Infant And Young Child Feeding Practices Research Articles

The potential effectiveness of community health and nutrition volunteers on mothers’ infant and young children feeding knowledge and practice in remote areas, Hajjah, Yemen

BackgroundThe Infant and young child feeding (IYCF) practices directly affect the health, development and nutritional status of children under two years of age. However, IYCF counseling is one of the Community Health and Nutrition Volunteers (CHNVs) activities provided, which may contribute to improving the IYCF knowledge and practice among mothers. Since establishment of the CHNVs program in Yemen, its outcome has never been evaluated. Therefore, the aim of this study was to evaluate the role of CHNVs in improving the IYCF knowledge and practice among mothers in Hajjah governorate.MethodsA comparative cross-sectional study design was conducted in Bani Qais and Al-Maghrabah districts, Hajjah governorate between January and April 2023. A three-stage cluster sampling method was used to select districts, volunteer villages and households. A total of 926 mothers were interviewed. A pre-tested structured questionnaire was used to collect data. SPSS 26 was used for data analysis. The multinomial logistic regression and Chi-Square test were used to compare the IYCF knowledge and practices among mothers between the volunteer and non-volunteer villages. Odds Ratio (OR) with 95% Confidence Interval (CI) were calculated. A p-value < 0.05 was considered statistically significant.ResultsThe mothers in volunteer villages had significantly better breastfeeding and complementary feeding (CF) knowledge than mothers in non-volunteer villages. The OR of having good and moderate knowledge of breastfeeding were 3.5 (95%CI: 2.4–5.2) and 1.6 (95% CI: 1.2–2.2), respectively. The OR for good and moderate knowledge of CF were 1.7 (95% CI: 1.1–2.7) and 2.2 (95% CI: 1.5-3.0), respectively. Moreover, there is a statistically significant association in prevalence of Exclusively breastfed for the first two days after birth (EBF2D), Mixed milk feeding under six months (MixMF) and Bottle feeding 0–23 months (BoF) between volunteer and non-volunteer villages [(OR = 1.4, 95% CI: 1.0-1.8), (OR = 0.4, 95% CI: 0.2–0.8) and (OR = 0.5, 95% CI: 0.4–0.7), respectively].ConclusionsThe study found that CHNVs play a significant effect in improving the breastfeeding and CF knowledge, and prevalence of EBF2D, MixMF and BoF practices among mothers in their villages compared to non-volunteer villages. Future follow-up study and expansion to other settings in different governorates is recommended.

A Mobile Gaming App to Train Teenage Mothers on Appropriate Child Feeding Practices: Development and Validation Study.

Undernutrition is an underlying factor in nearly 50% of 1 million estimated annual deaths among Nigerian children aged <5 years. Inappropriate maternal infant and young child feeding (IYCF) practices are basic contributors to child undernutrition. Teenage motherhood exacerbates the problem of inadequate child feeding. One possible intervention method to improve IYCF knowledge and practices of teenage mothers is the use of mobile gaming technologies. Despite extreme poverty in low- and middle-income countries, a ubiquity of mobile phone networks exists. This study aims to develop and validate a mobile gaming app, called BabyThrive, to train Nigerian teenage mothers on appropriate IYCF practices. To identify gaps in current IYCF practices in northern Nigeria, we conducted an extensive search of the literature and held 2 focus group interviews with 16 teenage mothers with low-income status. An initial app content design was then created, and content validity was established by 10 nutrition experts. Next, we developed an app prototype, which was assessed for quality by 7 nutrition and mobile gaming experts and evaluated for usability by 90 teenage mothers from rural areas in Abuja, the country's capital. The final app, BabyThrive, is a 2D mobile game that is fully functional offline and available in English as well as Hausa, which is commonly spoken in northern Nigeria. The efficacy of the BabyThrive app was assessed using IYCF knowledge scores obtained from the administration of the validated Teen Moms Child Feeding Questionnaire for Sub-Saharan Africa. Construct validity was established via crossover design by comparing the total IYCF knowledge scores of the teenage mothers obtained after a verbal training program and BabyThrive app use. Large proportions of the study participants were married (53/90, 59%) and had no personal income (63/90, 70%). The mean quality rating for the BabyThrive app was 4.3 (SD 0.39) out of 5.0. High levels (>80%) of usability and user satisfaction were documented. Knowledge of exclusive breastfeeding (P<.001) and total knowledge scores (P=.002) were significantly higher in the BabyThrive group than in the verbal training group. The IYCF knowledge scores obtained from both groups showed coherence, with a statistically significant Spearman correlation coefficient of 0.50 (P<.001). This research developed and validated a novel, offline mobile gaming app. It will be an easy, effective, and acceptable method to disseminate critical knowledge on IYCF practices to teenage mothers in rural Nigeria.

