Infant and Young Child Feeding Practice Status and Associated Factors among Mothers of under 24-Month-Old Children in Shashemene Woreda, Oromia Region, Ethiopia

BackgroundAdequate nutrition during infancy and early childhood is essential to ensure the health, growth and development of children. However, infant feeding practice is suboptimal in Bahir Dar City, Ethiopia. The slum area is a heavily populated urban informal settlement characterized by substandard housing, squalor, with a lack of reliable sanitation services, supply of clean water, reliable electricity, law enforcement and other basic services. Residents of the slum area were poor and less educated. This further compromises infant feeding practice. The aim of this study was to assess infant and young child feeding practice among mothers with 0–24 month old children in the study area.MethodsA community based cross-sectional study was conducted among 423 mothers with 0–24 month old children from June 01-30 / 2016. Simple random sampling technique was used to select the respondents. Infant and young child feeding practice was assessed using the fifteen World Health Organisation (WHO) criteria.ResultsThe prevalence of exclusive breastfeeding practice was 113 (84%). Sixty (15%) mothers gave prelacteal feeds and, 96 (23%) mothers used a bottle to feed their index child. Appropriate complementary feeding practice was only 20 (7%). Thirty nine out of forty mothers introduced complementary food timely, 131 (47%) of mothers gave the minimum meal frequency, and 20 (7%) children took the minimum food diversity and acceptable diet. Independent predictors for complementary feeding practice were having secondary and above education of the mother, receiving postnatal care, possession of radio and giving birth at hospital.ConclusionIn this study infant and young child feeding (IYCF) practice was poor. Therefore, there is a need for strengthening the promotion on IYCF practice during postnatal care and using mass media to giving emphasis for optimal complementary feeding practices, especially for mothers with a lower educational status.

Ensuring optimal breastfeeding and improvements in complementary feeding to improve infant and young child nutrition in developing countries

Achieving optimum Infant and young child feeding practices is the major challenge in developed and developing countries. Globally, about 40% of under two years age deaths are attributed to inappropriate infant and young child feeding practices. In Ethiopia, a wide range of inappropriate infant and young child feeding practices were documented. The study was aimed to assess infant and young child feeding practice and its associated factors among children aged 0-23 months in Assayita districts, Afar region, Ethiopia, 2018. A Community based cross-sectional study was applied from January1-30/2018 among 620 study participants. A pre tested structured questioner was used to collect data. After data get collected it was cleaned and entered using EPI-Data version-3.02 and exported to SPSS version-20 for further analysis. Binary logistic regression analysis was used to measure the strength of association between explanatory variables and outcome variable. Variables with p<0.25 on univariable logistic regression analysis were candidates for multivariable logistic regression analysis and statistical significance was declared at P-value <0.05 and 95% CI. In this study the prevalence of appropriate infant and young child feeding practice was 9.2% (95% CI. 7.1–11.6), children from mothers with secondary education (AOR=4.44, 95% CI (1.84, 10.7), delivered at health facilities (AOR=2.55, 95% CI (1.32, 4.93), had Ante Natal Care follow-up (AOR=4.2, 95% CI (2.2, 8.7), and heard information about Infant and young child feeding (AOR=4.38, 95% CI (1.97, 9.5) were predictors of appropriate Infant and young child feeding practice at 95% CI. Promoting institutional delivery, promoting Ante Natal Care service, maternal education and increasing awareness on infant and young child feeding practice should be implemented.

