Infant And Young Child Feeding Research Articles

Infant and young child feeding practices of caregivers in Copesville, Pietermaritzburg, KwaZulu-Natal

Background: Although infant and young child feeding (IYCF) recommendations are widely accepted in South Africa, inappropriate IYCF practices still exist, leading to malnutrition in children. Objective: To investigate the IYCF practices of caregivers in Copesville, Pietermaritzburg (PMB). Design: A cross-sectional study was conducted. Setting: Masons Clinic, Copesville, PMB. Subjects: Two-hundred and fifty caregivers older than 18 years of age caring for a 6–24-month-old child at the time of the study. Outcome measures: A face-to-face questionnaire was developed using recent, relevant literature and was validated for the study. Results: The mean age of the caregivers was 32.25 (10.42) years. About 96% (n = 239) of infants were ever breastfed. The mean age at which breastfeeding was stopped was 5.9 ± 4.3 months. Mothers who were still breastfeeding planned to continue breastfeeding for a mean duration of 12.6 ± 5.6 months. About 60% (n = 149) of infants were started on solids at the appropriate age of 6 months. Lennon Entressdruppels (16.9%; n = 14), sugar water (15.7%; n = 13) and fruit and vegetables (13.3%; n = 11) were fed before the age of six months. Forty-nine caregivers (19.6%) consulted a traditional healer regarding IYCF. Non-edible items fed to cleanse the stomach included toothpaste and polish (5.6%; n = 8) and disinfectant solution (1.7%; n = 1). Conclusions: Caregivers should be educated on the benefits of continued breastfeeding until two years or beyond and the importance of starting solids at the appropriate age of six months. The potential dangers to the health of infants of feeding non-edible items should also be highlighted.

Influence of mothers' and frontline health workers' knowledge, attitude, and practices on infant and young child feeding and child nutrition: a cross-sectional study in aspirational districts of Assam, India.

The knowledge, attitude, and practices (KAP) of mothers and frontline health workers (FLWs) regarding optimal Infant and Young Child Feeding (IYCF) are essential for mitigating undernutrition and associated morbidities among under-five children. The study assessed the KAP of mothers (of children aged 0-60 months) and FLWs regarding recommended IYCF practices, the association of mother's KAP with their demographic characteristics and children's nutritional outcomes, and the prevalence of stunting, wasting, and underweight among children aged 0-60 months in five high-focus districts of Assam. Data were collected from 389 mothers, 456 children, and 138 FLWs using a standard method. Of the 389 mothers, 29% had good KAP scores, 42% scored average, and 29% had poor KAP scores regarding IYCF practices. The mean KAP score increased significantly with improvements in variables such as community, language, education level, monthly income, and living conditions (p < 0.01). Less than half of the children were stunted (40%), one-third were affected by wasting (28%), and approximately 43% were underweight. Children whose mothers had a KAP score of less than 40% were 2.05 times more likely to experience stunting (CI = 1.04-4.02) than those whose mothers scored above 60%. Similar findings were reported for wasting and underweight. Of the 138 FLWs, 56% had good KAP scores, 30% had average scores, and 14% had poor scores. There was a noticeable gap in the KAP of the mothers regarding IYCF practices compared to that of FLWs. A comprehensive intervention plan to improve feeding practices can enhance the nutritional status of under-five children.

School-age growth and development following infant feeding and/or water, sanitation, and hygiene interventions in rural Zimbabwe: long-term follow-up of a cluster-randomised trial

