Inappropriate Complementary Feeding Research Articles

Influence of eating concept on eating behavior and stunting in Indonesian Madurese ethnic group

Background and objectivesStunting is a serious public health problem in Indonesia. Madura Island, which is inhabited by the Madurese ethnicity, had a very high stunting prevalence. The cultural factors of stunting mainly focus on food, food taboos, and early complementary feeding or prelacteal feeding practices. Therefore, this study aims to analyze the eating concept and its association with child feeding practices and stunting among the Madurese ethnic group in Indonesia.MethodsThis qualitative study was conducted in Sampang District, Madura Island, East Java, Indonesia. A total of 61 informants participated in this study (25 informants of in-depth interviews, 26 informants of FGDs, and 10 families in observations). Data collection consists of culture, values, and beliefs in child feeding practices that influence children’s nutritional status. The analysis used was content analysis by emphasizing the meanings, themes, and concepts of eating and stunting.Results and conclusionsStunting was considered a normal condition rather than a nutritional problem. The concept of eating is “eating rice.” Eating without other dishes is acceptable as long as there is rice on the plate. This concept affects inappropriate complementary food feeding practices and malnutrition among children under five. Overall, the study contributed to the improvement of the stunting reduction program by addressing how Madurese thought about eating and stunting.

Associations of Complementary Feeding Practice History and Protein Adequacy Level with Childhood Stunting in the Working Area of Puskesmas Bantaran in Probolinggo Regency

Stunting is often associated with too early complementary feeding time and inadequate protein intake. The purpose of this study was to analyze the relationship between the practice of complementary feeding and the level of protein adequacy with the incidence of stunting in toddlers in the working area of Puskesmas Bantaran Probolinggo regency, East Java. Research used observational analytic with retrospective case control design. The sample were 22 stunted group and 22 non-stunted control group who met the inclusion criteria, and taken by simple random sampling. The sample was a stunting locus village toddler in the working area of Puskesmas Bantaran, Probolinggo Regency with mother as respondents. Data collection instruments included questionnaires of characteristic, SQ-FFQ to assess protein adequacy, and microtoise to measure height. Analysis using Chi-Square and Spearman test. The results showed that stunted toddlers get inappropriate complementary feeding (81.8%) and deficit of protein intake (81.8%). Non-stunted toddlers get the right complementary feeding practices (63.6%) and adequate protein intake (59.1%). There is a relationship between the practice of complementary feeding (p=0.002, OR=7.87) and the level of protein adequacy (p=0.005, OR=6.5) with the incidence of stunting in toddlers. The conclusion of this study is that toddlers with improper complementary feeding practices are 7.87 times higher risk of stunting and toddlers with adequate levels of protein deficit are 6.5 times higher risk of stunting. Mothers should be able to increase the amount of protein intake and proper complementary feeding.

The Correlation Between Mother's Knowledge about Complementary Feeding with The Incidence of Stunting in Toddlers Under Two in Mayang, Jember

Stunting is a condition of toddlers who have a height-for-age less than -2 SD WHO Z-score. The period from a newborn until two years is also known as the golden period. Nutrition obtained after birth affects the growth and development of them. Complementary feeding was given when they were 6 months old. The level of mother's knowledge about complementary foods has an impact on complementary feeding. Inappropriate complementary feeding can lead to stunting. The research objective was to determine the correlation between mother's knowledge about complementary feeding and the incidence of stunting in toddlers under two in Mayang. The research was an analytical observational with a cross sectional study design. The sample was 90 respondents taken using consecutive sampling method. Data collection using a questionnaire on the mother and using height-for-age data from the toddlers. Statistical test using the Spearman test, showed that there was a significant correlation between the level of mother's knowledge about complementary feeding and the incidence of stunting (p=0.024.; rho=-0.238). Due to this result, we recommend continuous health promotion and education among mothers to decrease the risk of stunting in their children.
 Keywords: stunting, complementary feeding, toddlers under two, mother’s knowledge