Although infant and young child feeding practices play an important role in reducing early childhood morbidity and mortality, very large proportions of women do not practice optimal breastfeeding and complementary feeding for their children in Ethiopia. Till date, none has addressed the supply and demand side factors that influence infant and young child feeding practices (IYCFP). This work aims to assess supply and demand side factors that influence infant and young child feeding. A community based cross sectional study was employed involving quantitative and qualitative methods among sampled mothers with children under 24 months in Gibe District Southern Ethiopia. Qualitative data were collected through in-depth interviews and focus group discussion, and analyzed through a thematic analysis approach. Quantitative data were entered into Epi-data 3.1 and then exported to SPSS 21.&nbsp; Bivariate and multivariate logistic regression was used. Prevalence of inappropriate infant and young child feeding practice was 67.9%. Being government employee of husband [AOR = 4; 95%CI: 1.65, 10.04], lower income status [AOR = 3.1;95%CI:1.36, 7.07], not attending ANC (AOR = 2.03 (1.22, 3.36)], child age 0 - 5 months [AOR = 2.4;95%CI:1.02, 5.72], negative attitude of mothers towards IYCFP [AOR = 2.35 (1.44, 3.84)] and number of children 3-4 [AOR = 1.99;95%CI:1.08, 3.64] were predictors of inappropriate IYCFP. There is high prevalence of inappropriate infant and young child feeding practice in the study area. Interventional initiatives should focus on improving socio-economic status, and access to information, education and communication for improvement of IYCFP. Key words: Infant and young child feeding practice, supply side factors, demand side factors, Ethiopia. &nbsp

BackgroundInappropriate infant and young child feeding (IYCF) practice is the leading cause of malnutrition in children. Data is needed to identify children at risk of poor feeding practice and to target interventions to improve IYCF practices. Therefore, this study aimed to assess IYCF practice and associated factors among mothers of children age 6 to 23 months in Debrelibanos district, north Showa zone, Oromia region, Ethiopia.MethodA community-based cross-sectional study design was conducted among 380 mothers of children age 6 to 23 months from March 1 to April 5, 2019. A simple random sampling technique was used to select the respondents. Data was collected using a structured interviewer-administered questionnaire that had been pretested. The data was entered into Epi-Data 3.1 and then transferred to SPSS 21 for analysis. Descriptive statistical analysis was done, and an association between an outcome variable and independent variables was examined in logistic regression models.ResultOverall, 65.8% of mothers practiced appropriate IYCF practice. The study revealed that 70.5% of children started breastfeeding within one hour of birth, and 61.6% were breastfed exclusively for six months. Among studied mothers, 79.5% continued to breastfeed their children until 2 years, and 69.2% of the participants started complementary feeding timely at six months. Minimum dietary diversity was observed in 19.2% of children, while minimum meal frequency was found in 79.2%. The majority of mothers (77.6%) fed their babies with bottles. Mother’s educational status of primary school [AOR = 4.50, 95% CI: (1.38,14.61)], husband’s occupation being merchant [AOR = 6.45, 95% CI: (1.51, 27.59)]; antenatal care follows up [AOR = 3.15, % CI: (1.22, 8.12)], radio/television ownership [AOR = 7.41, 95% CI: (2.86, 19.20)], child’s sex being female [AOR = 4.78, 95% CI: (2.26, 10.064) and sufficient knowledge on child feeding [AOR = 2.82, 95% CI: (1.27, 26.26)] were independent predictors for appropriate IYCF practice.ConclusionThe prevalence of appropriate infant and young child feeding practice indicators was found to be rather high among the mothers in this study. The use of a bottle to feed babies, in particular is very common among the mothers who were studied. To address child malnutrition, it is critical to educate families about proper IYCF practices. This study suggests that mothers be properly educated about IYCF recommendations at health care facilities during their visits, as well as the promotion of appropriate IYCF through various media.

Infant and young child feeding practices have substantial consequences for the growth, development, and survival of infants and children during the first two years of life and throughout life. The study aimed to assess the infant and young child feeding practices among the caregiver of children (0 -23 months) enrolled in a community infant and young child feeding programme. A validated semi-structured questionnaire was used to collect informations. The major food consumed was legumes (62.7%) and cereals (60.8%). Over (74.8%) of the caregivers were still breastfeeding during the period of the study, (22%) of caregivers initiated breastfeeding within one hour of birth and 8.2% exclusively breastfed their children; the majority (91.7%) of the caregivers breastfed on demand. Only (24.5%) of the caregiver met minimum meal frequencies, (10.1%) diversified their diet, while (47.5%) met the minimum acceptable diet. Almost two third of the indices measured for the quality of Communit Infant and Young Child Feeding programme was rated very good in Wucicciri , rated poor in Rafin Magaji and also poor in Babban Dodo primary health care. This study revealed inappropriate infant and young child feeding practices in study area, despite being enrolled in the Communit Infant and Young Child Feeding programme. Therefore, these poor practices needed urgent action and aggressive sustained intervention.