Few trials have explored long-term effects of interventions designed to reduce child stunting. We evaluated school-age outcomes in rural Zimbabwean children who received cluster-randomised water, sanitation and hygiene (WASH) and/or infant and young child feeding (IYCF) interventions from pregnancy up to 18 months of age. The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial enrolled pregnant women from two rural Zimbabwean districts (Chirumanzu and Shurugwi) between 2012 and 2015, and cluster-randomised them using a 2×2 factorial design to standard-of-care, WASH, IYCF, or combined WASH & IYCF, with a co-primary outcome of height-for-age Z-score and haemoglobin at 18 months (clinicaltrials.govNCT01824940). Children who were HIV-unexposed, age 7 years, and still living in Shurugwi district were eligible for this follow-up study (registered at PACTR 202201828512110) and measured between 1st April 2021 and 30th September 2022. The primary outcome at 7 years was cognitive function using the Kaufman Assessment Battery for Children (KABC-II). Secondary outcomes were executive function, literacy and numeracy, fine motor skills, socioemotional function, handgrip strength, broad jump distance, shuttle-run test distance, anthropometry, lean mass index, and skinfold thicknesses. Study nurses conducting assessments were blinded to intervention arm. Analysis followed a pre-registered statistical analysis plan. Intention-to-treat analyses using generalized estimating equations were used to assess the long-term effects of WASH and IYCF on each outcome, leveraging the factorial trial design. A pre-specified subgroup analysis by child sex was also performed. Among 3989 HIV-negative women, 3676 children were assessed at age 18 months; of these, 1002 (510 female) were assessed at mean (SD) age 7.3 (0.2) years. There was no effect of IYCF or WASH on the KABC-II score or secondary cognitive outcomes, except a small improvement in socioemotional function in WASH arms (-0.98 points, 95% CI-1.73,-0.22, p=0.01). Children in IYCF arms had higher handgrip strength (0.28Kg, 95% CI 0.02, 0.53, p=0.03); however, in the pre-specified subgroup analysis, improved handgrip strength was seen only in boys (0.53Kg, 95% CI 0.19, 0.87 p=0.002). There were no significant effects of either intervention on other outcomes. Early-life IYCF and WASH led to few functional benefits by school-age. Interventions that are more comprehensive, delivered for longer, and include nurturing care should be considered to improve long-term cognitive and physical function. Wellcome [220671/Z/20/Z, 108065/Z/15/Z]; NIH [R61HD103101]; Thrasher [15250]; and IMMANA [3.02].

Individual and community level determinants of minimum meal frequency among breastfeeding children aged 6-23 months in Ethiopia: a multilevel analysis of 2019 Ethiopian Demographic Health Survey data.

Minimum meal frequency (MMF) is a vital indicator of whether a child's energy needs are being met. Previous studies in Ethiopia on MMF have primarily focused on individual factors, often using basic logistic regression models with limited scope and small sample sizes. In contrast, this study aims to identify the key determinants of MMF among breastfed children aged 6-23 months in Ethiopia, examining both individual and community-level factors through multilevel logistic regression analysis, utilizing nationally representative data. The study utilized a community-based cross-sectional design with a sample of 1,245 6-23 month breastfed children in Ethiopia, using data from the 2019 Ethiopian Mini Demographic Health Survey. Mixed effect logistic regression was used to identify factors associated with MMF. Adjusted odds ratios (AOR) with 95% confidence intervals were used to assess variable associations, while Intra-cluster correlation (ICC), median odds ratio (MOR), and proportional change in variance (PCV) were employed to gauge random variation. The proportion of 6-23-month breastfeeding children with MMF was found to be 55.9% (95% CI: 53.2, 58.6). In mixed effect logistic regression; breastfeeding initiation time within days after birth [AOR = 0.44; 95%CI: (0.24, 0.80)], maternal primary educational level [AOR = 1.46; 95%CI: (1.03, 2.05)], maternal higher level education [AOR = 2.43; 95%CI: (1.22, 4.81)] and children from wealthiest household wealth index [AOR = 2.13; 95%CI: (1.04, 4.33)] were individual-level factors and children from city-based regions [AOR = 1.75; 95%CI: (1.10, 2.77)] was community level factors significantly associated with MMF. The final model indicates that 50.8% of the variation in MMF was explained by combined factors at both individual and community levels and also the variation across clusters remained statistically significant (ICC = 8.1% and variance = 0.29 with p < 0.001). Minimum meal frequency is a proxy for meeting energy requirements and it is a key indicator of infant and young child feeding (IYCF) practice. According to this study finding, the prevalence of MMF among 6-23-month children in Ethiopia was found to be low. The study also suggest that time of breastfeeding initiation, women's educational level, household wealth index, and contextual region were factors significantly associated with MMF. It is recommended that IYCF strategies should be implemented widely through women's education and empowerment and promoting early initiation of breast feeding to increase the proportion of children to be fed with MMF appropriate for their age.

