meses com base nos alimentos consumidos no dia anterior, utilizando os marcadores de consumo alimentar para menores de 2 anos do Sistema de Vigilância Alimentar e Nutricional. O estudo foi aprovado no comitê de ética. Resultados: Aos 12 meses foram avaliadas 136 crianças: 45 alocadas no MT, 48 no BLISS e 43 no misto. Os alimentos com maior prevalência de consumo foram: leite materno103 (75,7%), frutas, legumes e verduras 122 (89,7%), carnes ou ovos 135 (99,3%), feijão 115 (84,6%), cereais ou tubérculos 135 (99,3%). Alimentos ultraprocessados que estiveram presentes na dieta dos lactentes foram hambúrguer ou salsichas 3 (2,2%), bebidas açucaradas 2 (1,5%), macarrão instantâneo 4 (2,9%) e biscoito recheado 2 (1,5%).Não foram encontradas diferenças entre os métodos de introdução da alimentação complementar. A diversidade alimentar mínima esteve presente na alimentação de 22 lactentes (16,2%), sendo: 6 (13,3%) no MT, 8 (16,7%) no BLISS e 8 (18,6%) no misto (p=0,793). Conclusão: Leite materno,frutas, legumes e verduras, carne, feijão e arroz estiveram presentes na alimentação da maioria dos lactentes; no entanto, a prevalência de diversidade alimentar mínima foi baixa.O consumo de alimentos ultraprocessados também esteve presente na alimentação dos lactentes. Registro Brasileiro de Ensaios Clínicos (ReBEC) identificação RBR-229scm.
Objective: To evaluate food consumption markers and minimum dietary diversity in 12-month-old infants exposed to different methods of food introduction. Methods: A randomized clinical trial with mother-infant pairs undergoing intervention on food introduction in three methods: Parent-Led Weaning (PLW), Baby-Led Introduction to SolidS (BLISS), and mixed (combination of the two techniques). Food consumption markers were evaluated by an online questionnaire at 12 months based on food consumed the previous day, using food consumption markers for children under 2 years of the Food and Nutrition Surveillance System. The study was approved by the ethics committee. Results: At 12 months, 136 children were evaluated: 45 allocated to PLW, 48 to BLISS, and 43 to mixed. The foods with the highest prevalence of consumption were breast milk 103 (75.7%), vegetables 122 (89.7%), meat 135 (99.3%), beans 115 (84.6%), rice, potatoes, or yam 135 (99.3%). Ultra-processed foods were present in the diet of infants, including hamburgers or sausages 3 (2.2%), sweetened beverages 2 (1.5%), instant noodles 4 (2.9%), and sandwich cookies 2 (1.5 %). No differences were found between the methods of introducing complementary feeding. The minimum dietary diversity was present in the diet of 22 infants (16.2%), being: 6 (13.3%) in the PLW, 8 (16.7%) in the BLISS, and 8 (18.6%) in the mixed (p=0.793). Conclusion: Breast milk, vegetables, meat, beans, and rice were present in the diet of most infants; however, the prevalence of minimal dietary diversity was low. The consumption of ultra-processed foods was also present in the diet of infants. Brazilian Registry of Clinical Trials (ReBEC) identification RBR-229scm.
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Humans , Infant , Eating , Infant Nutrition , Diet, Healthy , Infant Nutritional Physiological PhenomenaABSTRACT
Background: Nutritional status of under?5 children in India is not promising and lags far behind the WHO Global Nutrition Targets. Although the Integrated Child Development Services has been continuously delivered through Anganwadi centers since 1975, the burden of malnutrition still persists. Objectives: This study was conducted to estimate the knowledge and practice pattern of Anganwadi supervisors and the effect of capacity building through remote supportive supervision during the COVID-19 pandemic in Assam, India. Methods: A cross-sectional before-after study using a mixed methods approach was used to evaluate the knowledge pattern and service delivery of supervisors from each district of Assam. For qualitative assessment, telephone depth interviews were conducted. Results: Knowledge of supervisors in the beginning was 83.43% which improved by 7.97% at the end of the study. The highest burden of SAM children was in Tinsukia and Barpeta districts. On mapping, most districts with lower burden of SAM had supervisors with higher knowledge levels on Infant and Young Child Feeding practices. Qualitative assessment revealed house?to?house visit for ensuring service delivery and use of online platforms and phone calls for counseling. However, community resistance and lack of transport stood as a main challenge. Conclusion: Supportive supervision done remotely during the pandemic to enhance the performance of health workforce was found effective.
