Faulty Feeding Practices Research Articles

Factors Influencing Infant Morbidity in the Urban Field Practice Area of a Medical College in Bangalore

Background: Infants constitute 2.92% of the total population in India. Health of infants is considered as a sensitive indicator of health status and level of socio-economic development of a country. In India, the infant morbidity and mortality are in decline, but the pace of decline is not sufficient to attain the target goals of National Health Mission. Objective: To assess the factors influencing infant morbidity in the urban field practice area of a medical college in Bangalore. Methods and Material: This was a population based cross sectional study done at an urban poor locality in Bangalore. The study was conducted between April 2018 to September 2019 with a sample size of 300 after obtaining the approval from Institutional ethics committee. Population proportion to size was used to ensure equal representation. Data was collected using pre tested semi structured questionnaire & analysed using open epi like descriptive statistics with univariate & multi variate logistic regression were used. Results: Total of 165(55%) subjects were females, with majority 206(68.7%) Muslim by religion and 161(53.7%) lived in the nuclear family. The prevalence of morbidities among infants was 209(69.7%). The most common infant morbidities reported were 121(40.3%) ARI, 85(28.3%) fever and 45(15%) diarrhea. Infants with perinatal complications, faulty feeding practices like delayed initiation of breast feeding, bottle feeding and immunization had significant association with infant morbidities. Conclusions: To conclude there is a statistically significant association between perinatal complications, bottle feeding & partial immunization with infant morbidity. Keywords: Infant, Immunization, Breast feeding, Morbidity

Demographic Dynamics and the Changing Faces of Nutrition Literacy in India: A Tryst with the Transition among Communities Over Two Decades.

The development of a nation depends on well-nourished individuals. A country's economic independence also depends on adequate food supply for all sections of its population and the proper selection of the right kinds of food, called nutritional literacy. This review will show the transition of dietary selection and practices across India over the last two decades and its impact on health. We conducted a literature search to review the evidence of the last two decades. The literature search was done using the PubMed search engine and the MeSH words "Nutrition Literacy, Dietary Practices, Diet Transition, Nutrition transition, India and Food pattern." Evidence from the last two decades was collectively reviewed, and observations on the transition in nutrition literacy were summated. The literature search revealed 18 articles, out of which 13 articles were included in this review based on inclusion-exclusion criteria. Nine were review articles, and five were cross-sectional studies. The studies done over the last two decades on nutrition culture revealed that most of the studies related to transition have been done during the second decade of the twenty-first century. Most have found that the shift has been happening more among the urban poor and rural rich people. Indian diets have diversified and shifted away from cereals towards processed food. It was found that there is a shift in feeding preferences in diet-deprived sections in India. The findings are similar in rural and urban areas where the poor fall prey to the food fads, make poor nutrition choices, and gradually develop chronic ailments. Such a transition over the years clearly shows that a malnourished child, having faulty feeding practices, becomes prey to the triple burden of hidden hunger, lack of nutrition, and repercussions of chronic non-communicable diseases, including dental ailments.

Pre-Lacteal Feeding Practices: An Infraction of Nutritionally Secured and Healthy Generations