The Role of Complementary Feeding Practices in Addressing the Double Burden of Malnutrition among Children Aged 6-23 Months: Insight from the Vietnamese General Nutrition Survey 2020.

Background/Objectives: Optimal infant and young child feeding (IYCF) practices are crucial to addressing the double burden of malnutrition (DBM), encompassing undernutrition (including micronutrient deficiencies) and overnutrition. This study examined the demographic and socioeconomic determinants of IYCF practices, and their impacts on the DBM among 2039 Vietnamese children aged 6-23 months from the General Nutrition Survey 2020. Methods: Thirteen IYCF indicators recommended by the WHO/UNICEF were evaluated. Associations between IYCF indicators and outcome variables were assessed using logistic regressions. Results: The prevalence of stunting, underweight, and overweight subjects was 10.9%, 5.6%, and 3.1%, respectively. Low serum zinc affected 56.7% of children, while 14.3% had low serum retinol, 31.2% had anemia, and 34.6% had iron deficiency (ID). Only 36.7% of children achieved minimum dietary diversity (MDD), and 29.0% achieved the minimum acceptable diet (MAD). Children from the younger age group (6-11 months), ethnic minorities, those living in rural/mountainous regions, and poorer wealth quintiles had reduced odds of meeting IYCF criteria, including MDD and MAD. Infants meeting MDD had reduced odds of stunting [adjusted odds ratio (95% confidence intervals): 0.61 (0.41, 0.92)], and ID [0.69 (0.54, 0.88)]. Children meeting MAD had reduced odds of anemia [0.72 (0.57, 0.91)], ID [0.66 (0.52, 0.84)], and low serum retinol [0.63 (0.41, 0.99)]. Continued breastfeeding (12-23 months) reduced the odds of being underweight [0.50 (0.27, 0.92)] and of having low serum zinc [0.70 (0.52, 0.96)]. Adequate minimum milk feeding frequency had increased odds of being overweight [3.33 (1.01, 11.09)]. Conclusions: Suboptimal IYCF practices were significant predictors of the DBM among Vietnamese children, with evident age-specific, geographical, and socioeconomic disparities.

Infant formula donations and code violations during earthquake relief efforts in Türkiye in 2023: an observational study

BackgroundOn 6 February 2023, an Mw 7.8 earthquake struck southern and central Türkiye and north-western Syria, affecting the lives of 4.6 and 2.5 million children, respectively. In such crises, infants who are dependent on commercial milk formula (CMF) face increased vulnerability to diseases and malnutrition as safe preparation of CMF becomes difficult and sometimes impossible. The Operational Guidance on Infant and Young Child Feeding in Emergencies (OG-IFE) provides guidance on protecting and supporting recommended infant and young child feeding and minimizing the risks that come with CMF feeding. In addition, the International Code of Marketing of Breastmilk Substitutes (the Code) ensures adequate nutrition for infants by protecting and promoting breastfeeding and ensuring the proper usage of CMF. This study aims to document violations of the Code and the OG-IFE during the earthquake relief efforts to help strengthen infant and young child feeding emergency responses and inform future disaster relief policies.MethodsData was collected from 6 February to 10 March 2023 through Internet sources. Social media, news websites, and the Emergency Nutrition Network forum were used for data collection. Turkish content was translated into English for analysis, with a focus on donation-related information and Code violations related to baby food and infant feeding.ResultsA total of 40 reports on CMF, complementary food, and feeding equipment donations were collected. Three main types of violations of the OG-IFE and the Code were identified, with the majority of them being incidences of individuals, humanitarian organizations, and government agencies seeking or accepting donations. Infant formula companies continued to violate the Code by donating large quantities of CMF and feeding equipment to the Turkish Red Crescent, government agencies, and disaster relief infant and young child feeding (IYCF) coordination authorities.ConclusionsThese incidents reflected a systematic violation of the Code and non-compliance with the OG-IFE. Globally accepted IYCF standards and recommendations were not consistently followed due to fragmented early responses. There is a critical need to step up efforts to ensure appropriate and safe IYCF practice protecting and supporting breastfed and non-breastfed infants in emergencies.