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Optimal infant and young child feeding practices(IYCFPs), despite being emphasized since 2003, are yet to be met in India. This study assessed these practices and their association with various factors among mothers of children aged 0–23 months in Paniya tribes in Nilgiris, Tamil Nadu. About 89.1% of the infants below six months were timely breastfed and 77.9% of them were exclusively breastfed, respectively. Complementary food was introduced to 25% of infants aged six to eight months. About 27.8% of them received a diverse diet. About 91.7% of them were fed egg and/or flesh food and 37% of them were fed vegetables and fruits. Illiterate mothers and mothers who had a vaginal delivery fed the infant optimally. The adherence to these practices was found to decrease gradually with an increase in the infant’s age. The prevalence of IYCFP is higher in the study population compared to the corresponding indicators for the district according to the National Family Health Survey‑5.
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Introduction: COVID‑19 pandemic was postulated to affect the infant and young child feeding (IYCF) practices and their nutritional status. This study was planned to assess IYCF practices and nutritional status of infant and young children residing in slum areas and their association with selected background characteristics. Materials and Methods: Acommunity‑based, cross‑sectional study was conducted in slums of Kolkata Municipal Corporation among 161 mother–child dyads from October to December 2020. After obtaining informed consent, mothers were interviewed to collect information about their socioeconomic status, hardship faced during pandemic, and IYCF practices of their children using indicators proposed by the World Health Organization and Government of India. Weight and height were measured using the standard operating protocol. The proportion was used to express descriptive statistics. Binary logistic regression models were used for calculating the adjusted odds ratio (AOR) using PSPP (v 1.20). Results: Only 64 (39.8%) children received age‑appropriate feeding; 73 (45.3%) had single/multiple anthropometric failure(s). Reduction of family income was reported by 142 (88.2%) respondents. Children aged 6–8 months (AOR = 17.08, 6.43–45.42) were more likely to not have appropriate feeding. Association of female gender (AOR = 2.00, 1.01–4.00), maternal education less than middle class (AOR = 2.58, 1.22–5.46), and lack of appropriate feeding (AOR = 2.57, 1.08–6.12) were statistically significant with the presence of anthropometric failure. Conclusions: The study revealed a dismal scenario of child feeding and nutritional status of young children in the urban slums of Kolkata. Pandemic and imposed restrictions hit the families hard by reducing income and increasing food‑related costs.
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Objectives: This study was undertaken to identify stakeholder needs and wants in relation to an Infant and Young Child Feeding, Social and Behaviour Change Communication (SBCC) strategy for the 16 Southern African Development Community (SADC) member states during Covid-19 lockdowns and travel restrictions.Design: A rapid-assessment mixed-methods approach using qualitative and quantitative studies was adopted. Secondary data sources supported in-field findings. Setting/Subjects: Qualitative approaches included 17 key informant interviews from 7 SADC member states. Quantitative methods of an online survey elicited feedback from 61 participants from 11 SADC member states.Outcome measures: More strategic, best practice, infant and young child feeding SBCC programmes are recommended in SADC.Results: Programme challenges included increased demands on health systems from Covid-19, poor attitudes and beliefs toward IYCF behaviours, the dual burden of undernutrition and overnutrition, and financial and human resource capacity challenges to implement and evaluate SBCC campaigns at scale. Opportunities were also identified for improved detection,better meeting IYCF nutritional needs from locally sourced foods, training and capacity building for greater engagement of front-line field staff, effective policy development to support parent-friendly hospitals and workplaces, and improved regional integration. Conclusions: The needs assessment demonstrated that priority programme planning can continue while the health sector deals with a pandemic threat. The adaptation to virtual support provided a variety of learnings for research designs, data collection and analysis, albeit over an extended timeframe of six months. A number of innovative approaches were identified in the resultant SBCC strategy for SADC along with opportunities for regional efficiencies in adapting existing, best practice SBCC creative and programming approaches.