In India, child malnutrition is prevalent, especially among the poor and vulnerable. It is mostly the result of high levels of exposure to infection and inappropriate infant and young child feeding and caring practices, and it sets in mostly during the first 2 to 3y of life. Therefore, the present study was done to assess the role of inter personal communication in influencing the infant and young child feeding practices of mothers in an urban slum of Delhi. Case study method was used to document the practices of mothers residing in an urban slum of Delhi, for infant and young child feeding. In most of the cases, it was observed that full potential of health system contact of beneficiary was not utilized for providing appropriate Inter Personal Communication (IPC). It was not able to make proper use of the opportunity to create awareness on nutrition issues, change norms and practices, and persuade mothers/families to make positive behavior change. IPC was not effective, as it was not personalized as per patient's educational level and ability to understand technical information. Though IPC component was better for immunization services, it was weakest for nutrition in case of children younger than 2y. ICDS program implementation lays more emphasis on food supplementation than on nutrition and health education interventions. Thus, role of IPC should be increased manifold to inculcate appropriate feeding practices among mothers to improve nutrition in these children. Health and nutrition messages need to reach every household repeatedly through multiple complementary sources to bring desired behavior-change in the community.

Improved infant and young child feeding practices have the potential to improve child growth and development outcomes in India. Anganwadi Workers, the frontline government functionaries of the national nutrition supplementation programme in India, play a vital role in promoting infant and young child feeding practices in the community. The present study assessed the Anganwadi Workers' knowledge of infant and young child feeding practices, and their ability to counsel and influence caregivers regarding these practices. Eighty Anganwadi Workers from four districts of Gujarat participated in assessment centres designed to evaluate a range of competencies considered necessary for the successful promotion of infant and young child feeding practices. The results of the evaluation showed the Anganwadi Workers possessing more knowledge about infant and young child feeding practices like initiation of breastfeeding, pre-lacteal feeding and colostrum, age of introduction of complementary foods, portion size and feeding frequency than about domains which appear to have a direct bearing on practices. A huge contrast existed between the Anganwadi Workers' knowledge and their ability to apply this in formal counselling sessions with caregivers. Inability to empathetically engage with caregivers, disregard for taking the feeding history of children, poor active listening skills and inability to provide need-based advice were pervasive during counselling. In conclusion, to ensure enhanced interaction between the Anganwadi Workers and caregivers on infant and young child feeding practices, a paradigm shift in training is required, making communication processes and counselling skills central to the training.