A Review of Infant and Young Child Feeding Practices and Their Challenges in India.

This review focuses on infant and young child feeding (IYCF) practices in India, aiming to offer information on its trends, challenges, and opportunities for improvement. The overview starts by exploring the importance of IYCF practices and their results on child health, growth, and development. It delves into cultural norms, conventional practices, and local variations that impact feeding behaviors, acknowledging the range of nutritional habits across communities. The role of healthcare systems and community interventions in promoting the most desirable feeding practices is mentioned, addressing issues consisting of different breastfeeding practices, well-timed introduction of complementary meals, and micronutrient supplementation.By making thisassessment, the goal of this review is to make healthcare professionals, policymakers, and researchers aware of the current trends of IYCF and its demanding situations, and regions for development in India. It gives an understanding of the improvement of strategies and interventions that can make contributions to the increase and improvement of infant and young child nutrients, thereby nurturing the Upcoming generations.

Dietary Diversity and Associated Factors among Children 6-23 Months Old in Ethiopia: Systematic Review and Meta-Analysis.

Feeding diversified food for children is the major indicator of nutritional quality and adequacy that is crucial during the complementary feeding period for infants and young children aged 6-23 months. Ensuring diversified food is highly essential for the normal growth and development of the infant and young children. In Ethiopia, malnutrition and food insecurity remain prevalent, underscoring the need to understand and improve dietary diversity among children. The primary objective of this review was to determine the pooled prevalence of dietary diversity and its associated factors among children aged 6-23 months in Ethiopia. We thoroughly searched some electronic databases, including Pub Med, Africa Index Medicus, Science Direct, Hinari, and Google Scholar, to perform a meta-analysis. Excel was used to extract and combine the data, while Stata 17 was used for statistical analysis. To estimate pooled prevalence rates and related associated factors, we used a random-effect model and the Der Simonian-Laird technique. The I2-test was utilized to examine heterogeneity, and funnel plots, in conjunction with Egger's and Begg's tests, were employed to investigate publication bias. This review analyzed 42 full-text studies, finding a pooled prevalence of 26.78% (95% confidence interval (CI): 23.35-30.21) with significant heterogeneity (I2 = 98.95%). Maternal education levels-college & above Adjusted Odds Ratio (AOR: 5.377, 95% CI: 3.116-9.279), secondary and above (AOR: 3.324, 95% CI: 1.939-5.700), primary (AOR: 3.065, 95% CI: 2.275-3.129), and formal education (AOR: 2.484, 95% CI: 1.722-3.583)-showed higher odds than counterparts. Similarly, fathers' education-secondary and above (AOR: 2.837, 95% CI: 1.981-4.065) and primary (AOR: 2.082, 95% CI: 1.016-4.266)-and father's occupation as merchant (AOR: 2.739, 95% CI: 1.355-5.539), and mother's occupation as housewife (AOR: 3.636, 95% CI: 2.457-5.381) showed higher odds. Additionally, male child sex (AOR: 1.877, 95% CI: 1.185-2.972), child age 18-23 months (AOR: 2.470, 95% CI: 1.568-3.987), and 12-17 months (AOR: 2.460, 95% CI: 1.914-3.163) indicated higher odds than counterparts. Having Postnatal Care (PNC) follow-up, counseling on infant and young child feeding (IYCF) practices, and no history of child illness were associated with higher odds (AOR: 3.155, 95% CI: 2.104-4.732), (AOR: 2.960, 95% CI: 2.288-3.829), and (AOR: 2.420, 95% CI: 1.765-3.318), respectively. Maternal knowledge of dietary diversity, urban residency, Antenatal Care (ANC) follow-up, child growth monitoring, and media exposure also showed higher odds. Similarly, maternal age groups 25-34 years and 35-44 years had higher odds compared to those aged 15-24 years. Other factors associated with higher odds included home grading, food security, institutional delivery, availability of cow milk, and household wealth index. Among Ethiopian children aged 6-23 months, the prevalence of recommended dietary diversity feeding practices was remarkably low, with only about 25% meeting the minimum recommended diversified food. The scientific predictors factor affecting dietary diversity included maternal media exposure, place of delivery, food security, urban residency, availability of cow milk, child growth monitoring, age, and knowledge of IYCF practices; paternal factors like education and occupation; child-related variables like age, sex, and history of illness; and history of ANC and PNC.

