Infant and child feeding index reflects feeding practices, nutritional status of urban slum children.

Neha Lohia,Shobha A Udipi

doi:10.1186/s12887-014-0290-7

Abstract

BackgroundInfant and child feeding index (ICFI) an age-specific index, can be used to assess child feeding practices. We used the ICFI to assess feeding practices for urban slum children and the association between ICFI and child nutritional status.Methods446 children aged 6 to 24 months from urban slums of Mumbai, India were studied. We used the 24-hour diet recall to study dietary diversity and a food frequency questionnaire for consumption of food groups during the preceding week. ICFI was computed using five components, namely, breastfeeding, use of bottle, dietary diversity score (DDS), food group frequency score (FGFS) and feeding frequency scores (FFS). Weight, height and Mid-Upper Arm Circumference (MUAC) were measured, and z scores were calculated. Association between ICFI scores and nutritional status was examined.ResultsThe mean total ICFI score for all was 5.9 ± 1.9. Among the five components, FGFS and FFS differed between children <12 months of age and >12 months and by breast feeding status. In contrast, there were no differences vis-à-vis dietary diversity scores (DDS), breast feeding, and use of bottle. Non-breastfed children had significantly higher DDS scores than did breastfed children. The mean feeding frequency score (FFS) for children <12 months of age was slightly but not significantly lower than scores for children >12 months of age. Mother’s age and child’s age were significant determinants of ICFI. Multivariate analysis indicated that ICFI was significantly associated with Length-for-Age z scores (LAZ) and BMI-for-Age z scores (BAZ). Sensitivity of ICFI was lower than its specificity.ConclusionsThe results of the present study confirmed that the ICFI can be used to collect information on key components of young child feeding practices and be incorporated into public-health programmes. Further, it could be used to determine the influence of complementary feeding practices on nutritional status of children.

Highlights

Infant and child feeding index (ICFI) an age-specific index, can be used to assess child feeding practices
With respect to Weight-for-age z score (WAZ) and body mass index (BMI)-for-Age z scores (BAZ), the mean z scores were significantly better among children >12 months than the younger age children (WAZ: F value = 14.885, p = 0.000; BAZ: F value = 23.087, p = 0.000)
The mean Mid-upper arm circumference-for-age z score (MUACZ) score was better among children

Summary

Introduction

Infant and child feeding index (ICFI) an age-specific index, can be used to assess child feeding practices. In the Indian context, most of the reports in the literature have focused on specific feeding behaviours such as breastfeeding, age at introduction of complementary foods [3,8,9,10] All these studies have not captured the multidimensionality of feeding practices including dietary diversity and have not examined their influence on child nutritional status. Ruel and Menon developed a composite feeding index to identify nutritionally vulnerable children [11] This index is based on an age-specific scoring system that gives points for positive practices such as breastfeeding, avoiding use of bottle for feeding, meal frequency and dietary diversity. We used the index developed by Ruel and Menon [11] to assess feeding behaviours and to identify which of the ICFI components may require attention in nutrition education interventions in Indian slums. We calculated the specificity and sensitivity of the ICFI in order to determine whether it can serve to identify undernourished children

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Discussion

Conclusion