Inappropriate Infant Feeding Practices Research Articles

Inappropriate feeding practices as a risk factor for severe acute malnutrition in children aged between one month to five years: a case control study

Background: In developing country like India, inappropriate feeding practices like lack of exclusive breastfeeding, early or late introduction of complimentary diet, lack of direct breastfeeding, prelacteal feed, bottle feeding are the major risk factors for development of severe acute malnutrition in children aged between one month to five years.Methods: It was a case control study, 109 children aged between one month to five years with severe acute malnutrition (SAM) who fulfilled the WHO criteria for SAM admitted to KIMS Hubli were taken as cases and 109 children aged between one month to five years without SAM admitted to KIMS Hubli were taken as control, the data gathering tool was questionnaire of children and mother. Data were entered and analysed using SPSS software version 11. Proportions were compared using Chi square (χ2) test of significance, categorical variables were assessed using χ2. Odds ratio (OR) and 95% confidence interval (CI) were calculated. To estimate the independent effect of the factors that were significantly associated with SAM and to control the confounding effect they may have on each other, logistic regression analysis was done. In all the above test the p value of less than 0.05 was accepted as indicating statistical significance.Results: In the study lack of EBF (exclusive breastfeeding), DBF (direct breastfeeding), h/o prelacteal feeds, h/o bottle feed and late initiation of complimentary diet >6 months were significantly associated with SAM (p value less than 0.05).Conclusions: The findings of this study clearly establishes the association of SAM with inappropriate infant feeding practices prevailing in our country.

An assessment of knowledge and practices of breastfeeding among mothers having child less than 2 years of age in a city of central Uttar Pradesh, India

Background: Breastmilk is the natural first food for babies which provides all the energy and nutrients that the infant needs for the first few months of life. More than two thirds of the 2.4 million child deaths occurring each year in India are related to inappropriate infant feeding practices. Initiation of breastfeeding within 1 hour of birth in central Indian states is among the lowest. The situation in central Indian states especially Uttar Pradesh is worse than the rest of India which is usually attributed to prevalent socio-economic and cultural factors.Methods: A cross-sectional descriptive study that was conducted among 144 mothers visiting a tertiary care hospital in Lucknow, Uttar Pradesh, India over a period of nine months using a questionnaire-based interview. Results: The study found that majority of subjects has good knowledge about breastfeeding. 92.4% mothers reported knowledge of putting the baby on the breast within an hour of birth. 65% had the correct breastfeeding position knowledge. Majority were aware that breastfeeding protects from various infections and that colostrum or first milk serves as the first immunization for the baby. 90.3% knew the correct definition of complementary feeding. Most of the subjects planned to breastfeed their baby for a year or more (86.8%). Conclusions: Majority mothers had good knowledge of breastfeeding and complementary feeding and good breastfeeding practices were being followed. This study brought out that educated mothers had better breastfeeding knowledge and practices, thus highlighting to the importance of formal education in mothers.

Awareness, attitude and practice of breast feeding among mothers at tertiary care center, Puducherry, India

Background: The knowledge and practice of exclusive breastfeeding has been prejudiced by demographic, social, cultural, biophysical, and psychosocial factors. About two-thirds of under-five deaths in India are associated with inappropriate infant feeding practices. Objective of this study was to assess the awareness, knowledge and practice of breastfeeding among the mothers attending to the tertiary care institute at Puducherry, India.Methods: This hospital-based, cross-sectional study was carried out among 150 postnatal mothers who attended immunization clinics, post-natal and paediatric wards at the tertiary care hospital at Puducherry collecting data about breastfeeding knowledge and practices using a structured interview.Results: The breastfeeding practices were significantly poorer in terms of initiation, feeding colostrums, timing and frequency of feeding and inclusion of pre-lacteal feeds among obese women compared to the normal weighted mothers. The breastfeeding knowledge and attitude was healthy among the mothers as depicted by the awareness of nutritive value of breast milk by majority (84%) of mothers.Conclusions: The mothers had poor knowledge regarding initiation of breastfeeding and administration of colostrum. There was a positive attitude about exclusive breastfeeding, frequency of feeding and social aspects of breastfeeding.