Various studies have emphasized the role of breast feeding in the prevention of wide range of infancy infections. But initiation of breast feeding is hindered by the cultural practices of Pre-Lacteal Feeding (PLF). In India this practice of giving pre-lacteal feeds cut across all the communities as it is considered to have a positive effect on child's Gastrointestinal (GI) health and intellectual growth. However, PLF has a detrimental effect on the child's growth and development as it delays initiation of breastfeeding and prevents initial bonding between the mother and the baby. Evidently Infants who receive PLF are more likely to be malnourished. In Karaikal, practice of PLF is very common. Hence it becomes imperative to assess the prevalence of PLF practices. The objectives of the study included assessment of PLF practices, types of PLF and delineate the factors associated with same among the working lactating mothers. Locale of the study was Karaikal, Puducherry. A sample size of 427 lactating working mothers using non-probable purposive sampling (0-12months) was chosen. To elicit information a pre-designed, pre-tested, semi-structured questionnaire was used. The data obtained was statistically analysed and showed prevalence of PLF practices among 47% of the mothers. 29% of the mothers gave sugar water to the newborns. Other PLFs included omam water (carom seeds), cow's milk, plain water, religious water, jaggery with honey, castor oil, mashed dates, mercury etc. 31% mothers cited traditional cultural practice running through generations as the reason behind giving pre-lacteal feedings, whereas other reasons included cleansing the GI tract (14%) and better suckling reflex (22%) etc. It may be concluded that PLF practices are one of the many faulty feeding practices prevalent in Karaikal, which are a major infraction of optimum growth and development. Hence there is an emergent need to educate mothers regarding ill effects of pre lacteal feeding along with benefits of colostrum, early initiation of breastfeeding and exclusive breastfeeding which can reduce the chances of morbidity and mortality in infants and may thus lay foundation for nutritionally secured and healthy generations.

Feeding practices and knowledge regarding vaccination in mothers of under 5 children: a questionnaire based study in a metropolitan city hospital of India

Background: India has a high burden of under five mortality. Faulty feeding practices and mortality due to vaccine preventable diseases is a major hurdle. Objective was to assess breast feeding practices and vaccination status of children of less than 5 years by age and its correlation with socio-demographic profile.Methods: This was a cross- sectional descriptive study involving children of nine months to five years.Results: Health seeking behavior in terms of adequate antenatal checkup and institutional deliveries was quite high; but only one third of children had early initiation of breast feeding and the main reason was delay in rooming-in. Early breast feeding had significant correlation with the greater duration of breast feeding and the duration of exclusive breast feeding was significantly associated with the literacy status of mother. Only 34% of children were vaccinated on time and frequent migration was the cause of delay in 25%. Ground level workers were the main source of information regarding vaccination in this study population.Conclusions: Feeding practices were not satisfactory. Institutional fallacies also came into focus such as delayed rooming-in. Awareness regarding vaccination was inadequate and was incomplete in majority of children. General awareness and health seeking behavior of our community still need enhancement to a great extent.

A SPLIT FACE COMPARATIVE STUDY OF MICRONEEDING WITH PLATELET RICH PLASMA VERSUS FRACTIONAL CO2 LASER WITH PLATELET RICH PLASMA IN MANAGEMENT OF ATROPHIC ACNE SCARS

Introduction : Adopting optimal breast feeding practices is fundamental right to a child’s survival, growth  and development. Despite all the potential benefits, only about two fifths of infants 0-6 months of age worldwide are exclusively breastfed. Analysis of data on feeding practices  among infants highlights the need for accelerated programming in this area. Present study  was aimed to survey feeding practices in infants up to 6 months and observing variables for  faulty feeding practices Method :Mother of infants up to 6 months coming from urban area in a tertiary care hospital were  interviewed for feeding practices as per preformed questionnaires. If feeding practices were  faulty all details regarding various factors leading to same were asked and analysed. Results :Total 518 mothers were interviewed. Only 37% infants were exclusively breast feed, in 29%  feeding was started in 1st hour of life and in 25% some form of prelacteal feeds were given.  On analysing different factors for faulty feeding practices we found that primigravida, CS  delivery, (p<0.001)different myths regarding mother health, baby health, and breast  feeding, lack of awareness ,faulty feeding techniques, low socioeconomic status(65%) and  poor education(80%) were contributing factors leading to same. There were multiples  factors in single mother for faulty feeding practices. Conclusion : Promotion, support and adherence to recommendations of breast feeding is still a gold  standard to gain optimal growth and development of children. still health personnel has to  do lot more to particularly in field of proper education, explanation and demonstration in field of same. Using newer media technology like mobile and TV will be helpful to spread it  fast.&nbsp