Household Food Insecurity, Inappropriate Complementary Feeding, and Associated with High Stunting and Anemia Among Children Aged 6–23 Months, in Madura Rural, Indonesia

ObjectivesStunting and anemia are prevalent among under-two years old. Household food insecurity can affect suboptimal complementary feeding and has been associated with growth faltering and anemia. However, an inadequate association exists between food security, complementary feeding, and nutritional status. The study investigated the relationship of household food insecurity with complementary feeding practices and the incidence of stunting and anemia among children under two years in rural IndonesiaMethodsA community-based cross-sectional study was conducted among 300 randomly selected children aged 6–23 months in rural West Madura. Indonesia. A structured questionnaire collected information on the following socio-demographic characteristics; household food insecurity was measured using the Household Food Insecurity Access Scale (HFIAS) and infant and child feeding (IYCF) indicators.ResultsNearly 65.3% of households were food insecure. The prevalence of anemia was 46.7% and stunting 34.7% among children aged 6–23 months. Prevalence stunting and anemia were higher among children in HH food insecure than in HH food secure, 36.2%, and 48.5% compared with 31.7% and 43.3%. Prevalence wasting and stunting was higher among children aged 12.0–23.0 months than children aged 6.0–11.9 months, 39.5%, 20.2%, and 40.8% compared with 18.2%, 15.6%, and 16.9%, respectively. Meanwhile, the prevalence of anemia was higher among children aged 6.0–11.9 months than children aged 12.0–23.9 months. Most children aged 6–23 months have poor complementary feeding practices with 72.7% infants have introduced of first complementary food less than six months of old; 58.7% not meeting minimum meal frequency, 75.3% not meeting minimum dietary diversity, 90.7% not meeting acceptable diet. There was no significant difference of four keys poor complementary food both age group and incidence of underweight, wasting, stunting, and anemia.ConclusionsComplementary feeding is a poor and low-quality diet and has a high prevalence of stunting and anemia. A challenge is improving complementary food through behavior change communication and fortified complementary food interventionFunding SourcesWe would like to acknowledge the funding the research (grant IN 246) provided by Neys-Van Hoogstraten Foundation.

HUBUNGAN POLA PEMBERIAN ASI DAN MP-ASI DENGAN SKOR PB/U PADA ANAK USIA 6-23 BULAN DI DESA KEMBANGAN KECAMATAN BONANG KABUPATEN DEMAK

Stunting is a chronic nutritional problem that can describe growth failure since before and after birth. Factors that also influence the incidence of stunting include the pattern of breastfeeding and complementary feeding. The stunting rate in Kembangan village, Demak Regency is 80 cases. The purpose of this study was to analyze the relationship between breastfeeding and complementary feeding patterns with Z PB/U scores in children aged 6-23 months. The type of research used is explanatory research with a cross sectional approach. The research population is 138 toodler under two. Research subjects were found to be 65, selected by purposive sampling. The research instrument consisted of a structured questionnaire used to obtain the characteristics of the subject and exclusive breastfeeding, a1x24 hour recall form, and food photo book used to determine the amount of complementary feeding, infantometer for body length, and WHO anthro determines the PB/U index. Statistic test used Spearman Rank correlation. 73,8% of children did not initiate early breastfeeding, 38,5% less breastfeeding, 47,7% less duration of breastfeeding, 69,2% of children not exclusively breastfeed. The first age of children eating inappropriately was 69,2%, the frequency of eating was not appropriate as much as 41,5%, the portion of food was not appropriate as much as 43,1%, the texture of thee food was not appropriate as much as 16,9%. The Z PB/U score for short children was 26,2%. There is a relationship between breastfeeding patterns (p=0,003) and complementary feeding patterns (p=0,001) with Z PB/U scores. Inappropriate breastfeeding and complementary feeding are related to the Z PB/U score of children aged 6-23 months.

