Abstract
BackgroundStudies evaluating child feeding in Madagascar are scarce despite its importance in child growth during the first two years of life. This study assessed the associations between the WHO infant and young child feeding (IYCF) indicators and stunting and identified determinants of inappropriate child feeding practices.MethodsThe most recent Demographic and Health Survey was used including a total of 1956 infants aged 0–23 months. Logistic regressions were performed for the association between IYCF indicators and stunting and for the determination of risk factors for inappropriate feeding practices.ResultsThe rates of initiation of breastfeeding within one hour after birth (77.2%), continued breastfeeding at one year (99.6%) and timely introduction of solid, semi-solid or soft foods at 6–8 months (88.3%) were high. Exclusive breastfeeding under 6 months (48.8%), attaining minimum dietary diversity (22.2%) and consumption of iron-rich foods (19.6%) were relatively low. Higher length-for-age was associated with achieving minimum dietary diversity (p<0.01). The other indicators assessed (early initiation of breastfeeding, exclusive breastfeeding under 6 months, timely introduction of complementary foods and consumption of iron-rich foods) were not associated with stunting. Infants born to mothers who had first given birth at an age younger than 19 were more likely not to be breastfed within one hour after birth, not to be exclusively breastfed and not to have the recommended dietary diversity. Infants whose mothers had low media exposure were at increased risk of being inappropriately fed. Low household wealth also was associated with higher odds of not meeting the minimum dietary diversity.ConclusionsDespite almost total continued breastfeeding at one year and early initiation of breastfeeding by more than three-quarter of mothers, minimum dietary diversity scores were still low, confirming the need for more effective programs for improving child feeding practices in Madagascar. Improving dietary diversity in children aged 6–23 months may help reduce stunting. The identified risk factors for inappropriate feeding practices could be used in directing future nutrition sensitive interventions.
Highlights
Studies evaluating child feeding in Madagascar are scarce despite its importance in child growth during the first two years of life
The reported rates of exclusive breastfeeding under 6 months were relatively low in countries such as Ethiopia (43%), Zambia (51.4%), Bangladesh (36.1%) and India (42%) [4]
This study looked at the association of the WHO infant and young child feeding (IYCF) indicators and child stunting in Madagascar
Summary
Studies evaluating child feeding in Madagascar are scarce despite its importance in child growth during the first two years of life. This study assessed the associations between the WHO infant and young child feeding (IYCF) indicators and stunting and identified determinants of inappropriate child feeding practices. Aware that feeding practices directly impact nutritional status of infants and young children, the WHO validated a set of indicators to assess infant and child feeding practices across countries [3]. The reported rates of exclusive breastfeeding under 6 months were relatively low in countries such as Ethiopia (43%), Zambia (51.4%), Bangladesh (36.1%) and India (42%) [4]. Inappropriate complementary feeding practices were reported in Ethiopia and Zambia where the proportion of children aged 6–23 months given more than four food groups in a day were respectively 7.1% and 37.1% [5]. Lack of dietary diversity was found in Uganda with 29.5% and India with 16% of young children receiving four or more food groups in a day [6]
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