Epidemiological characteristics, clinical profile and nutritional status of hospitalized under five children

Background: Malnutrition accounts for 68.2% of the total under-5 deaths in India, and is an important underlying risk factor for morbidity in all ages, responsible for 17.3% of the total disability-adjusted life years. Objective was to find out prevalence of moderate to severe acute malnutrition in hospitalized under 5 children and to find out socio-epidemiological characteristics and disease profile in the same group.Methods: This observational study was conducted in a tertiary care teaching hospital on hospitalized children aged 6 months to 5 years. After obtaining informed consent and detail history including epidemiological profile, complete physical examination and anthropometry were recorded. WHO criteria were used for nutritional assessment. Disease profile of the patients was recorded.Results: A total of 230 children were enrolled. Male: Female ratio was 1.64:1; total 153 (66.5%) children were malnourished. The prevalence of MAM and SAM was 28.7% and 20% respectively. Most common diseases were acute gastroenteritis and pneumonia. More than 80% children exhibited anemia. Low birth weight, higher birth order, incomplete immunization, lower socioeconomic status, lower maternal literacy and faulty feeding practices were significantly associated with malnutrition.Conclusions: About 2/3rd admitted children were malnourished and 20% were suffering from SAM. Acute gastroenteritis and pneumonia were most common diseases. There was strong need to educate the family specially mother about nutritional needs of the child. Parents must be counselled about the importance of birth spacing, family planning, immunization and exclusive breastfeeding till 6 months of age.

Clinicoepidemiological and laboratory profile of children with severe acute malnutrition admitted to a tertiary care centre

Background: Severe Acute Malnutrituon (SAM) is a form of malnutrition where there is an imminent threat of death to the child. The chances of complications are very high and in most case child requires hospitalization for stabilization and rehabiliatation. Objective of study the clinicoepidemiological and laboratory profile of children with severe acute malnutrition (SAM) admitted to a Nutritional Rehabilitation Centre (NRC) of our hospital.Methods: A retrospective chart review of admitted patients. Nutritional Rehabilitation centre (NRC) at GB Pant Hospital Government Medical College Srinagar over a one year period between June 2017 and June 2018.Results: Total of 187 patients of SAM was admitted in NRC during the study period. One hundred and eight (57.7%) were males and 79(42.3%) were females .Patients were equally among various districts. Infants (<12months) constituted the majority of admissions (54.5%). Marasmus was by far the commonest phenotype presenting as SAM (85.5%).Respiratory comorbidity was the commonest present in about 41 (26.3%) followed by daiarrhea in 32(20.5%). Delayed initiation of complimentary feeding was found in 75(40.1%) while early weaning was found in another 55 children (29.4%). Birth order more than three was present in 92 children (49%). Mother’s literacy status had a direct bearing on the prevalence of SAM. Most of the children were from rural background (75%).Most belonged to low economic and income class as around 65.2% had a very meager family income.Conclusions: SAM is more common in Infants and in children from rural background. It is highly associated with faulty feeding practices including lack of breast feeding and presence of mixed and faulty feeding. It is also associated with increasing birth order, low maternal education and low family income Pneumonia and diarrhea are leading comorbidities. Hypoglycemia and hypothermia are leading complications. Marasmus is the commonest phenotype.

Breast Feeding Practices up to 6 Months in Infants of Urban Area : a Hospital Based Survey