Inappropriate infant feeding practices of HIV-positive mothers attending PMTCT services in Oromia regional state, Ethiopia: a cross-sectional study

BackgroundInappropriate infant feeding affects the probability of mother-to-child transmission of HIV and HIV-free survival of infants. However, in Ethiopia limited evidence exists regarding the infant feeding practice of mothers who are HIV-positive. The aim of this study was to determine the prevalence and predictors of inappropriate infant feeding among HIV-positive mothers attending the prevention of mother-to-child transmission (PMTCT) service in Adama and Bushoftu towns, Oromia, central Ethiopia.MethodsA cross-sectional study was conducted in ten PMTCT service providing health facilities in the towns; 283 mother-infant pairs were enrolled. Appropriate infant feeding practice was defined as exclusive breastfeeding in the first six months of age. Logistic regression was employed to analyze the data and the outputs are presented using adjusted odds ratio (AOR) with 95% confidence intervals (CI).ResultsOne hundred thirty of the infants were aged below six months, 103 between 6 and 11 months and 50 were older than 12 months. The prevalence of inappropriate infant feeding was 14.5% (95% CI 10.6, 18.7). About 6.3% and 8.3% practiced exclusive replacement feeding and mixed feeding respectively, in the first six months. Only 1.8% ever expressed their breast milk to feed their baby and none practiced wet nursing. Among 38 mothers who already discontinued breastfeeding 52.6% did so before 12 months of age. Mothers who were HIV-positive and had received antenatal (AOR = 0.05: 0.01, 0.30) and postnatal visits (AOR = 0.18: 0.04, 0.81); received infant feeding counseling (AOR = 0.18: 0.06, 0.55); and disclosed their HIV status to their partners (AOR = 0.28: 0.12, 0.63), showed a reduction of practicing inappropriate infant feeding. Mothers having breast problems (AOR = 4.89: 1.54, 15.60) and infants with mouth ulcers (AOR = 6.41: 2.07, 19.85) were more likely to practice inappropriate feeding.ConclusionPrompt management of breast complaints in mothers and mouth ulcer in infants; and provision of nutrition counseling to HIV-positive mothers, especially during antenatal and postnatal care, may help to improve the infant feeding practices for HIV exposed infants.

The influence of maternal psychosocial circumstances and physical environment on the risk of severe wasting in rural Gambian infants: a mixed methods approach

BackgroundSevere wasting affects 16 million under 5’s and carries an immediate risk of death. Prevalence remains unacceptably high in sub-Saharan Africa and early infancy is a high-risk period. We aimed to explore risk factors for severe wasting in rural Gambian infants.MethodsWe undertook a case-control study from November 2014 to June 2015, in rural Gambia. Cases had WHO standard weight-for-length z-scores (WLZ) < −3 on at least 1 occasion in infancy. Controls with a WLZ > −3 in the same interval, matched on age, gender, village size and distance from the clinic were selected. Standard questionnaires were used to assess maternal socioeconomic status, water sanitation and hygiene and maternal mental health. Conditional logistic regression using a multivariable model was used to determine the risk factors for severe wasting. Qualitative in depth interviews were conducted with mothers and fathers who were purposively sampled. A thematic framework was used to analyse the in-depth interviews.ResultsTwo hundred and eighty (77 cases and 203 controls) children were recruited. In-depth interviews were conducted with 16 mothers, 3 fathers and 4 research staff members. The mean age of introduction of complementary feeds was similar between cases and controls (5.2 [SD 1.2] vs 5.1 [SD 1.3] months). Increased odds of severe wasting were associated with increased frequency of complementary feeds (range 1–8) [adjusted OR 2.06 (95%: 1.17–3.62), p = 0.01]. Maternal adherence to the recommended infant care practices was influenced by her social support networks, most importantly her husband, by infant feeding difficulties and maternal psychosocial stressors that include death of a child or spouse, recurrent ill health of child and lack of autonomy in child spacing.ConclusionIn rural Gambia, inappropriate infant feeding practices were associated with severe wasting in infants. Additionally, adverse psychosocial circumstances and infant feeding difficulties constrain mothers from practising the recommended child care practices. Interventions that promote maternal resilience through gender empowerment, prioritising maternal psychosocial support and encouraging the involvement of fathers in infant and child care promotion strategies, would help prevent severe wasting in these infants.