Assessment of Complementary Feeding Practices and Nutritional Status of Children (0-24 months) in Akuku Toru Local Government Area of Rivers State, Nigeria

This study was carried out to assess complementary feeding practices of under-five children in Akuku Toru Local Government Area of Rivers State. A cross-sectional descriptive survey research was adopted for the study. The population for the study consisted of nursing mothers with children (0-24 months) attending their normal health services in seven (7) major primary health care centres in Akuku Toru Local Government Area, Rivers State. A sample size of 210 nursing mothers was selected for the study. The instrument used for data collection was a self-structured questionnaire titled “Assessment of Complementary Feeding Practices of Children Questionnaire”. The questionnaire was validated by three validates. Data generated using the research instrument was analyzed using frequency, percentages and mean. The findings obtained showed that most nursing mothers initiate complementary feeding at early age and their reasons often times are pressure from their family members who do not understand the benefits of adequate breast milk and pressure from employers to resume work. Majority of the sampled nursing mothers in the study area prefer cereal/grain, fruits, vegetables, yoghurt and custard over other complementary foods used in nursing a child. Majority of the respondent agreed that the nutritional status of infants introduced to complementary foods at their early stage of development is usually underweight, stunting and wasting. It was also established that inappropriate complementary feeding practices adopted by nursing mothers in the study areas has significant effect on the nutritional status of their infants. Therefore, the study recommends that there is need for promotion of women’s health and nutrition as a strategy that will benefit child nutritional status. Interventional programmes should target poorer household and mothers with lower educational level to improve complementary feeding practices of mothers. Developmental programmes should focus on empowering women in rural communities by improving of household income through creation of employment and access to credit facilities that will enable women engage in sustainable means of livelihood.

Complementary feeding pattern and its determinants among mothers in selected primary health centers in the urban metropolis of Ekiti State, Nigeria

The incidence of malnutrition in the first two years of life has been directly linked with inappropriate complementary feeding practices along with high infectious disease levels. This study was therefore aimed to assess the complementary feeding pattern among mothers of children aged zero to two years in selected health centres in Ado Ekiti, the capital of Ekiti State, Nigeria. The study was cross-sectional in design. One hundred and thirty-five mothers were selected from two health centres within Ado-Ekiti for this study. A semi-structured interviewer-administered questionnaire was used to collect information from the mothers. The questionnaire included questions that assessed the mothers’ socio-demographic characteristics and complementary feeding pattern. Most (62.5%) infants were introduced to complementary foods at 3–5 months old and water (43.3%) at 3 months of age. The main food item given to the infants on commencement of complementary feeding was formula food (45.9%) followed by fermented cereal gruel (37%). The timing of introduction for different food items revealed that in contrast to the use of fermented cereal gruel (23.8%), fewer children were introduced to iron-rich foods (15.1%) and fruits (11%) at 6 months to a year old. Mother’s knowledge of ideal age for the introduction of complementary feeding ({chi }^{2}= 20.547; p < 0.001) associated significantly with the age of introduction of complementary feeding. More than three-fifth (62.5%) of the respondents had commenced complementary feeding to their infants between 3 and 5 months while an excess of two-fifth (43.3%) of the respondents started giving their children water to drink at 3 months of age. Nurses and nutritionists in primary health care centers should take the lead role in educating mothers about the need for exclusive breastfeeding for the first 6 months of life and appropriate complementary feeding for ages 6–24 months.

The Shishu Pushti Trial-Extended Peer Counseling for Improving Feeding Practices and Reducing Undernutrition in Children Aged 0-48 Months in Urban Bangladesh: Protocol for a Cluster-Randomized Controlled Trial.