Psychosocial predictors of infant and young child feeding practices among mother-infant dyads in Malawi

Suboptimal feeding practices in the first two years of life are risk factors for poor child growth and development(1). Sociodemographic predictors of infant and young child feeding (IYCF) practices are well documented (maternal age, education, marital status, sociodemographic status)(2). However, psychosocial factors have received less attention, and few studies have considered complementary feeding practices. Therefore, this study aimed to explore associations between maternal depression, exposure to intimate partner violence, perceived social support, and stimulating home environments, and IYCF practices among mother-infant dyads in Malawi.Khula is a longitudinal birth cohort that aims to characterise brain development across the first 1,000 days of life(3). At the third study visit, when infants were approximately 10–16 months of age, mothers completed a series of psychosocial questionnaires: Edinburgh Postnatal Depression Scale (EPDS; score 0–30), Intimate Partner Violence Questionnaire (IPV), Multidimensional Scale of Perceived Social Support (MSPSS). The Family Care Indicators (FCI) was used to assess stimulation and support for early learning within the home (score 0–17). Information on infant’s dietary intakes during the previous 24 hours was used to determine the WHO IYCF indicators: minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD)(4). Logistic regression modelling was used to identify significant associations between maternal psychosocial measures and IYCF indicators.Data were analysed for 153 dyads. Mean maternal age was 27.0 ± 6.0 years, 84.1% were married, 52.8% had some/completed secondary education, and the majority were either employed (45.1%) or housewives (41.7%). The median (Q1, Q3) EPDS score was 2 (0, 6), 12% of women had been exposed to IPV in the previous 12 months, and mothers reported medium levels of perceived social support. The median FCI total score was 6 (5, 8). Among infants (mean age 13.3 ± 1.7 months), 97.4% were still being breastfed, and 54.2%, 73.2% and 45.1% achieved MDD, MMF and MAD, respectively. Women with higher EPDS scores were less likely to breastfeed at around 1 year (OR 0.53, 95% CI 0.29, 0.96; p = 0.04). However, this relationship was not significant after controlling for maternal age, education, marital status, and socioeconomic status. Exposure to IPV in the previous 12 months, MSPSS score and FCI total score were not associated with any IYCF indicators. Stimulation within the home environment was positively associated with dietary diversity score in unadjusted multiple regression (β 0.17, 95% CI −0.002, 0.15; p = 0.05), although this was no longer significant in adjusted analyses.In this study, we found little evidence of associations between psychosocial factors and IYCF practices. Early screening for postnatal depression may benefit women and infants and should potentially be considered during infant feeding counselling in low-resource settings. The indications of improved dietary diversity with greater familial interactions should be examined in larger, diverse populations.

Adaptation of the Diet Quality Questionnaire as a Global Public Good for Use in 140 Countries