Factors associated with infant and young child feeding practices in children aged 6–23 months in Indonesia: A nationwide study

IntroductionChildren-related nutrition raises significant attention due to the low implementation of infant and young child feeding (IYCF) practices. However, the factors affecting the low implementation of IYCF remains limited globally. This study aimed to identify factors influencing IYCF in children aged 6–23 months in Indonesia. MethodsWe conducted a cross-sectional study using data from the 2017 Indonesian Demographic and Health Survey. A total of 4943 responses were included. We employed binary logistic regression to determine the factors affecting IYCF practices in children aged 6–23 months. The results are reported as odds ratios (OR) with a 95% confidence interval (CI) and a significance level of p < 0.05. ResultsSeveral factors significantly influenced IYCF practices among children aged 6–23 months, including the age of the child (OR: 0.42; 95% CI: 0.27–0.65), middle wealth index (OR: 1.85; 95% CI: 1.12–3.08), regional disparities (OR: 0.43; 95% CI: 0.23–0.77), place of residence (OR: 1.77; 95% CI: 1.17–2.68), and a history of childhood diseases like fever (OR: 1.65; 95% CI: 1.05–2.58). ConclusionThis study highlights the significance of various factors related to IYCF practices among children aged 6–23 months. These factors include maternal aspects such as wealth index, child-related factors like age, a history of childhood illnesses such as fever, and environmental factors such as regional disparities and place of residence. Practice implicationsPaediatric nurses can contribute to enhancing maternal knowledge by providing education on the importance of infant and child feeding practices, beginning early in the child's life.

Minimum Acceptable Diet, Anthropometric Failure and Correlates among Children Aged 6-23 Months in a Rural Area of Murshidabad, West Bengal

Background: Minimum acceptable diet (MAD), one of eight core indicators for infant and young child feeding (IYCF), is measured through minimum dietary diversity and minimum meal frequency. MAD is also a determinant for anthropometric failure. We aimed to assess the status of minimum acceptable diet, extent of anthropometric failure and correlates of MAD among children aged 6-23 months in a rural area of Murshidabad, West Bengal. Methodology: We conducted a cross-sectional study in a block during April-July’2023, among 96 calculated sample of children selected through multistage sampling. We used a pre-designed schedule to collect data by interviewing the mothers of the children. Nutritional status was assessed by anthropometry and using Composite Index of Anthropometric Failure. Data were analysed using SPSS 20.0. Results: Only 34.4% (95% CI 24.6-44.5) children received optimal MAD; 70.8% had total anthropometric failure. Muslims (AOR: 6.13; 95% CI: 2.03-18.54) and currently non-breastfed children (AOR: 4.44; 95% CI: 1.09-7.95) were at higher risk of sub-optimal MAD. Anthropometric failure was significantly associated with MAD (p= .033). Conclusions: Minimum acceptable diet status is unfavourable and associated with high anthropometric failure among children in the area; breast-feeding status being an influencing factor. Findings highlight the need for strengthening IYCF practices.

Infant and Young Child Feeding (IYCF) Practices in Rural and Urban Regions of Indonesia

Background. The global strategy on infant and child feeding recommends the best pattern of feeding for infants and young child feeding (IYCF) from birth to 24 months. Practices of proper feeding of children up to 2 years of age contribute to a child’s survival, growth, and development because they can prevent micronutrient deficiencies, morbidity, and obesity in later life. This study aims to determine the risk factors for the failure of IYCF practice in urban and rural Indonesia. Materials and Methods. The study used Indonesia Demographic and Health Survey (IDHS) 2017 data with a cross-sectional research design. The sampling technique used systematic probability proportional to size sampling. The number of samples was 4,869 children consisting of 2,424 children in urban and 2,445 children in rural. Bivariate analysis using chi-square test. Multivariate analysis using multivariate logistic regression. Results. The study found that most of the children in urban (79.3%) and rural (97.2%) did not practice IYCF under the recommendations. There is a difference in the proportion of IYCF practices between urban and rural areas (p &lt;0.001). The risk factors for the failure of IYCF practice in urban areas are socioeconomic, maternal age, and age at first marriage. The poorest socioeconomic is at risk of 2.4 times, maternal age &gt; 35 years are at risk of 1.5 times, age at first marriage is less than 21 years at risk of 2.1 times carrying out IYCF practices not according to recommendations compared to the comparison group. The risk factors for the failure of IYCF practice in rural are socioeconomic, maternal education, quantity, and quality of antenatal care (ANC). The poorest socioeconomic is at risk of 2.1 times, mothers with primary education are at 1.5 times, the quantity of ANC is not good at risk at 1.9 times, the quality of ANC is not good risk at 1.5 times practicing IYCF is not according to the recommendations compared to the comparison group. Conclusion. The practice of IYCF in Indonesia starting from giving early breastfeeding initiation, exclusive breastfeeding, and complementary feeding according to recommendations is still low. The priority of IYCF intervention through education and assistance to pregnant women needs to be a sustainable program.