Introduction Adopting optimal breast feeding practices is fundamental right to a child’s survival, growth and development. Despite all the potential benefits, only about two fifths of infants 0-6 months of age worldwide are exclusively breastfed. Analysis of data on feeding practices among infants highlights the need for accelerated programming in this area. Present study was aimed to survey feeding practices in infants up to 6 months and observing variables for faulty feeding practices Method Mother of infants up to 6 months coming from urban area in a tertiary care hospital were interviewed for feeding practices as per preformed questionnaires. If feeding practices were faulty all details regarding various factors leading to same were asked and analysed. Results Total 518 mothers were interviewed. Only 37% infants were exclusively breast feed, in 29% feeding was started in 1st hour of life and in 25% some form of prelacteal feeds were given. On analysing different factors for faulty feeding practices we found that primigravida, CS delivery, (p<0.001)different myths regarding mother health, baby health, and breast feeding, lack of awareness ,faulty feeding techniques, low socioeconomic status(65%) and poor education(80%) were contributing factors leading to same. There were multiples factors in single mother for faulty feeding practices. Conclusion Promotion, support and adherence to recommendations of breast feeding is still a gold standard to gain optimal growth and development of children. still health personnel has to do lot more to particularly in field of proper education, explanation and demonstration in field of same. Using newer media technology like mobile and TV will be helpful to spread it fast.

A study on the prevalence of acute and chronic malnutrition and influence of feeding practices among 6 months to 2 years children in rural field practice area of Kilpauk Medical College, Tamil Nadu

Background: In India, 54% of under five children death mainly due to under nutrition. First two years of age is most critical. Nutritional status was assessed by using WHO standard growth chart. Wasting represents acute malnutrition, stunting with chronic, underweight represents both acute and chronic. Based on NFHS-3 data the prevalence of under nutrition rise up to 2 years of age, thereafter more or less stabilizes. Faulty feeding practices plays major role in under nutrition. Hence, this study carried out to assess nutritional status of 6 months to 2 years children in terms of acute and chronic malnutrition and to estimate the association of nutritional status with feeding practices.Methods: Cross sectional study done during March to August 2016. Sample size estimated was 180. Stratified random sampling method used to collect data among children in Peerkankaranai.Results: Mean age of children was 15.82 months. About 61.2% belonged to 12 to 24 months age group. Sex distributions were equal. About 55% belongs to middle socioeconomic status. The prevalence of underweight was 31.65, wasting 15%, stunting 45.6%. Male children affected by chronic malnutrition more than female children. Not initiating breast feeding within 4 hours of birth plays significant role in acute malnutrition. Prevalence of malnutrition was high among those not practising colostrum feeding and exclusive breast feeding. Only 15 mothers not influenced by formula feeding. Feeding frequency and traditional feeding practices had main role in chronic malnutrition.Conclusions: The prevalence of under nutrition among study population was high among this area. Feeding practices should be improved among the mothers.

Does faulty feeding practices act as a driver to undernutrition? A comparative study on rural and urban pre-schoolchildren in Western Uttar Pradesh

Background: India is home to the largest number of underweight and stunted children in the world. While several studies have focused on the determinants of child’s nutrition status in India, little attention has been given to the aspect of rural-urban variation in child’s nutritional status. Bearing in mind that around 70% of India’s population resides in the rural area, the study of rural-urban divergence in nutritional status as indicator can be appreciated naturally. Objective: The objective of the study is to compare the feeding practices of children in the initial six months of life in rural and urban setting and to find out any relation between early feeding practices and nutritional status of young children. Materials and Methods: A community-based study was conducted for 2 months in the field practice areas of a tertiary care hospital. Multistage random sampling technique was used for the selection of study subjects. A total of 117 under-five children were studied equally from rural and urban area. A pre-designed pre-tested proforma was used to assess the feeding practices. Stunting and underweight were used to proxy the child nutrition status. Data were evaluated on SPSS version 17. Chi-square test was used to compare the feeding practices and to find out their association with nutritional status in the two areas. Results: Undernutrition was found in children who initiated early artificial feeds, i.e., in the first 6 months of life, were given over diluted milk, were bottle fed, and had inappropriate weaning practices in both the areas. Conclusions: Faulty feeding practices were found in both areas, but some of the parameters were still better in urban areas. Faulty feeding practices were found to be a significant predictor for undernutrition.