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Humans , Needs Assessment , Nutritional Sciences , Child , Diet , InfantABSTRACT
Background: Suboptimal feeding practices during the infancy increase the risk of death, illness, and malnutrition. Despiteoverwhelming evidence of the benefits of exclusive breastfeeding, only about 40% babies under 6 months are exclusivelybreastfed, due to the lack of understanding of optimal feeding practices and lack of support from health service providers,community members, and families; babies who are not exclusively breastfed in the early months have a higher risk of death,especially from infection. The Lancet’s 2003 child survival series identified that exclusive breastfeeding could save up to 1.3million children worldwide. This essential intervention involves the early initiation of breastfeeding and ensuring that the mothergives only breastmilk and no other food or fluids during the first 6 months of life. Undernutrition of children is an importantcontributor to the deaths of 10.5 million children globally each year.Aims and Objectives: The present study seeks to estimate the proportion of mothers carrying out age-appropriate infantfeeding practices. Besides, the present study was conducted to study factors associated with infant feeding practices andreasons preventing exclusive breastfeeding in infants.Materials and Methods: A cross-sectional community-based study was conducted in the field practice area of Rural Health andTraining Centre, Mandur, Goa, from February 2019 to August 2019. Recruitment of study population was done by a systematicrandom sampling method and study population comprised of mothers with infants between 9 months and 1 year. A structuredquestionnaire was used to collect data in a face to face interview with the mother.Results: In the present study, 150 infants aged 9 months to 1 year were recruited. It was observed that exclusive breastfeedingup to 6 months was carried out in 94 infants (62.66%). Early initiation of breastfeeding was carried out in 37 infants (24.7%).Weaning of infants by 6 months was started in 72 infants (48.18%). Exclusive breastfeeding of infants was found to bestatistically significantly associated with mother’s occupation (≥2 = 27.152; P = 0.00019), religion (≥2 = 12.19; P = 0.015), andage (≥2 = 25.4; P = 0.0002).Conclusions: Suboptimal feeding practices during the infancy increase the risk of death, illness, and malnutrition. It is imperativeto educate mothers on infant and young child feeding practices and create awareness within communities to achieve optimalgrowth and development of infants.
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Background: Optimal feeding of infants under two years of age has the greatest potential impact on child survival of all preventive interventions. This study was done to evaluate feeding practices of infants in first two years of life.Methods: In this cross sectional study, 161 mothers with infants 6 mo to 24 mo of age, attending the well-baby clinic of this hospital were selected for study from April 2014 to March 2015 and interviewed using a structured questionnaire.Results: The prevalence of exclusive breastfeeding for 6 mo was 44% with a median duration of 4.9'1.8 mo. The proportion of infants who received continued breast feeding at 1 year of age (12-15 mo) was 67%. The median duration of any breast feeding was 13.6 mo by survival analysis. Early introduction of cow's milk and bottle feeding were associated with nonexclusive breast feeding under 6 mo and early termination of breast feeding.Conclusions: While rate of exclusive breast feeding was comparable to the state average (48%), there was a higher rate of introduction of cow's milk and bottle feeding which contributed to early termination of breastfeeding before one year of age. This study emphasis the fact that bottle feeding and inappropriate complementary feeding should be tackled to improve IYCF indicators in Tamilnadu.
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Background: Early or timely initiation of breastfeeding, specifically within 1 hour of birth has benefits for survival and beyond and it is recommended by the World Health Organization. Breastfeeding initiation after the first hour of birth doubles the risk of neonatal mortality. The present study has been conducted to estimate the prevalence and determine the factors affecting early initiation of breastfeeding in rural areas of Dibrugarh, district, Assam. Methods: Community based cross sectional study from May 2017 to April 2018 among mothers having children in the age group 0 to 23 months in the rural areas of Dibrugarh district. The sample size calculated for the study was 360 children. Results: The results were analyzed for 334 children. Prevalence of early initiation of breastfeeding was found to be 54.8%. On multivariate regression analysis the occupation and education of mothers, number of antenatal checkup visits, type of delivery and religion were found to be independently associated with early initiation of breastfeeding. Conclusions: This study reveals that the early initiation of breast feeding is lower in rural areas of Dibrugarh district. The findings clearly highlight the importance of imparting health education to family members and mothers right from antenatal period on infant and child feeding practices.
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Background: Optimal infant and young child feeding practices (IYCF) are essential to address the increasing burden of malnutrition and for the overall development of the children. The present study was conducted to estimate the proportion of optimal infant and young child feeding practices among rural children aged 0 to 23 months and study the associated socio demographic factors.Methods: A community based cross-sectional study was conducted among 360 children in the age group of 0 to 23 months in a rural field practice area of a medical college in Puducherry. Data on IYCF practices were collected using a standardized tool developed by WHO. Core and optional IYCF indicators were calculated. Chi-square test and Fishers’ exact test were used as tests of significance.Results: Almost 88.0% of infants were initiated early on breastfeeding and 90.8% were exclusively breastfed for six months. Children who were continuously breastfed at one year and two years were 77.4% and 22.4% respectively. About 75.0% were introduced with solid or semisolid foods at 6 to 8 months of age. Among children aged 6 to 23 months, 77.3% had the recommended minimum dietary diversity, 81.3% had the minimum meal frequencies, while 57.7% received the minimum acceptable diet and only 39.4% consumed iron rich foods. Gender was significantly associated with the practice of continued breastfeeding at one year, adequate minimum dietary diversity and minimum meal frequency.Conclusions: The core and optional IYCF indicators were acceptably good in the initial six months of life but thereafter showed suboptimal levels, which should be emphasized among the mothers or primary care givers.