Awareness, perception and practices regarding Breast-Feeding and IYCF Practices among mothers of Children Up to 2 Years in Two Districts of Central India: A Cross-Sectional Study

Background: Breastfeeding is an absolute necessary intervention for childhood survival. WHO/UNICEF have given utmost emphasis on first 1000 days of life comprising of 270 days in-utero and the first two years post birth as most vital period for nutritional interventions. [1] Infant and Young Child Feeding (IYCF) is a set of renowned and usual recommendations for appropriate feeding of new-born and children below two years of age. Aims &amp; Objectives: To assess the awareness, perception and practices, regarding breast-feeding and IYCF practices among mothers of children up to 2 years, in two districts of Central India. Settings and Design: Cross Sectional Study. Materials and Methods: This Cross-sectional study was carried out in two districts of Central India from January 2021 to December 2021. The study subjects included 400 mothers of babies less than two years old, who had given consent. Interpersonal interview using a pre-designed semi-structured questionnaire was carried out. Data was collected, compiled and analysed using SPSS 25.0 (Trial Version). Result: Only (58.60%) of respondents were completely knowledgeable about exclusive breastfeeding, the value of colostrum feeding, the advantages of breastfeeding (81.69%), and its early onset (64.75%), duration (71.25%), and frequency (74.50%). However, 50.25% of women lacked understanding about the ideal positioning and attachment of the infant to the breast. Conclusion: All beneficiaries should be shown demonstrations of all IYCF practices. Family members should also be counselled and encouraged to support IYCF practices.

Paternal Participation in Optimal Infant and Young Child Feeding Practice and Associated Factors: A Community-Based Analytical Cross-Sectional Study from Chronically Food-Insecure Communities, Ethiopia

Evidence shows that paternal participation helps to improve the utilization of optimal infant and young child feeding (IYCF) practices. However, little has been known about chronically food-insecure (CFI) communities. The aim of this study to assess paternal participation in optimal IYCF practice and associated factors in the Dodota district of the Arsi zone, Ethiopia, 2022. A community-based cross-sectional study involving 1152 fathers was conducted after ethical clearance was obtained. Measures of optimal IYCF are based on criteria established by the World Health Organization. We analyzed the data using bivariate and multivariate logistic regression models. Results indicated that paternal participation in optimal IYCF practice was 26.2%. The percentages of early initiation of breastfeeding (EIBF), exclusive breastfeeding (EBF), and minimum acceptable diet (MAD) were respectively 72.9%, 66.1%, and 37.3%. Paternal knowledge of IYCF (AOR:3.2, P &lt;0.01), education (AOR:2.1, P&lt;0.05), income (AOR:1.8, P&lt;0.05), child's age (AOR 1.7, P&lt;0.05), and the number of children (AOR:2.1, P&lt;0.05) were the predictors of the outcome. Large-scale, in-depth studies should be required to justify the result unequivocally.

Assessment of Dietary Intake and Nutritional Status of Children (0-23 Months) Accessing Care in Community Infant and Young Child Feeding (C-IYCF) Practices in Hasiya Bayero Pediatric Hospital Kano