BackgroundThe aim of this study is to assess if peer counseling of women improves breastfeeding, complementary feeding practices, and child growth, and thus reduces the prevalence of undernutrition in children up to 4 years of age.ObjectiveLack of exclusive breastfeeding and inappropriate complementary feeding are critical factors in reducing child undernutrition, morbidity, and mortality. There are reported trials of peer counseling to improve breastfeeding; however, they did not examine the efficacy of peer counseling to improve complementary feeding or the long-term impacts on child growth and development.MethodsThis study has used a community-based, cluster-randomized controlled trial with a superiority design and 2 parallel treatment arms. It is assessing the impact of peer counseling, starting in late pregnancy up to 1 year after delivery, on child feeding practices, growth, and development with follow-up until 48 months of age. The study site was Mirpur, a densely populated area in Dhaka. Using satellite maps and geographic information system mapping, we constructed 36 clusters with an average population of 5000 people. We recruited pregnant women in the third trimester aged 16-40 years, with no more than 3 living children. Trained peer counselors visited women at home twice before delivery, 4 times in the first month, monthly from 2 to 6 months, and again at 9 and 12 months. Trained research assistants collected anthropometric measurements. The primary outcome will be differences in child stunting and mean length for age at 6, 12, 15, and 18 months. Secondary outcomes will be differences in the percentage of women exclusively breastfeeding in the mean duration of any breastfeeding and in the percentage of children at 6 and 9 months of age who receive solid, semisolid, or soft foods; and the percentage of children consuming foods from 4 or more food groups at 9, 12, 15, and 18 months. We will assess the mean cognitive function scores from the Ages and Stages Questionnaire (9 and 18 months) and Bayley tests (24 and 36 months).ResultsWe identified 65,535 people in mapped residences, from which we defined 36 clusters and randomly allocated them equally to intervention or control groups stratified by cluster socioeconomic status. From July 2011 to May 2013, we identified 1056 pregnant women and 993 births in the intervention group and 994 pregnancies and 890 births in the control group. At 18 months, 692 children remained in the intervention group and 551 in the control group. From January 2015 to February 2017, we conducted the long-term follow-up of the cohort. We have now completed the data collection and processing and have started analyses.ConclusionsThis study will help fill the evidence gap about the short- and long-term impact of peer counseling on improving infant feeding, preventing childhood undernutrition, and enhancing child cognitive development.Trial RegistrationClinicalTrials.gov NCT01333995; https://clinicaltrials.gov/ct2/show/NCT01333995International Registered Report Identifier (IRRID)DERR1-10.2196/31475

Infant and Young Child Feeding Practices and Nutritional Status in Two Health Zones of South Kivu, Eastern Democratic Republic of Congo: A Community-Based Study

Background: In DRC, childhood undernutrition remains a serious public health concern. Internationally recommended infant and young child feeding (IYCF) practices may improve child nutritional status. This study aimed to describe IYCF practices, factors associated with inappropriate complementary feeding, and infant’s nutritional status.

Pendidikan Kesehatan tentang Pemberian Makanan Pendamping ASI pada Ibu yang Mempunyai Bayi 6-24 Bulan

Growth in infants and nutritional problems in children are often caused by the inaccuracy of parents in their habits of inappropriate breastfeeding and complementary feeding, and mothers are less aware that babies aged 6 months already need complementary feeding. mothers in good quantity and quality. At the age of 6 months apart from breastmilk, the baby can start to be given complementary foods, because at this age the baby already has a chewing reflex with stronger digestion. In giving baby food, it is necessary to pay attention to the punctuality of delivery, frequency, type, quantity, foodstuff, and method of manufacture, improper infant feeding habits, such as feeding too early or too late, insufficient food given and inadequate frequency. this can have an impact on the health and nutritional status of the baby. Based on the data obtained from the health office, it is known that from 12 districts the prevalence of malnutrition and malnutrition based on the BB / U indicator is 17.2% and based on the TB / U indicator is 20.2%. This community service aims to provide information and improve the skills of mothers in complementary feeding of breast milk. This community service was carried out in the Work Area of the Simpang Kawat Puskesmas, at the time of January 2020 the service method used a survey approach, lectures and discussions. The results obtained by mothers can understand the meaning of complementary foods for breast milk, the benefits of complementary foods for breast milk and the schedule for which they are given.