Aim: The objective of the exercise was to determine the factors influencing infant and young child feeding practices among Rohingya communities and come up with ways to address them in areas where the nutrition-sensitive program is implemented. The findings would be used by the implementing partners to develop more effective, longer-term strategies for improvement and scale-up of IYCF–E program in the camps. Study Design: This study adopted a mixed-methods design to assess Infant and Young Child Feeding (IYCF) practices among Rohingya refugee communities. The study incorporated both quantitative data from cross-sectional household surveys (541 children surveyed from 531 households) to generate measurable indicator data and qualitative data from focus group discussions (FGDs) and Key Informants Interview (KII) to gain contextual insights into socio-cultural factors influencing feeding practices. Place and Duration of Study: The assessment was conducted in ten Rohingya camps (Camps 4, 5, 6, 8W, 10, 13, 14, 15, 16, and 22) within the Ukhiya and Teknaf sub-districts of Cox’s Bazar, where ongoing nutrition-specific and nutrition-sensitive programs are being implemented from July 26, 2023, to August 16, 2023 Methodology: A detailed monitoring exercise involved quantitative and qualitative methods of data collection. A formative questionnaire was developed targeting children aged 0-23 months, and as with all the questions on IYCF, the questionnaire was administered to primary caregivers, mainly the mothers of the children aged 0-23 months. Children aged 0 – 23 months were targeted specifically to find-out the proportion of children ever breastfed and timely initiation of breastfeeding in 0 – 23 months, exclusive breastfeeding (EBF) in 0 – 5 months, continuation of breastfeeding at one year and introduction of semi-solid, solid or soft food in 6 – 8 months. Other indicators were minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) in 6 – 23 months. Result and Discussion: The findings from the assessment of breastfeeding and complementary feeding practices among the Rohingya communities in the refugee camps provide valuable insights and highlight both positive aspects and areas of concern. Quantitative results showed that children aged 0-23 months, 97.23% from Rohingya camps, were ever breastfed, which was a good indication of breastfeeding practices. It was also found that 84.1% of infants were introduced to breastmilk immediately after their birth (within 1 hour). Though the exclusive breastfeeding rate was 66.1% in the survey, it has improved from last year’s UNICEF-ACF IYCF survey (62.3%), and the continuation of breastfeeding up to 23 months was also high at 81.5% According to the survey findings, 78.05% of the camps surveyed children aged 6-8 months were timely introduced to complementary feeding in addition to breastmilk. 55.3% of the children from Rohingya camps aged 6-23 months were reported to have eaten at least five or more of the eight food groups within 24 hours, and 68.5% of caregivers of children maintained a minimum meal frequency. Finally, we found that 30.3 % of children 6-23 months fed with age-appropriate complementary feeding with minimum diversity and frequency of meals. However, caregivers during the focus group discussions reported that mothers who get pregnant while still breastfeeding usually stop breastfeeding the current child, even if this child is still at a recommended breastfeeding age. This practice is related to religious beliefs where breastfeeding while being pregnant is considered a sin among the religious communities, hence directly affecting the continued breastfeeding practices in communities where child spacing is not fully practiced. The qualitative results from the focus group discussions also indicate that caregivers have good knowledge of the timely introduction of complementary feeding. Nevertheless, the practices on the timely introduction of solid/semi-solid foods continue to be negatively affected by some social influence from family members like in-laws, grandmothers, and neighbors, hence resulting in either too early or too late introduction of solid/semi-solids before the 6th month after birth. The qualitative results from the conducted focus group discussions reveal that mothers have good knowledge of how often a child above 6 months should eat, but the actual practices do not always reflect this knowledge. Conclusion &amp; Recommendation: This survey revealed strong cultural and religious influences on IYCF practices. Introducing pre-lacteal feeds was a common practice due to a strong cultural belief that giving honey, mustard seeds, and sugar/glucose water enhances the child’s lip movement and improves suckling. This has negatively affected exclusive breastfeeding for infants under six months. Mothers who reported giving birth at home due to cultural barriers were also deprived of the initial assistance and guidance provided by medical personnel regarding appropriate breastfeeding practices immediately after delivery at the health facility, or later during the 1000-day window of opportunity. Consequently, this negatively impacted the child's breastfeeding practices during the first two years of life. From both the quantitative and qualitative surveys, some short-term, medium-term term and long-term recommendations came out for nutrition-sensitive programming. Strengthening the community awareness interventions through training and engaging peer counsellors, mother-to-mother support groups, and community support groups to provide counselling and guidance to mothers in their communities on Infant and Young Child Feeding, including hygiene practices Scale up outreach activities through quality home visits, group meetings, growth monitoring sessions, and cooking sessions (i.e., Mukhe vat) for nutrition education and interpersonal communication to facilitate knowledge into optimal practices Ensure that monitoring, evaluation, and research are conducted regularly and are used to revise strategies and interventions for improving infant and young child feeding Pay special focus on nutrition-sensitive activities for minimizing economic barriers and ensuring the availability of a nutritious diet year-round, like income-generating activities, homestead gardening/ kitchen gardening, livestock rearing, etc., to meet the nutritional needs Promote gender equality and empower women in multi multi-sectoral approach to fight against malnutrition and improve IYCF-related decision-making