Determinants of exclusive breastfeeding among lactating women in sub-Himalayan region

Introduction: Trend of faltering growth in children begins in the critical period of first 2 years of life, and a major cause is due to faulty feeding practices. Breastfeeding is one of the most important determinants of child survival, birth spacing, and prevention of childhood infections. Aim: To determine factors influencing exclusive breastfeeding (EBF). Methodology: The Multiple Indicator Cluster Survey technique with thirty clusters proposed by the World Health Organization was used for the purpose of this study. Results: EBF was reported by 48.1% (101/210) of mothers. Among the 55% who initiated breastfeed in an hour of birth, 56.5% were EBF as compared to 43.5% were non-EBF and this difference was statistically significant (P - 0.01). As the education status of mothers increased from primary to matriculate the proportion of EBF decreased. Conclusions: Poor feeding practices are present across all socioeconomic groups, and a significant difference was observed with the age of mother, education status of both parents, occupation of father, and time of initiation of breastfeeding.

Feeding practices and malnutrition at the Princess Marie Louise Children’s hospital, Accra: what has changed after 80 years?

Sub-optimal feeding practices are associated with malnutrition. In 1933, Dr Cecily Williams, while working at Princess Marie Louise Children’s Hospital (PML) in Accra described Kwashiorkor as the disease of children “deposed” from breast feeding who were being fed plain fermented maize diets. Presently, it is not clear how this has changed after 80 years. We conducted an unmatched case–control study at PML in 2013 in order to determine faulty feeding practices associated with malnutrition. PML is a 74 bed children’s hospital and the largest centre for treating children with malnutrition in Ghana. Under-fives with Moderate or Severe Acute Malnutrition (SAM or MAM) were selected as cases while the controls were children without SAM or MAM. A total of 182 malnourished and 189 well-nourished under-fives and their mothers were studied. Faulty feeding practices including early weaning, shorter duration of exclusive breastfeeding, mixed feeding, bottle feeding and limited consumption of fruits were found. Though the use of “iced kenkey” a maize-based diet was limited, over one-third of malnourished children (39.1 %) were still being weaned with plain unfortified fermented maize gruel both of which Dr Williams associated with Kwashiorkor. Well-nourished children were more likely to receive solid food (38.0 %), fortified maize gruel (29.2 %), and Cerelac® (24 %) a processed cereal-based complementary food. A child’s refusal to breastfeed was the most common reason for stopping breastfeeding among malnourished children. More effective nutrition education and new complementary feeding diets that are wholesome yet appeal to a new generation of mothers are needed. The patho-physiology of feeding problems needs further study.

A cross-sectional study to assess the protein energy malnutrition in children between one to five years of age in a tribal area Parol, Thane district, Maharashtra, India

Background: Nutrition in children is considered as one of the foundation not only for good health and freedom from disease, but also for normal growth and development. Nutrition has a profound and largely incalculable impact on human health. Preschool children are most vulnerable to the effect of undernutrition because of rapid growth and thus their nutritional status is considered to be sensitive indicator of community health. The objective of the study was to study prevalence of protein energy malnutrition in children between one to five years of age; socioeconomic, demographic, ecological and other health problems associated with protein energy malnutrition; immunization status; to suggest appropriate recommendations based on observation. Methods: The present study was carried out in a tribal area, Parol, Thane district, Maharashtra, India. The study population comprised of children in the age group of 1-5 years. The study was a cross sectional descriptive epidemiological study. Results: In our study maximum number of children 26.83% were in the age group of 2-3 years. 97.33% were Hindus, 45.33% of the mothers were illiterate, 10.67% of the fathers were illiterate, and 51.11% of children belong to nuclear families. 30.22% were given exclusive breastfeeding for 6months.74.67% were completely immunized, 25.33% were partially immunized. There was statistically significant association between Acute Malnutrition and type of family, education of mother, Socioeconomic status, mother’s age at marriage of less than 18 years, immunization status of the child, history of respiratory tract infection in last one month and history of diarrhea in last one month. Conclusions: In our study, the number of male children was slightly higher than the female children. Faulty feeding practices were commonly observed in this area and most of the children‘s diet were not adequate for calories and proteins as per ICMR guidelines. Primary immunization was satisfactory in the study area, no child was unimmunized and around one forth was partially immunized.