Complementary feeding practices in children aged 6-23 months: An institution-based observational study

Background: Inappropriate complementary feeding practices in children may lead to adverse consequences ranging from growth failure to mortality. Intervention programs intending to optimize the practices should be based on identification of the lacunae and on the assessment of the magnitude of the problem. Aim: The aim of the study was to determine appropriateness and adequacy of complementary feeding given to children aged 6?23 months. Materials and Methods: Data regarding demographic profile, maternal education, source of information for feeding, and details of complementary feeding provided in the last 24 h were obtained from caregivers, using the standard WHO questionnaire. Chi-square test was used for determining the association between optimal feeding practices and continued breastfeeding, age-group, maternal education, and source of information. Results: The study enrolled 480 children (mean age: 12.9+5.1 month; male: female=1.22:1). 225 children (46.87%) had minimum meal frequency and 66 (13.8%) had minimum dietary diversity, 41 (11.08%) were receiving minimum acceptable diet. Only 103 mothers (21.5%) obtained the information regarding recommended complementary feeding practices from health professionals. There was a significant association between health professional being the source of information and presence of adequate dietary diversity (p&lt;0.01) and minimum acceptable diet (p&lt;0.01). Conclusion: Complimentary feeding practices are inadequate and thus, require an intervention of healthcare providers with better involvement.

A Mixed-Methods Study of Factors Influencing Access to and Use of Micronutrient Powders in Rwanda.

The World Health Organization recommends point-of-use fortification with multiple micronutrients powder (MNP) for foods consumed by children aged 6-23 months in populations where anemia prevalence among children under 2 years or under 5 years of age is 20% or higher. In Rwanda, anemia affects 37% of children under 5 years. The MNP program was implemented to address anemia, but research on factors affecting the implementation of the MNP program is limited. We conducted a mixed-methods study to examine the factors influencing access to and use of MNP among mothers (N=379) in Rutsiro district, northwest Rwanda. Inductive content analysis was used for qualitative data. Logistic regression analysis was used to determine factors associated with the use of MNP. Qualitative results indicated that the unavailability of MNP supplies and distribution issues were major barriers to accessing MNP. Factors influencing the use of MNP included mothers' perceptions of side effects and health benefits of MNP, as well as inappropriate complementary feeding practices. Mothers of older children (aged 12-23 months) were more likely to use MNP than those of younger children (aged 6-11 months) (adjusted odds ratio [aOR]=3.63, P<.001). Mothers whose children participated in the supplementary food program were nearly 3 times more likely to use MNP than those whose children had never participated in the program (aOR=2.84, P=.001). Increasing household hunger score was significantly associated with lower odds of using MNP (aOR=0.80, P=.038). Mechanisms to monitor MNP supply and program implementation need to be strengthened to ensure mothers have access to the product. MNP program implementers should address gaps in complementary feeding practices and ensure mothers have access to adequate complementary foods.

Effect of inappropriate complementary feeding practices on the nutritional status of children aged 6-24 months in urban Moshi, Northern Tanzania: Cohort study.