Situation of breastfeeding and complementary feeding in a medium-sized municipality in the Ribeira Valley, São Paulo

OBJECTIVE: To analyze the situation of breastfeeding and complementary feeding in the city of Registro, São Paulo. METHODS: This cross-sectional study collected sociodemographic and feeding information of infants aged less than one year who participated in the 2011 multiple vaccine campaign. Breastfeeding and complementary feeding were analyzed by indicators proposed by the World Health Organization. The association between outcomes (exclusive breastfeeding and introduction to complementary feeding) and the explanatory variables (maternal and child characteristics) was investigated by the Poisson model with a robust error variance. RESULTS: We analyzed 713 children. The prevalence of exclusive breastfeeding was 50.0%. Children who were breastfed exclusively on the first day at home (PR=2.40; 95%CI=1.42-4.06) and not given pacifiers (PR=1.95; 95%CI=1.153.30) were more likely to be exclusively breastfed. The complementary feeding indicators showed that 62.1% of the children aged 6 to 8.9 months consumed fruit plus savory mashes. None of the explanatory variables was significantly associated with this outcome. CONCLUSION: The study identified inappropriate infant feeding practices. Such studies can contribute to the proposal of policies, which is particularly important in an unfavorable social development context characterized by the study city.

Effectiveness of IMNCI guideline on feeding problem among young infants (0-2 months) admitted in a selected hospital at Bhubaneswar, Odisha.

Malnutrition and other preventable disease among the young children are caused mainly due to poor care and inappropriate infant feeding practices, delaying and restricting breast feeds and giving other products before six months. Development of feeding problem occur due to poor position and attachment. An evaluative approach was undertaken to assess feeding problem among 50 young infants (0-2months) admitted in IMS & SUM Hospital, Bhubaneswar. The study design adopted was quasi experimental with one group pre-test and post-test design. The samples were selected by non probability convenience sampling. Pre-test and post test assessment was done by standard IMNCI guideline. The reliability was established 0.78 by using chronback's formula. Finding of the study shows that, comparison of pre test and post test assessment of't' value was 5.8 which were significant at p<0.05 level. It revealed that feeding problem among young infant were improved after administration IMNCI guideline. Keyword:Effectiveness, Feeding problem, young infant, IMNCI guideline Breast feeding influences the child's health positively and improves nutritional status. A data analysis from those developing countries showed that infants who were not breast feed had a six fold greater risk of dying from infectious diseases within first two months of life than those who were breast fed (UNICEF 2007). Six months of exclusive breast feeding and continued breast feeding in the first year of life could prevent 1.3 million child deaths worldwide. Malnutrition has been responsible, directly or indirectly for 60% of the 10.9 million deaths annually among children under five. Over two thirds of these deaths, which are often associated with inappropriate feeding practices, occur during the first year.(Cochrane collaboration 2005) National Institute of Environmental Health Sciences shows that children who are breast feed have a 20% of lower risk of dying between the age of 28 days and 1 year than children who were not breast fed. Every year over one million infants die and millions of others are impaired because they are not adequately breast feed. Every day between 3000 to 4000 infants die from diarrhoea and ARI because the ability to feed them adequately has been taken away from their mothers. Study suggest that maximal onset of breast feeding problems were noted in the first week after delivery. This is the period when mothers were more likely to fail to initiate breast feeding. The development of breast feeding problem occurs due to poor positioning of the baby. Findings reveals that breast problems like cracked nipple, mastitis and sore nipple were significantly associated with poor positioning and attachment which are essential for effective breast feeding. Coce etel 2011 reported that women those infants were incorrectly positioned were 1.94 times at risk to developing nipple trauma compared with women whose nipple were correctly positioned. 1.2 NEED FOR THE STUDY UNICEF 2008 reports that India has close to 25 million children born every year. Out of these 1.9 million are under five children, who die in a year. Among the deceased children, 1.4 million children die just within 1 year and roughly one million children dying with malnutrition and other preventable diseases caused mainly due to poor care and inappropriate infant feeding practices, delaying and restricting breast feeds and giving other products before six months are still common practices which increases the risk of infection, allergy, long term diseases and death

Using grounded theory methodology to conceptualize the mother–infant communication dynamic: Potential application to compliance with infant feeding recommendations