Introduction: Infant and young child feeding (IYCF) practices have substantial outcomes for the growth, development, and survival of infants and children during the first two years of age and throughout their lifetime. The study aimed to assess the dietary intake and nutritional status of children (0–23 months) registered for care in Hasiya Bayero Pediatric Hospital Kano. Methodology: A cross-sectional study was conducted among 125 randomly selected caregiver-child pairs accessing care in the hospital. A validated semi-structured questionnaire was used to collect information on socio-demographic and dietary intake information from the respondents. Anthropometric indices of weight for age, length for age, and weight for length measurements were used to assess the nutritional status of children. Result: Female caregivers were the most participants in this study 122 (98.2%). For marital status, almost all 124 (99.4%) of the mothers were married and only 1 each of the mothers reported to be single and being widowed. About 76 (60.8%) of the study population attended secondary education. The major occupation of the caregivers is trading in 92.4%. Dietary intake consists mainly of legumes in 30.0% and cereals in 56.5%. Only 39.0% portion of the population met the minimum World Health Organization (WHO) recommendation of dietary diversity and over 79.8% of the caregivers were still breastfeeding during the period of the study, 18% of them initiated breastfeeding within 1 h of birth and only 16.2% exclusively breastfed their children; majority 70.6% of the caregivers breastfed on demand while with a small proportion of 26.1% and 3.3% responded to breastfeeding when convenient and breastfeeding at a scheduled time respectively. Conclusion: The study revealed that the nutritional status of the children was poor. Up to 60 (51.2%), 98 (88.3%), and 74 (65.1%) of the infants were wasted, underweight, and stunted, respectively. The study also revealed that the nutritional status of the children (WLZ, WAZ, and LAZ) was significantly related to the dietary diversity at p = 0.002, p = 0.001, and p = 0.019, respectively. This study revealed poor IYCF practices in Hasiya Bayero Pediatric Hospital Kano. Therefore, more attention needs to be paid to the specific behaviors surrounding feeding practices and other constraints to children accessing care in Hasiya Bayero Pediatric Hospital Kano.

Do improvements in infant and young child feeding (IYCF) practices endure the test of time?

BackgroundReducing malnutrition is a key priority for governments in low- and middle-income countries given its lasting effects on child development, health, income, and economic growth. Strategies to improve recommended infant and young child feeding (IYCF) practices, especially during the first two years of life, are considered among the most effective.MethodsIn this paper, we evaluate the long-run impacts of an innovative education strategy based on interactive play and performing arts implemented in El Alto, Bolivia on caregivers’ IYCF knowledge and practices. Two thousand and fifteen households were randomly assigned to intervention and control groups. Two rounds of data were collected approximately 30 and 42 months after baseline. We estimate short-term (30 month) and longer-term (42 month) intent-to-treat effects using multivariate linear regression analysis, with and without controlling for covariates.ResultsThe program significantly increased caregiver IYCF knowledge by 0.13 SDs in the short run, and this effect grew over time. The program also improved adherence to recommended IYCF practices by 0.23 standard deviations (SDs) in the short term, but the effect on practices dissipated over time, and no longer-term impacts were detected. Caregivers with above median baseline knowledge, number of children, and age appear to have benefited most from the program.ConclusionsOur findings suggest that entertainment-education interventions are a promising model for improving and maintaining IYCF knowledge. However, their ability to sustain more permanent changes in IYCF practices is less certain. Further evidence is needed to identify other avenues for producing long-term, sustainable behavior change, especially among indigenous populations in Latin America, where literature on education and behavior-change interventions related to IYCF practices is limited.

Application of the integrated gateway model on child nutrition behaviors in Niger: An exploratory analysis.

To identify potential gateway factors and behaviors that are associated with infant and young child feeding (IYCF) practices in the Maradi and Zinder regions of Niger through application of the Integrated Gateway Model. We analyzed data from 2,727 married women of reproductive age including details on child feeding practices for their 2,551 children between the ages of 0 to 23 months. We assessed the association of three gateway behaviors (i.e., any antenatal care, facility delivery, and communication on nutrition practices) and gateway factors (i.e., behavioral determinants, exposure to information, decision-making agency, and woman's group participation) on four IYCF practices (i.e., early initiation of breastfeeding, exclusive breastfeeding, minimum meal frequency, and minimum dietary diversity) while controlling for age, parity, educational attainment, and household wealth. We found antenatal care was associated with exclusive breastfeeding of children 0-5 months [adjusted odds ratio (aOR): 1.17 (95% confidence interval (CI): 1.03-1.33)], and minimum meal frequency of children 6-23 months [aOR: 1.10 (95% CI: 1.03-1.17)], and facility delivery was associated with early initiation of breastfeeding among children 0-5 months [aOR: 2.08 (95% CI: 1.39-3.12)]. We found negative associations with exclusive breastfeeding and communication on nutrition practices with husbands, family/friends, and health workers. Exposure to nutrition messages through radio, women's groups participation, and with health workers was positively associated with minimum dietary diversity. Self-efficacy was positively associated with both early initiation of breastfeeding, exclusive breastfeeding among children 0-5 months and minimum dietary diversity among children 6-23 months. Women's agency was positively associated with early initiation of breastfeeding. The association of antenatal care and facility delivery with child nutrition outcomes suggest intervening before a woman becomes pregnant or early in her pregnancy could improve nutrition outcomes. Programs strengthening the continuum of care should identify gateway behaviors to maximize adoption of priority health behaviors.