IntroductionChildhood undernutrition is a major public health problem especially in low and middle-income countries (LMIC). The prevalence of early introduction of complementary feeding, low meal frequency, and low dietary diversity are frequent in LMICs. The effect of inappropriate complementary feeding practices on the nutritional status of children is not well documented in East African countries including Tanzania. Therefore, this study aimed at determining the effect of inappropriate complementary feeding practices on the nutritional status of children aged 6–24 months in urban Moshi, Tanzania.MethodologyA retrospective cohort study was done using the Pasua and Majengo cohorts of mother-child pairs in urban Moshi who were enrolled from 2002 to 2017. About 3355 mother-child pairs were included in the analysis. Appropriate complementary feeding practices were assessed using WHO IYFP indicators such as age at introduction of solid, semi-solid, or soft foods, minimum dietary diversity, and minimum meal frequency. Nutritional status (stunting, wasting, and underweight) was determined. Multilevel modeling was applied to obtain the effect of inappropriate complementary feeding practices on the nutritional status of children and to account for the clustering effect of mothers and children and the correlation of repeated measures within each child.ResultsMajority of the children (91.2%) were given soft/semi-solid/solid foods before six months of age, 40.3percent had low meal frequency, and 74percent had low dietary diversity. Early introduction of complementary food at age 0–1 month was statistically significantly associated with higher risks of wasting and underweight (ARR 2.9, 95%CI 1.3–6.3; and ARR 2.6, 95% CI 1.3–5.1 respectively). Children with low minimum meal frequency had higher risks of stunting, wasting, and underweight (ARR 2.9, 95%CI 2.3–3.6; ARR 1.9, 95%CI 1.5–2.5 and ARR 1.9, 95%CI 1.5–2.4 respectively). Children with low minimum dietary diversity were more likely to be stunted than is the case with their peers who received the minimum dietary diversity (ARR 1.3, 95% CI 1.01–1.6).ConclusionThere were a high proportion of children, which were fed inappropriately; Inappropriate complementary feeding practices predisposed children to undernutrition. Our study supports the introduction of complementary feeding, providing minimum dietary diversity, and minimum feeding frequency at six months of age as important in improving the nutritional status of the children.

Complementary feeding in Kongwa, Tanzania: Findings to inform a mycotoxin mitigation trial.

Complementary feeding of 6‐ to 24‐month‐old infants and young children with adequate, safe and developmentally appropriate food is essential to child health. Inappropriate complementary foods and feeding practices are linked to the high incidences of undernutrition among infant and young children in most developing countries, including Tanzania. Mycotoxin risk is an additional concern, given the documented presence of aflatoxin and fumonisin in food systems of Africa, especially maize and groundnut. In preparation for a trial of mycotoxin mitigation, we conducted focus group discussions and recipe trials to explore complementary foods and feeding practices in Kongwa, a rural district of central Tanzania. Sixty mothers of infants from 6 to 18 months of age in five villages across the district were purposefully sampled. During focus group discussions, mothers reported to mostly feed their children with cereal and groundnut‐based foods as thin or thick porridges. The most common porridge preparations contained cereal (mostly, maize) ranging from 66.7% to 80.0% by weight and groundnuts from 7.7% to 33.3%. The ratio of cereal to groundnut ranged from 3:1 to 4:1. For the recipe trial sessions, mothers chose similar ingredients reported during discussions to prepare complementary foods. The reliance on maize and groundnuts in complementary foods predisposes the children to undernutrition and exposure to aflatoxins and fumonisins. These formative research results suggest multiple intervention points to improve complementary feeding and reduce mycotoxin exposure in this population, including education messages package on feeding practices, mycotoxin control practices and complementary food formulation.

Independent and joint contribution of inappropriate complementary feeding and poor water, sanitation and hygiene (WASH) practices to stunted child growth.

The causes of undernutrition are often linked to inappropriate complementary feeding practices and poor households' access to water, sanitation and hygiene (WASH), but limited evidence exists on the combined effect of poor WASH and inappropriate complementary feeding practices on stunted child growth. We assessed the independent and joint contribution of inappropriate complementary feeding and poor WASH practices to stunted growth among children aged 6-23 months in the Jirapa Municipality of Ghana. A community-based cross-sectional analytical study design was used with a sample of 301 mothers/caregivers having children aged 6-23 months. The results indicate that in a multivariable logistic regression model that adjusted for confounders, children receiving both unimproved water and inappropriate complementary feeding had a higher and significant odd of becoming stunted (adjusted odds ratio = 33. 92; 95 % confidence interval 3⋅04, 37⋅17; P = 0⋅004) compared to households having both improved water sources and appropriate complementary feeding practices. Except for unimproved drinking water sources, poor sanitation and hygiene, which comprised the use of unimproved household toilet facilities, washing hands without soap and improper disposal of child faeces were not associated with the risks of stunting among children aged 6-23 months. The combined effect of unimproved water and inappropriate complementary feeding on stunting was greater than either unimproved water only or inappropriate complementary feeding only.