Faulty feeding practices in children less than 2 years of age and their association with nutritional status: A study from a rural medical college in Central India

Background: Undernutrition has a direct correlation with the prevailing feeding practices. Early years are crucial in determining the rate and extent of growth and mainly depend on the level of nutrition and care provided. The first episode of growth faltering occurs mostly in children <2 years of age that often goes unnoticed. Objective: The objective of this study was to explore the faulty feeding practices, their determinants, and association with nutritional status in children <2 years of age. Materials and Methods: This cross-sectional study using mixed (qualitative and quantitative) methods was conducted in a sample of 187 mothers and their children at the mother and child health (MCH) clinic of a rural medical college. Results: Only 144 (77%) of the study children had received colostrum. 47 (25.1%) of the mothers had used prelacteal feeds. Although breastfeeding (BF) was universal, only 133 (71.1%) of the mothers were exclusively breastfeeding (EBF) their children. The duration of each feed was an issue; in 49 (32.4%) of the children, the duration of each feed was <10 min with almost all the mothers swapping the baby to other breast during one episode of feeding. Not giving colostrum, not giving EBF, duration of feeds <10 min, swapping the breasts during each feed, and decreased frequency of feeding during illness were found to be significantly associated with poor nutritional status. Conclusion: In our study, we found out that although practice of BF was universal, there is definite scope for further improving the practices. A definite gap between knowledge and practice was observed, which was associated with adverse nutritional outcomes.

Influence of environmental factors, parental attributes and feeding practices on prevalence of severely acute malnutrition among children

Environment plays an important role in the growth and development of children. The objectives of the present research was to study the environmental factors, parental attributes and feeding practices of the children suffering from Severely Acute Malnutrition (SAM). One hundred children suffering from Severely Acute Malnutrition attending NRHM centre of Malkanagiri District, Odisha were selected by random purposive sampling method for the present study. Pretested questionnaires and required tools were used to collect information. The results of the study revealed that majority of the respondents were belonged to the age group of 7 months to 2 years. Most of the parents were labourers having annual income less than Rs.30,000 and were illiterate. Maximum families (63%) had more than four children. Age at marriage was found to be less than 15 years in case of 74 per cent mothers and had their first child at the age of 16 years in 60 per cent respondents. Joint family system heaving more than 3 children was found to be prevalent in that area. Birth spacing was found to be 10 month or less than 1 year in 33 per cent cases. Exclusive breast feeding was practised among 61 per cent respondents and rest of the respondents took only Mandia Peja along with Breast Milk upto one year of age. 56 per cent children continues to take breast milk upto three years of age. One year onwards most of the children were fed with home prepared diet along with Anganwadi supplied food. “Salafa” one type of beverage was also taken by the children. Thus it can be concluded that poor environmental factors and faulty feeding practices were the main contributory causes for prevalence of Severely Acute Malnutrition among the respondents.

Clinical Profile of Severe Acute Malnutrition in Western Rajasthan: A Prospective Observational Study from India