BackgroundAlthough infant and young child feeding practices play an important role, children in Ethiopia suffer from poor infant and young child feeding. To date, there is a limited study which addresses factors that influence infant and young child feeding practices. The aim of the study was to determine the predictors of infant and young child feeding practices in Gibe District, Hadiya Zone, Ethiopia.MethodsA community-based cross-sectional study was employed on 418 randomly selected mothers with children under the age of 24 months from March 13 to April 13, 2017. The pre-tested structured questionnaire was used to collect the data. Multiple logistic regressions were applied to determine the predictors of infant and young child feeding practices.ResultsA total of 284 (67.9%) infant and young child suffered from the sub-optimal infant and young child feeding practices. The husband being a government employee [adjusted odds ratio (AOR) = 4.08 (1.65, 10.04)], lower household income [(AOR) = 3.11 (1.36, 7.07)], not attending antenatal care (AOR = 2.03 (1.22, 3.36)], child age 0–5 months [AOR = 2.42 (1.02, 5.72)], negative attitude towards infant and young child feeding practices [AOR = 2.35 (1.44, 3.84)], and the number of children 3–4 [AOR = 1.99 (1.08, 3.64)] were predictors of the sub-optimal infant and young child feeding practices.ConclusionSub-optimal infant and young child feeding practices were very high as compared to the WHO infant and child feeding recommendation. The husband being a government employee, lower household income, not attending antenatal care, child age 0–5 months, negative attitude towards infant and young child feeding practices, and the number of children 3–4 were the predictors of the sub-optimal infant and young child feeding practices. Nutritional interventions should emphasize the predictors of sub-optimal infant and young child feeding practices to improve optimal infant and young child feeding practices in Ethiopia.

BackgroundDespite different interventions to improve child nutrition conditions, chronic malnutrition is still a public health concern in Rwanda, with a high stunting prevalence of 38% among under 5-year-olds children. In Rwanda, only 18% of children aged 6–23 months are fed in accordance with the recommendations for infant and young child feeding practices. The aim of this study was to explore challenges to infant and young child feeding practices and the responses applied to overcome these challenges in Muhanga District, Southern province of Rwanda.MethodsSixteen (16) focus group discussions were held with mothers, fathers, grandmothers, and community health workers from 4 rural sectors of Muhanga District. The discussions were recorded, transcribed verbatim, and thematically analyzed using qualitative data analysis software, Atlas.ti.ResultsTwo main themes emerged from the data. Firstly, there was a discourse on optimal infant and young child feeding (IYCF) practices that reflects the knowledge and efforts to align with early initiation of breastfeeding, exclusive breastfeeding for the first 6 months, as well as initiation of complementary foods at 6 months recommendations. Secondly, challenging situations against optimal practices and coping responses applied were presented in a discourse on struggling with everyday reality. The challenging situations that emerged as impeding appropriate IYCF practices included perceived lack of breast milk, infant cues, women’s heavy workload, partner relations and living in poverty. Family and social support from community health workers and health facility staff, financial support through casual labor, and mothers saving and lending groups, as well as kitchen gardens, were used to cope with challenges.ConclusionFactors influencing IYCF practices are multifaceted. Hence, intervention strategies to improve child nutrition should acknowledge the socially embedded nature of IYCF and address economic and social environmental constraints and opportunities, in addition and above knowledge only.

BackgroundDiarrhoea is a leading cause of child mortality in Tanzania. The association between optimal infant feeding practices and diarrhoea has been reported elsewhere, but the evidence has been limited to promote and advocate for strategic interventions in Tanzania. This study examined the association between infant and young child feeding (IYCF) practices and diarrhoea in Tanzanian children under 24 months.MethodsThe study used the Tanzania Demographic and Health Survey data to estimate the prevalence of diarrhoea stratified by IYCF practices. Using multivariable logistic regression modelling that adjusted for confounding factors and cluster variability, the association between IYCF practices and diarrhoea among Tanzanian children was investigated.ResultsDiarrhoea prevalence was lower in infants aged 0–5 months whose mothers engaged in exclusive breastfeeding (EBF) and predominant breastfeeding (PBF) compared to those who were not exclusively and predominantly breastfed. Infants aged 6–8 months who were introduced to complementary foods had a higher prevalence of diarrhoea compared to those who received no complementary foods, that is, infants who were exclusively breastfed at 6–8 months. Infants who were exclusively and predominantly breastfed were less likely to experience diarrhoea compared to those who were not exclusively and predominantly breastfed [adjusted odds ratio (AOR) 0.31, 95% confidence interval (CI) 0.16–0.59, P < 0.001 for EBF and AOR = 0.30, 95% CI 0.10–0.89, P = 0.031 for PBF]. In contrast, infants aged 6–8 months who were introduced to complementary foods were more likely to experience diarrhoea compared to those who received no complementary foods (AOR = 2.91, 95% CI 1.99–4.27, P < 0.001).ConclusionsThe study suggests that EBF and PBF were protective against diarrhoeal illness in Tanzanian children, while the introduction of complementary foods was associated with the onset of diarrhoea. Strengthening IYCF (facility- and community-based) programmes would help to improve feeding behaviours of Tanzanian women and reduce diarrhoea burden in children under 2 years.