Anthropometric, biochemical, dietary, morbidity and well-being assessments in women and children in Indonesia, India and Senegal: a UKRI GCRF Action Against Stunting Hub protocol paper

IntroductionChild stunting has a complex aetiology, especially in the first 1000 days of life. Nutrition interventions alone have not produced expected impacts in reducing/preventing child stunting, indicating the importance of...

Observational Methods in Studies of Infant and Young Child Feeding Practices in Low- and Middle-Income Countries: A Twenty-Year Retrospective Review.

This narrative review describes the observational approaches used to study infant and young child feeding (IYCF) practices in low- and middle-income countries (LMICs) published between 2001 and 2021. Articles were included in this narrative review if they were (1) original peer-reviewed articles published in English in PubMed and Web of Science; (2) published between 1 January 2001, and 31 December 2021; (3) conducted in an LMIC; and (4) employed observations and focused on IYCF practices among children aged 6-59 months. The studies (n = 51) revealed a wide-ranging application of direct meal and full-day observations, as well as indirect spot checks, to study IYCF. The findings revealed that meal observations were typically conducted during a midday meal using precise recording approaches such as video and aimed to understand child-caregiver interactions or specialized nutritious food (SNF) usage. Conversely, full-day observations lasted between 6 and 12 h and often used a field notes-based recording approach. Behaviors occurring outside of mealtime, such as snacking or interhousehold food sharing, were also a primary focus. Finally, spot checks were conducted to indirectly assess SNF compliance during both announced and unannounced visits. This review highlights the adaptability of observations across contexts and their versatility when used as a primary data collection tool to help monitor and evaluate nutrition programs.

Infant and young child feeding practices among mothers in the pilot Micronutrient Powder Initiative in four geographically and ethnically diverse districts in Ghana.

In Ghana, breastfeeding and complementary feeding counselling have been used as a nutritional intervention to promote optimal Infant and Young Child Feeding (IYCF) and nutrition. This study examined IYCF practices in four geographically and ethnically diverse districts (Ho West, Tain, Talensi and Tolon). A qualitative study involving key informant interviews (KIIs) and focus group discussions (FGDs) was conducted between November and December 2019 among women who participated in a pilot micronutrient powder intervention for children 6-23 months of age. The KIIs and FGDs were audio-taped, transcribed verbatim, and analyzed thematically using NVivo 10. Three themes emerging from the KIIs and FGDs were: level of adherence to IYCF recommendations among mothers and caregivers; IYCF recommendations perceived as the hardest to follow; and perceived motivators, facilitators, and barriers to IYCF practices. Mothers in the four districts generally followed the eight IYCF recommendations. Mothers in the Tolon district demonstrated adherence to IYCF practices, often citing the need for early initiation of breastfeeding, timely introduction of complementary feeding, and feeding children aged 9-23 months 3 times daily in addition to breastfeeding. In contrast, mothers in other districts faced challenges that hindered adherence. Giving children 4 or more food groups and timely introduction of complementary feeding were perceived as the hardest practices to follow. The main facilitators of IYCF practices include midwives and frontline nurses teaching mothers how to breastfeed, and midwives ensuring mothers initiate breastfeeding immediately after delivery. The main barriers to IYCF practices identified were insufficient breastmilk; mothers-in-law giving water to children before six months; resumption of work; and lack of financial means. Mothers in the Ho West district reported more barriers to IYCF practices, followed by mothers in the Tain, Talensi, and Tolon districts. Health practitioners, stakeholders, and policymakers should design targeted interventions that address the contextual barriers to improve IYCF practices in the various districts.