Introduction: The present study is undertaken to evaluate incidence and clinical profile of patients admitted with severe acute malnutrition and the assessment of relative contribution of various variables. Methods and material: This prospective study was conducted at department of paediatrics Umaid hospital, Dr. S.N. medical college Jodhpur, for a period of 7 months on patients of severe acute malnutrition admitted in malnutrition treatment corner. A total of 75 cases were enrolled in the study and a detailed history and physical examination finding were recorded in pretested proforma at the time of admission by using standard methodology and anthropometric measurement expressed in standard deviation from the median of the reference population (NCHS). Results: Incidence of severe acute malnutrition is 3.28%. Mean age of admitted patients was 14.92 ± 7.48 months and mostly belonged to lower socioeconomic scale, rural area and large family. Most of the caretakers were illiterate and in all cases, caretakers were mothers. In our study that 41.3%, 32.1%, 21.3% and 5.3% patients were in PEM grade IV, III, II and I respectively. Female patients were more severely malnourished than males (84.2% v/s 68.21%).Most common presenting symptom was fever (70.7%), followed by vomiting (52) and co morbidity associated with PEM was gastrointestinal (60%) followed by respiratory tract infection (52%). Mean duration of exclusive breast feeding was 2.6 ± 1.5 months and mean age of weaning was 8.4±3.9 months.78.7% children were still on breast feed at the time of hospitalisation and among them 40.7% of children were above 12 months of age. Mean age of starting semisolid and solid food was 11.6+3.53 months and most commonly used supplementary food was top milk in (100%), followed by chapati (42.3%) in patients. Conclusion: On the basis of this study, we conclude that the problem of severe malnutrition is multi-dimensional and inter-generational in nature. The determinants of severe malnutrition includes household food insecurity, illiteracy, low socioeconomic status, lack of awareness to access health services, large family size and poor purchasing power etc. Besides these, faulty feeding practices, poor complementary feeding practices, ignorance about nutritional needs of infants and young children and repeated infections, also aggravates the malnutrition amongst

An Epidemiological Study of Child Marriages in a Rural Community of Gujarat.

Context:India has the maximum number of child marriages (CMs; < 18 years) because of the size of its population, and in 47% of all marriages the bride is a child. Children who are married at young age are exposed to multiple risks pertaining to their physical, mental, and social health.Aims:(i) To estimate the prevalence of CM in rural population. (ii) To study the determinants and health effects of CM. (iii) To assess the awareness among the married women regarding the health implications of CM.Settings and Design:Community-based cross-sectional study conducted in Ardi village of Anand district.Materials and Methods:All the married women of the village were surveyed to find out the prevalence of CM. For collection of other relevant information, only those women having a married life of less than 10years were interviewed using semicoded and pretested questionnaire. Data collected were analyzed using Statistical Package for Social Sciences (SPSS) 17.0 software.Statistical Analysis Used:Proportions, ratios, χ2 test, and Fisher's exact test.Results:The prevalence of CM was found to be 71.5%. Caste and spouse's education were revealed as important determinants for CM. CM was found to be significantly associated with mother's age at birth of first child, delayed antenatal care (ANC), spontaneous abortion, preterm delivery, low birth weight (LBW), health problems in new born baby, faulty feeding practices, lack of knowledge regarding family welfare methods, and health implications of CM.Conclusion:Exceptionally high prevalence of CM in rural community and its serious health consequences warrant stricter enforcement of legislation, better educational opportunities for girls, and easy access to quality health services.

Effect of Nutritional Intervention among Children with Protein Energy Malnutrition

Nutritional problems like protein energy malnutrition (PEM), anemia and vitamin A deficiency continue to plague a large proportion of Indian children. Faulty feeding practices and recurrent infections make this age group more vulnerable1. A quasi experimental one group pretest post test study was conducted among 109 under five children in Koayam district to determine the effectiveness of nutritional intervention to the children with protein energy malnutrition. The study population consisted of 109 children in the age group of 2–5 years and their mothers aending selected anganwadies of Koayam District, during the period of data collection. The subjects were selected by using non probability purposive sampling technique. To identify the effectiveness of nutritional interventional programme of PEM repeated measures ANOVA was used. Mauchly's W test was used to check the homogeneity of variances. Since the P value (0.051) is more than 0.05, the variances are equal. The P value for the factor, sphericity assumed is <0.05 (F=114.403). Hence there is a difference in mean PEM over a period of time. It indicates the nutritional intervention is effective. Keeping in mind the results obtained in this study reveals the need for multi pronged approach like maternal and child health care, nutrition education and growth monitoring to combat the problem of malnutrition.