An Innovative Grandmother-Inclusive Approach for Addressing Suboptimal Infant and Young Child Feeding Practices in Sierra Leone

Infant and young child feeding (IYCF) practices directly affect the nutritional status of children under two years of age, and ultimately, impact child survival. These practices are influenced by maternal knowledge and attitudes as well as socio-demographic and cultural factors; and an understanding of such factors is important to scaling up IYCF practices. This study was designed to assess the role of religion on knowledge, attitude and infant feeding practices among Christian and Muslim lactating mothers in Ibadan North Local Government Area (LGA), Oyo State. The descriptive cross-sectional study was conducted among 320 lactating mothers in the LGA. Eight focus group discussions were carried out among Christian and Muslim lactating mothers. An adapted pre-tested questionnaire was used to collect information on socio-demographic characteristics and IYCF knowledge, attitude and practices of the respondents. Knowledge on IYCF was assessed on 14-item scale, and the scores categorised as: ˂5.60 poor, 5.60–10.88 fair, and ˃10.88 good knowledge. Attitude was assessed on 13 statements from the IOWA Infant Feeding Attitude scale with lowest and highest obtainable score of 13 and 65 respectively. A score of ˂44 was ranked as poor, and ˃44 points good. Data were analysed using descriptive statistics and one-way ANOVA. Qualitative data was analysed thematically. Mean age of respondents was 30.0±4.9 years, 55.9% were Muslims, and 63.8% had fair knowledge. There was no significant difference in fair knowledge categorisation (63.7%, 63.8%), but there existed slight difference in good (20.7%, 21.3%) and poor (15.6%, 14.9%) knowledge of the Muslim and Christian respondents respectively. Mothers with poor attitude constituted 56.0%. Muslim religion directly supports pre-lacteal feeding and duration of breastfeeding while the other indirectly supports breastfeeding. Religious practices directly and indirectly affect knowledge, attitude and practices of nursing mothers on infant feeding; hence, healthcare Professionals should pay more attention to nutrition education in religious houses using the infant and young child feeding module.

Background: Appropriate infant and young child feeding (IYCF) practices are a key strategy to reduce under-5 mortality. Increasing mobile technology penetration in rural areas can influence IYCF practices. Aims: This study aims to assess IYCF practices among mothers of children under 5, in a rural maternity hospital in Ramanagara district and its association with the use of various mass media including internet and smartphones. Methods: A hospital-based cross-sectional study was conducted among 89 mothers and a pre-tested face-validated semi-structured interview schedule was administered to collect information regarding sociodemographic details, IYCF practices, and use of media. Results: The mean age of the study population was 23.84±3.5 years. About 44.9% of them had their last child in the age group of 6–24 months. About 87.6% of them were breastfed within the 1st h of birth. The mean age of starting complementary feeding was 7±2.6 months. About 98.9% had access to a smartphone, however, only 19.1% used WhatsApp videos and messages and 12.3% internet to search for information regarding IYCF practices. Almost all respondents reported health-care providers as their primary source of information regarding IYCF practices. Conclusion: IYCF practices of the study population were better than national average. These findings highlight the importance of the role of grassroot level workers and primary care physicians in imparting knowledge among mothers in IYCF practices. The scope of using media to bring about behavior change communication in this context can be explored.