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@#Introduction: The Penan people are largely settled in rural and remote areas of Sarawak with high rates of undernutrition among the children. The study aimed to determine the nutritional status and infant and young child feeding (IYCF) practices of Penan children. Methods: Subjects consisted of 121 children, aged between 0-23 months, from 15 Penan longhouses in Belaga district. Malnutrition was assessed using anthropometric measurements of children and categorised according to the World Health Organization (WHO) Growth Standards (2006). Feeding practices were assessed using questionnaires based on WHO IYCF Indicators (2008). Results: The prevalence of underweight was 29.8%; stunting 43.0% and wasting 5.8%. Prevalence of exclusive breastfeeding under 6 months was 44.4%. About 86% of infants aged 6-8 months were already given solid, semi-solid and soft foods. The proportion of children aged 6-23 months achieving minimum dietary diversity (MDD) was 76.6%, while minimum meal frequency (MMF) was 83.0% (breastfed and non-breastfed). Among the children who achieved MDD, 64.9% of their meals were derived from 4-5 food groups. More than half (55.3%) of all subjects (breastfed and non-breastfed) received minimum acceptable diet (MAD). Achievement of iron-rich foods (IRF) indicator was 77.7%. There was no significant association between the IYCF indicators of MDD, MMF and MAD and underweight, stunting and wasting. Conclusion: A high prevalence of poor nutritional status was recorded among the Penan children. While the IYCF indicators apparently showed satisfactory complementary feeding practices, future studies should assess quantitatively the intake of complementary food among Penan infants and young children.
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Background: The first two years of life involve rapid physical, cognitive and social development that requires optimal nutrition. Tribal populations are the most backward section of the society. In West Bengal, the Santal tribe contributes to 51.8% Scheduled Tribe population of the state. Aims & Objective: The present study was conducted to assess infant and young child feeding practice among Santal women in Bhatar block of Burdwan District, West Bengal in India. Materials and Methods: It was a descriptive study of cross-sectional design. Bhatar block was purposively selected and 10 villages inhabited by Santals were chosen purposively. Data were collected by interview method using a pre-designed pre-tested schedule from 120 mothers having children of 0-23 months of age. WHO indicators for assessing infant and child feeding practices were used. Results: Breast feeding was initiated within one hour of birth in 48.33% cases, 46.15% babies were exclusively breastfed and in 47.37 % cases breastfeeding was continued at 1 year of the baby. Solid, semisolid or soft foods were correctly introduced at 6-8 months in 46.67% infants. Only 30.85% mothers maintained minimum dietary diversity while 41.49% mothers maintained minimum meal frequency. Conclusion: The poor status of indicators of Infant and child feeding practice found in present study may be attributed to high rate of illiteracy and poor socio-economic condition among Santal women. Therefore intense total literacy campaign, income generating activities and health education by health personnel is the need of the day.
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A cross-sectional study was conducted among 245 under-two slum-dwelling children in Bankura town, West Bengal, to assess their feeding practices and its association with nutritional status. Child’s gender, number of family members, standard of living (SLI), and household food security (HFS) were assessed through interview of mothers/ caregivers. Child feeding practices were measured with Composite Child Feeding Index comprising of age-appropriate, multiple, infant and young child feeding (IYCF) indicators and expressed in standardized IYCF score. Weight and length of the children were measured and the nutritional status was assessed using World Health Organization Growth Standard 2006. Standardized IYCF score was signifi cantly lower in undernourished children than those with normal grades. Per unit increase in standardized IYCF score was likely to reduce the prevalence of underweight, stunting and wasting by 2-3% after adjusting for other variables. Low/ very low HFS, low SLI and female gender were associated with underweight and stunting.
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A cross sectional study was conducted to study the diet pattern of children less than 2 years with regard to certain infant and young child feeding (IYCF) indicators. A total of 374 children less than 24 months of age coming to the immunization clinic were studied using a standard pretested and prevalidated questionnaire. Exclusive breastfeeding was followed by 57.1% of children under 6 months of age. Minimum dietary diversity, minimum meal frequency, and minimum acceptable diet were seen adequate in 32.6%, 48.6%, and 19.7% of children between 6 months and 2 years of age, respectively.