A study on relevance of mid arm circumference measurement among 13-60 months of children at urban field practice area of Alluri Sita Ramaraju Academy of Medical Sciences, Eluru

Background: Protein energy malnutrition commonly seen in 2 to 5 years of age group in developing countries like in India. This could be due to lack of awareness about nutritive value of foods, faulty feeding practices, ignorance plays a major role in the development of Protein malnutrition in early ages of life. This leads to hampering of physical and mental development of the child. Objectives of current study were: 1) To know the prevalence of protein energy malnutrition among 13-60 months of children. 2) To determine relevance of mid arm circumference measurement with WHO standards. 3) To study the demographic variables associated with Protein energy malnutrition. Methods: The present community based cross sectional study was conducted at urban area of Eluru during the period from Sep 2013 to December 2013. A total of 133 individuals were selected from the field practice area of Alluri Sita Ramaraju academy of medical sciences, Eluru. Results were analyzed and necessary statistical tests like proportions and chi square tests were applied. Results: Out of 133 individuals, the prevalence of severe malnutrition among 13-60 months children was 7.5%; prevalence of mild to moderate malnutrition was 24%. Among the severe malnutrition individuals, 60% from labourer occupation. Classification of mid arm circumference of 2-5 years children compared with World Health Organization weight standards, 87.9% were shown as normal and 70% matching of results with severe malnutrition individuals. Conclusion: Based on the above study results, need to give the training to gross root level workers regarding the measurement of arm circumference of children between the age group of 13-60 months children. Still we can consider mid arm circumference is one of the best tool for consideration of protein energy malnutrition detection at the basic level health point and this is cheap, easy and to be detected at early stage of life.

Formulation of Low Cost Complementary Baby Food to Improve the Nutritional Status of the Malnourished Children in Bangladesh

In the present study we formulated a low cost complementary baby food and investigated its role to improve the nutritional status of the malnourished baby. One hundred gm of complementary baby food was prepared by blending of 40 gm cereal powder, 16 gm green gram powder, 14 gm sesame powder, 14 gm banana powder, 10 gm pumpkin powder and 6 gm sugar powder according to the proportion of balanced diet. The formulated complementary baby food contained 336.5 Kcal energy and 6.56% moisture, 1.76% crude fiber, 17.5% protein, 13.7% fat, 31.31% carbohydrate, 30.93% ash, 27.7 mg of vitamin C, 210 µg of vitamin E, 30.15 mg of iron, 45.32 mg of zinc, 470.3 mg of calcium, 73.6 mg of magnesium and 1100 µg β-carotene. Impact of formulated complementary food to improve nutritional status was observed by conducting a cross-sectional study on 27 suspected malnourished children living in low socioeconomic status. According to the anthropometric data 18 children were found to be malnourished. From the 18 children, 13 children were taken as Feeding Group and remaining 5 children taken as Control Group. We found that 30.76% children were severe malnourished, 46.15% children were moderate malnourished and 23.07% children were mild malnourished according to Gomez classification. Nutritional status of the feeding and control group was investigated during the three months study period. It was found that control group gradually lost their weight (wasting) during the study periods due to faulty feeding practices and lack of calorie intake. Percent weight loss (wasting) at the end of the study period for Control-1, Control-2, Control-3, Control-4 and Control-5 were 8.60%, 7.14%, 8.33%, 10.0%, and 9.25% respectively. While the newly formulated complementary baby food was provided 120gm/day for the severe malnourished children and 80gm/day for the mild to moderate malnourished children during the study period. It was found that the formulated complementary baby food can reverse muscle wasting and improving nutritional status of the malnourished children during the study period. Thus newly formulated complementary baby food was efficiently providing both calorie and other dietary essentials to the malnourished children.