Infant and Young Child Feeding Practices among Mothers Attending a Government Hospital

Background: Appropriate young children (from birth to two years of life) feeding practice is very crucial to boost up children’s survival and optimum growth and development. Early initiation of breastfeeding (within an hour of childbirth), exclusive breastfeeding for six months and providing nutritionally adequate and appropriate complementary feeding for six months and continued breastfeeding up to two years of age or beyond are the major components of infant and young child feeding (IYCF) practices. The objective of the study was to find out the IYCF practices of mothers.&#x0D; Methods: Descriptive cross-sectional research was used and all 180 mothers attending government hospital of Biratnagar were the sample. Interview-based data collection was used by a self-developed, structured and semi-structured questionnaire. Data were analyzed using descriptive statistics using SPSS version 25.0.&#x0D; Result: Less than half (40%) mothers started breastfeeding within an hour after delivery, 90.6% fed colostrum, 73.3% practiced exclusive breast feeding and 89.4% continued to feed breastmilk along with complementary feed to under two years children. Among mothers, 68.3% started feeding complementary food at appropriate age, 70.6% of the mothers fed minimum numbers of time or more according to their child age, 80% mothers used to provide diverse food and 66.1% children were receiving minimum acceptable diet.&#x0D; Conclusion: The prevalence of timely initiation of complementary feeding at 6 months, minimum dietary diversity, minimum feeding frequency and minimum acceptable diet were satisfactory as almost two third and more children have met minimum acceptable diet. However, practice of early initiation of breast feeding is still low.

A cross-sectional study of feeding practice status in children (6–23 months), association with malnutrition, and impacts of maternal determinants

Background: Inadequate complementary feeding practices lead to poor cognition, stunting, and increased rate of infections. Insight into deficiencies of complementary feeding practices could help in planning and implementing newer approaches at various levels of intersection. Aims and Objectives: The aim and purpose of the study were to determine the complementary feeding practices, to identify maternal determinants of each practice, and to analyze the associations between complementary feeding practices with malnutrition. Materials and Methods: A prospective observational study was conducted at the Department of Pediatrics, of a tertiary hospital over a 14-week period. All children aged 6–23 months were included in the study. Data were collected using a pre-structured questionnaire based on the World Health Organization Infant and Young Child Feeding (IYCF) indicators for assessing IYCF practices. Results: A total of 400 mothers participated in the study. The mean age of children was 12.58 20±5.02 months, male: female = 1.6:1. The mean age of starting complementary feeding was 6.81±1.79 months. Semisolid food was introduced in 90.2% of children, minimum dietary diversity was received by 61.0%, minimum meal frequency by 83.8%, and minimum acceptable diet by 58.2%, eggs and flesh by 14.2% and 3.5% children, respectively; only 9.2% received vitamin A rich fruits and 38.5% did not receive any vegetable or fruit. Bottle feeding was present in 55.5% of population. Maternal parameters (education, employment access to media) and socioeconomic status were significantly associated with feeding practices (P&lt;0.05). A significant difference was found in the nutritional status (wasting and stunting) of children who did not receive minimum dietary diversity (P&lt;0.01). Conclusion: Wide gap exists in feeding practices even in urban settings and was significantly associated with child’s nutritional status.

Association between mass media exposure and infant and young child feeding practices in India: a cross-sectional study

The first two years of life is a critical window for good nutrition. Promoting infant and young child feeding (IYCF) practices in the first two years can help improve child survival and promote healthy growth and development. Assessment of IYCF practices is important, especially in developing countries like India where optimal IYCF practices can potentially prevent 12% of all deaths under 5 years of age, to promote awareness and intervene appropriately. The objective of our study is to generate evidence for the association between different types of mass media and appropriate IYCF practices in India, including optimal breastfeeding and appropriate complementary feeding practices. A positive association between them can point to intervention at scale. We analyzed data from India’s National Family Health Survey 5 (NFHS-5), 2019–2021. Multivariable logistic regression was used to examine the association of appropriate IYCF practices with mass media exposure. After controlling for demographics and socioeconomic status, the analyses showed that, overall, women who had exposure to television followed by newspaper and movies, had higher odds of adopting the recommended IYCF practices. The results also showed that the association of media exposure varied for different IYCF practices by geography. For instance, in the rural areas, television exposure was positively associated with all the IYCF practices, but in the urban areas, television exposure was positively associated with only early initiation of breastfeeding [OR 1.25; (95% CI 1.1–1.42)]. The study strengthens our understanding that an appropriate selection of mass media channels for intervention programs can promote IYCF practices at scale. Appropriately selecting the type of mass media to create awareness about different IYCF practices, in specific urban–rural settings, could help customize intervention programs to successfully influence IYCF behaviors.