BackgroundFood group consumption data are useful for measuring and monitoring diet quality. To collect valid data across contexts, consistent and rigorous adaptation of survey questions is needed. ObjectivesThe objective of this research was to adapt food group consumption survey questions for 140 countries, by identifying the most common (sentinel) food items in each food group using a structured, participatory process and global standards for classification. MethodsSurvey questions were adapted for 29 food groups of the diet quality questionnaire (DQQ) and for additional questions for infant and young child feeding (IYCF) indicators. For each country, adaptation comprised the following: 1) review of existing questionnaires, dietary intake data, and other information to draft food lists; 2) key informant (KI) interviews with 5–12 experts to identify and prioritize sentinel items including terminology; 3) comparison of items across countries within the same region to identify discrepancies, and follow-up with KIs to resolve them. ResultsIn total, 1016 KIs contributed to the adapted DQQs for 140 countries and IYCF DQQs for 96 countries, amounting to ∼9550 h of collective effort (68 person-hours/country on average) from 2020 to 2024. The process revealed numerous challenges and decisions to ensure consistent classification of items and valid question formulation. ConclusionsCountry-specific questions adhering to global standards, and adapted through cumulative and iterative input of local experts, enable the collection of food group consumption data that are valid and comparable across time and geographies. The adapted survey questions have been implemented in the Demographic and Health Surveys and Gallup World Poll in 94 countries, generating the first cross-country data on minimum dietary diversity and other diet quality indicators. The finalized country-adapted DQQs and IYCF DQQs were translated to 143 national languages and are published online as a global public good for population-level diet quality measurement.

Evaluation of Complementary Feeding Indicators Among Children Aged 6–23 Months According to the Health Literacy Status of Their Mothers

Background/Objectives: Infant and young child feeding (IYCF) practices directly affect child health, development, and survival, especially under 2 years of age and ultimately affect adult life well-being. As the primary caregivers of the children, mothers with higher health literacy may better perceive the benefits of optimal complementary feeding practices, leading to improved health outcomes for their children. In this study, we aimed to assess complementary feeding practices among children aged 6–23 months in Turkey according to 2021 World Health Organization IYCF indicators [minimum dietary diversity (MDD); minimum meal frequency (MMF); minimum acceptable diet (MAD); egg and/or flesh food consumption (EFF); sweet beverage consumption (SwB); unhealthy food consumption (UFC); zero vegetable or fruit consumption (ZVF); and bottle feeding (BoF)] and investigate their associations with sociodemographic characteristics and mothers’ health literacy. Methods: With a descriptive study design, we reached 572 mothers of children aged 6–23 months from five regions of Turkey. We used the Turkey Health Literacy Scale-32 (TSOY-32) to assess mothers’ health literacy. Results: While maternal and child age are significantly associated with more complementary feeding practices, specifically MDD, MAD, and EFF, having multiple children has negative impacts on several complementary feeding indicators, including MDD, MMF, MAD, UFC, and ZVF. The only indicator associated with mothers’ TSOY-32 scores was zero fruit and vegetable consumption. Conclusion: Raising awareness among mothers about the importance of complementary feeding practices and identification of vulnerable groups will guide practitioners and policymakers to improve child health and nutrition.

Understanding infant and young child feeding (IYCF) practices among Muslim mothers/caregivers: A qualitative study in the Bangsamoro Autonomous Region in Muslim Mindanao, Philippines

BackgroundThe study focused on understanding infant and young child feeding practices (IYCF) among Muslim mothers in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM), Philippines.ObjectiveRecognizing the cultural and religious sensitivities associated with these practices, the research aimed to identify influencing factors and assess the influence of advertisements on maternal decisions regarding infants' and children's diets.MethodsA total of 74 Muslim mothers with infants 6-23 months old were recruited and participated in the focus group discussions (FGD). Ten FGD sessions were conducted in Maguindanao Province, Philippines from July to August 2021. Verbatim transcriptions of audio-recorded discussions were transcribed into Microsoft Word files and QSR NVivo version 12 was used in the coding and analysis of the transcripts.ResultsMothers exhibited limited awareness of such important complementary feeding issues as preferring fruits and vegetables while avoiding junk food as chips. IYCF information came primarily from health workers and other mothers - their own mothers, mothers-in-law, and midwives. Television commercials were identified as particularly influential in shaping maternal feeding decisions.ConclusionsThere was a diversity of breastfeeding practices and limited knowledge, especially of complementary feeding among these Muslim mothers. Both traditional beliefs and marketing were said to influence feeding choices. This underscores the need for culturally-sensitive interventions and targeted educational initiatives to enhance maternal knowledge and advocate for optimal infant feeding practices within Muslim communities, as well as regulation of the marketing of commercial infant foods.