Excessive, rapid weight gain in early infancy has been linked to risk of later overweight and obesity. Inappropriate infant feeding practices associated with this rapid weight gain are currently of great interest. Understanding the origin of these practices may increase the effectiveness of interventions. Low-income populations in the Southeastern United States are at increased risk for development of inappropriate infant feeding practices, secondary to the relatively low rates of breastfeeding reported from this region. The objective was to use grounded theory methodology (GTM) to explore interactions between mothers and infants that may influence development of feeding practices, and to do so among low-income, primiparous, Southeastern United States mothers. Analysis of 15 in-depth phone interviews resulted in development of a theoretical model in which Mother-Infant Communication Dynamic emerged as the central concept. The central concept suggests a communication pattern developed over the first year of life, based on a positive feedback loop, which is harmonious and results in the maternal perception of mother and infant now speaking the same language. Importantly, though harmonious, this dynamic may result from inaccurate maternal interpretation of infant cues and behaviours, subsequently leading to inappropriate infant feeding practices. Future research should test this theoretical model using direct observation of mother-infant communication, to increase the understanding of maternal interpretation of infant cues. Subsequently, interventions targeting accurate maternal interpretation of and response to infant cues, and impact on rate of infant weight gain could be tested. If effective, health care providers could potentially use these concepts to attenuate excess rapid infant weight gain.

Infant feeding practices among mildly wasted children: a retrospective study on Nias Island, Indonesia.

BackgroundThis study investigated the infant feeding practices of participating mothers who were recruited into a research project aimed at improving the nutritional status of mildly wasted children (< -1.0 to ≥ -1.5 Weight-for-Height Z-scores) aged ≥ 6 to < 60 months on Nias Island, Indonesia.MethodsCross-sectional, questionnaire-based interview of mothers of the index children (n = 215) who were admitted to the community program for mildly wasted children in the study area. Four focus groups and twenty in-depth interviews were conducted to explore further information on infant feeding practices in the study area.ResultsRetrospective results indicated that 6% of the mothers never breastfed. Fifty two percent of mothers initiated breastfeeding within six hours of birth, but 17% discarded colostrum. Exclusive breastfeeding until 6 months of age was practiced by 12%. Seventy-four percent of the mothers offered supplementary liquids besides breast milk within the first 7 days of life, and 14% of infants received these supplementary liquids from 7 days onwards until 6 months of age. Moreover, 79% of the infants were given complementary foods (solid, semi-solid, or soft foods) before 6 months of age. About 9% of the children were breastfed at least two years. Less than one in five of the mildly wasted children (19%) were breastfed on admission to the community program. Qualitative assessments found that inappropriate infant feeding practices were strongly influenced by traditional beliefs of the mothers and paternal grandmothers in the study areas.ConclusionGenerally, suboptimal infant feeding was widely practiced among mothers of mildly wasted children in the study area on Nias Island, Indonesia. To promote breastfeeding practices among mothers on Nias Island, appropriate nutrition training for community workers and health-nutrition officers is needed to improve relevant counseling skills. In addition, encouraging public nutrition education that promotes breastfeeding, taking into account social-cultural factors such as the influence of paternal grandmothers on infant feeding practice, is needed.

Infant feeding practices and baby bottle tooth decay in hispanic women, infants, and children program participants

Healthy People 2000 National Health Promotion and Disease Prevention objectives include improving parental and caregiver feeding practices that prevent baby bottle tooth decay (BBTD). The purpose of this study was to determine the prevalence of BBTD and its relationship to reported infant feeding practices of preschool children participating in a dental screening study in San Antonio, TX. Face-to-face interviews were conducted by one trained bilingual interviewer with a total of 718 guardians/parents of Hispanic children (ages 6 months-5 years) in a Women, Infants, and Children (WIC) Supplemental Food Program who were examined and classified according to a four stage BBTD Severity Index developed by the authors. A 70 item forced-choice questionnaire, including 13 specific infant feeding practice items was developed, field tested, and translated into Spanish to address cultural sensitivity and regional issues. A portable computer and custom data entry program were used to document responses. The overall prevalence of BBTD was 12.9%. There was a significant difference (p<0.01) in prevalence of BBTD between breast-fed children (7.9%) and bottle-fed (17.5%). Napping with the bottle was reported to occur significantly (p<0.001) more frequently among those with BBTD. When respondents identified the age at which the bottle was stopped, the prevalence of BBTD was significantly correlated (p<0.0001) with length of time on the bottle. Use of pacifiers was not significantly related to BBTD prevalence. Most respondents reported putting milk, formula, juice, koolaide, water and cereal in the bottle on a daily basis. The association between BBTD and inappropriate infant feeding practices is supported by these data, which suggest that guardian/parent oral health education should begin as early as possible and include feeding practice guidelines along with other preventive measures. Supported by Centers for Disease Control and Prevention.