Dietary Vitamin A Intake, Coverage of Vitamin A Megadose Supplementation, and Prevalence of Vitamin A Deficiency among Marginalized Children 6-59 Months in Anganwadis of Chandigarh: A Multistage Cluster Sampling Survey.

Background:Lack of recent local data regarding Vitamin A deficiency, dietary intake, and coverage of biannual high-dose Vitamin A prophylaxis among marginalized children poses challenges for policy change.Objective:Our study aimed to evaluate the burden of serum Vitamin A deficiency, dietary Vitamin A intake, and current Vitamin A supplementation coverage.Methodology:We enrolled 216 children aged 6–60 months from 30 Anganwadis of Chandigarh using two-stage cluster sampling.Results:Dietary intake of Vitamin A-rich foods and vegetables in the last 24 h was observed only in 20% of enrolled children. Although 79.21% (160/202) of children aged ≥9 months reported receiving Vitamin A supplementation, only 38.52% had documented record of age-appropriate complete supplementation. None of the children showed ocular manifestations of Vitamin A deficiency. For the subjects in which C-reactive protein levels were ≤5 mg/l (n = 148), 35.14% (52/148) had serum retinol ≤0.7 μmol/L and 2.03% (3/148) had serum retinol ≤0.3 μmol/L. The multivariate odds ratios (ORs) of Vitamin A deficiency (serum retinol <0.7) were 2.23 times higher in subjects with inappropriate complementary feeding (OR: 2.23; 95% confidence interval [CI]: 1.07–4.80; P = 0.035) whereas odds were significantly lower for middle (OR: 0.27; 95% CI: 0.09–0.76; P = 0.015) and higher income (OR: 0.14; 95% CI: 0.03–0.53; P = 0.005) families in reference to low-income group.Conclusions:Subclinical Vitamin A deficiency is still a public health crisis with suboptimal dietary intake of Vitamin A-rich foods and compromised food diversity necessitating targeted approach for marginalized children.

Prevalence of Minimum Meal Frequency Practice and Its Associated Factors among Children Aged 6 to 23 Months in Ethiopia: A Systematic Review and Meta-analysis.

Background. Inappropriate complementary feeding practices are amongst the key causes of child undernutrition. It rises the risk of undernutrition, illness, and mortality among children. Objectives. This study was aimed to determine the pooled prevalence of MMF practice and associated factors among children aged 6 to 23 months in Ethiopia. Methods. The search was conducted by using the following electronic databases; PubMed/MEDLINE, HINARI, EMBASE, Google Scholar, Web of Science, Scopus, African journals, and Google for grey literature. The publication bias was determined by using a funnel plot and Egger’s test. The heterogeneity between the studies was checked by using I2 statistic. The subgroup analysis was done by sample size, region, and year of publication. Result. A total of 20 studies with 12 656 study participants were included in the present systematic review and meta-analysis. The pooled prevalence of MMF practice among children aged 6 to 23 months in Ethiopia was estimated to be 63.80% (95%CI: 56.59, 71.01). PNC visit (AOR = 1.90, 95%CI [1.31, 2.49]), wealth index (AOR = 2.11, 95%CI [1.42, 2.81]) and age of child (AOR = 5.75, 95%CI [4.25, 7.26]) were factors significantly associated with MMF among children aged 6 to 23 months. Conclusion. The findings showed that the pooled prevalence of MMF among children aged 6 to 23 months in Ethiopia was relatively low. PNC visit, wealth index and age of child were factors significantly associated with MMF among children aged 6 to 23 months. Therefore, community-based health education concerning the recommended MMF among children aged 6 to 23 months is required to take place.