Commercial milk formula marketing entry points: setting the course of infant and young child feeding trajectories

BackgroundThere is a limited understanding of the dynamic influences that shape infant and young child feeding (IYCF) decisions over time. We conducted an innovative qualitative study to reconstruct IYCF trajectories across early life course phases, in the context of the socioecological model (SEM) and the commercial determinants of IYCF.MethodsWomen of different socioeconomic status were interviewed in two large metropolitan areas in Mexico. Our specific goal was to allow us to better understand if and how the commercial milk formula (CMF) marketing influenced breastfeeding decisions in a complex dynamic way involving the individual, relational, community and societal levels.ResultsHospitals, health professionals, and interactions with social media were key category entry points throughout the prenatal, perinatal, early infancy period and beyond. The CMF industry interfered by engaging a wide array of actors across the different layers of the SEM, most prominently the health care system and the workplace. Through its marketing strategies the CMF operates subconsciously and its messages are most effective when health institutions, health care providers, workplace spaces and social norms are weak in their support for breastfeeding.ConclusionsThe cases in our study highlight how, together with a weak breastfeeding counseling system, and health professionals who lack training in breastfeeding and normal infant behavior, lead to the opportunity for CMF marketing to shape infant feeding, and ultimately to the decision to feed formulas that some mothers were not planning to use and cannot afford.

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.

Bifidobacterium longum and microbiome maturation modify a nutrient intervention for stunting in Zimbabwean infants

Small-quantity lipid-based nutrient supplements (SQ-LNS), which has been widely tested to reduce child stunting, has largely modest effects to date, but the mechanisms underlying these modest effects are unclear. Child stunting is a longstanding indicator of chronic undernutrition and it remains a prevalent public health problem. The infant gut microbiome may be a key contributor to stunting; and mother and infant fucosyltransferase (FUT) phenotypes are important determinants of infant microbiome composition. We investigated whether mother-infant FUT status (n=792) and infant gut microbiome composition (n=354 fecal specimens from 172 infants) modified the impact of an infant and young child feeding (IYCF) intervention, that included SQ-LNS, on stunting at age 18 months in secondary analysis of a randomized trial in rural Zimbabwe. We found that the impact of the IYCF intervention on stunting was modified by: (i) mother-infant FUT2+/FUT3- phenotype (difference-in-differences-32.6% [95% CI:-55.3%,-9.9%]); (ii) changes in species composition that reflected microbiome maturation (difference-in-differences-68.1% [95% CI:-99.0%,-28.5%); and (iii) greater relative abundance of B.longum (differences-in-differences 49.1% [95% CI: 26.6%, 73.6%]). The dominant strains of B.longum when the intervention started were most similar to the proficient milk oligosaccharide utilizer subspecies infantis, which decreased with infant age and differed by mother-infant FUT2+/FUT3- phenotypes. These findings indicate that a persistently "younger" microbiome at initiation of the intervention reduced its benefits on stunting in areas with a high prevalence of growth restriction. Bill and Melinda Gates Foundation, UK DFID/Aid, Wellcome Trust, Swiss Agency for Development and Cooperation, US National Institutes of Health, UNICEF, and Nutricia Research Foundation.

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.

Measuring Infant Feeding Health Literacy: A Gap Analysis between Communication Policy and Practice

Health literacy is often associated with health outcomes as people with higher health literacy are found to have better health conditions. Past researchers conclude that people with higher health literacy have greater control over the means of their health determinants resulting in better health decisions. Therefore, it is imperative to understand whether government health communication policies are impacting the health literacy levels of its citizens. Moreover, communication plays a vital role in translating policies into practice. However, sub-optimal Infant and Young Child Feeding (IYCF) practices among rural mothers suggest gaps in the current communication strategies. Therefore, this study is objectivized to analyze the current IYCF communication policies for the rural mothers of Gaya, India. For this purpose, an analysis of the IYCF communication policies followed by observation of the key phenomenon, interviews with relevant stakeholders and focus group discussions with the rural mothers were carried out to identify the barriers in the current communication strategies. The study also tried to assess the impact of IYCF communication policies on rural mothers by unveiling their current level of IYCF health literacy.