Complementary feeding practice and associated factors among children aged 6 to 12 months attending governmental health facilities in Addis Ababa: Ethiopia

BACKGROUND: Inappropriate feeding practices, coupled with high rates of infectious diseases, are the proximate causes of malnutrition during the first two years of life. Around 10 million under-five children died annually of which over one-third were due to inappropriate complementary feeding. OBJECTIVE: To assess factors associated with timely initiation of complementary feeding among children aged 6 to 12 months in public health care facilities of Addis Ababa Ethiopia. METHODS: An institutional-based cross-sectional study design was conducted. Data was collected using a pretested structured questionnaire. Binary and multivariable logistic regressions analyses were performed. Variables with p-value ≤0.05 were considered as statistically significant. RESULTS: The proportion of timely initiation of complementary feeding was 65.2% (95% CI = 60.8, 69.5). Being married [AOR = 2.622, 95% CI: 1.182–5.817], belongs to 18–24 years age at first marriage [AOR = 1.671, 95% CI: 1.019–2.742], being grade 9 and above [AOR = 1.910, 95% CI: 1.401–2.258], average income &gt; 1500 Ethiopian birr [AOR = 2.138, 95% CI: 1.762–2.347], and postnatal care follow up [AOR = 1.641, 95% CI:1.435–3.224] were significantly associated with complementary feeding. CONCLUSIONS: In this study, the magnitude of timely initiation complementary feeding was higher as compared to the country level figure. Implementing nutrition strategy which scales-up mother’s living standards improve complementary feedings practices.

Effects of Nutrition Education on Improving Knowledge and Practice of Complementary Feeding of Mothers with 6- to 23-Month-Old Children in Daycare Centers in Hawassa Town, Southern Ethiopia: An Institution-Based Randomized Control Trial.

Undernutrition and hidden hunger threaten the survival, growth, and development of children, young people, economies, and nations. Inappropriate complementary feeding practice due to poor maternal knowledge and awareness in combination with low income and infectious disease is the contributing factor for child undernutrition. Hence, this study was aimed at determining the effect of nutrition education on improving the knowledge and practice of complementary feeding of the mothers with 6- to 23-month old children in daycare centers of Hawassa Town, Southern Ethiopia. An institution-based randomized control trial design was employed. Daycare centers were randomly allocated for the intervention group and the control group. Among the total daycare centers in the town, five were assigned to receive nutrition education and the rest five for the control group (CG). The simple random sampling technique used to select individual participants from each daycare center. Two hundred (200) mother-child pairs (100 for each group) were recruited. Sociodemographic and economic variables were collected by the structured questionnaire. Knowledge of appropriate complementary feeding was assessed by seven knowledge questions. Appropriate complementary feeding practice was assessed by adapting Alive and Thrive Infant and Young Child Feeding (IYCF) practice guidelines. Nutrition education was given for four consecutive months by using Alive and Thrive IYCF guidelines. Data were analyzed by the SPSS software program version 20. The chi-squared test was used to test the significant differences in the proportion of good knowledge and good practice of complementary feeding and good dietary diversity between two groups. The independent t test was used to test the significant differences in mean dietary diversity between two groups. At 95% confidence interval, p < 0.05 was considered statistically significant. The results revealed that the proportion of mothers with good knowledge of appropriate complementary feeding was increased from 59% at pretest to 96% at posttest and the appropriate complementary feeding practice was improved from 54% at pretest to 86% at posttest in IG. There was no change in the knowledge and practice of complementary feeding practice in CG after four months. The proportion of mothers with good complementary knowledge was 54% both at pretest and at posttest and good complementary feeding practice was 51% and 52% at pre- and posttest in CG, respectively. There was no significant difference (p > 0.05) on complementary feeding knowledge and practice between two groups at pretest, while the difference was highly significant (p < 0.05) at the posttest. In conclusion, providing nutrition education improved the appropriate complementary feeding knowledge and practice of mothers. In recommendation, government and other partners working on sustainable child nutrition reduction should focus on the nutrition education to improve the knowledge and appropriate complementary feeding practice including daycare centers.

Optimal feeding practices in Tamilnadu, breast feeding and complementary feeding: the reality

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.