Cross-sectional study of predictors of infant nutrition knowledge among new mothers in Iraq.

Despite recent improvements, infant and young child feeding (IYCF) remains a challenge in Basra, Iraq. To describe the predictors of IYCF knowledge among new mothers in Basra City, Iraq. This cross-sectional study collected data on infant nutrition knowledge from 400 new mothers attending 12 primary health care centres in Basra, Iraq, between February and June 2023. Jamovi version 2.3 was used for statistical analyses. Predictive analysis was performed with univariable and multivariable ordinal logistic regression, and the results were reported as crude and adjusted odds ratios with 95% confidence interval. P < 0.05 was considered significant. Most (60%) of the women interviewed were younger than 19 years, married (98%), living in an extended family setting (93%), and in the lowest income level (76%). Age ≤19 was a significant predictor of knowledge about breastfeeding, formula feeding, complementary feeding, water and supplements, and food allergies (adjusted odds ratio range 2.24-5.30). Unemployment and low education status predicted lower knowledge about breastfeeding, complementary feeding, water and supplements, and food allergies, but neither unemployment nor low education status predicted lower knowledge about formula feeding. Receiving information from doctors or healthcare workers and social media or the internet was associated with better maternal IYCF knowledge while receiving information from family and friends predicted poorer knowledge about food allergy and water and supplements. IYCF education in Basra should be improved, with particular attention to healthcare worker-mediated and social media- and family systems-based approaches. Priority should be given to the less educated, younger and unemployed women and those in the lower income group.

Social realities in remote villages: Infant and young child feeding in Kirewa, Uganda.

Understanding infant and young child feeding (IYCF) practices in Africa requires an examination of the social context. Social relationships influence people through mechanisms such as social support, social influence, social engagement, access to resources and negative social interactions. This study explores how these mechanisms manifest in IYCF in remote villages in Uganda. In 2018, we conducted two focus group discussions each with mothers, fathers and grandparents, ande interviews with two clan leaders, six village health teamers (VHT) and four healthcare workers (HCW). We deductively searched the data for any indications of elements that could influence child feeding and health using the psychosocial mechanisms of social support, social influence, social engagement, access to resources and negative social interactions as the broader themes. The manifestation of social support involved practical help from mothers-in-law (MIL), financial contributions from fathers, and informational, instrumental, emotional and appraisal support from VHTs. Social influence by MILs mainly concerned the transmission of food-related beliefs and pressure to have many children. The social engagement of young mothers was restricted. Access to resources was stratified and affected by poverty, patriarchy, and knowledge of HCWs and VHTs. Negative social interactions included physical abuse, alcoholism, and fear-based relationships. We found the different psychosocial mechanisms to construct a useful framework for describing the social reality surrounding IYCF. Changing attitudes towards family planning, involving fathers in IYCF, and strengthening the position of VHTs as family advisers can potentially improve IYCF in rural Uganda.

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.

Training on Infant and Young Child Feeding (IYCF) for Mothers in Sepan Lebang Village, Sintang Regency

Good and essensial nutrition has influence for children's growth and development. Infant and young children's nutritional needs will fulfilled by providing appropriate nutrition and appropriate feeding stages. IYCF requires skills. For this reason, it is necessary to provide knowledge and training related to IYCF, especially for mothers, prospective mothers, and cadres. The community in Sepan Lebang Village has never received training regarding IYCF. This activity aims to increase mothers' knowledge and skills about IYCF. This activity began with providing education about IYCF which was attended by 37 mothers, and IYCF training which was attended by 15 mothers. The training was carried out twice with material related to breast milk (how to express and practice giving breastfeeding), material related to complementary feeding (the practice of preparing menus according to the stages of child feeding), feedback, and evaluation of the practice of giving breastfeeding and complementary feeding. The results of this activity show that from the knowledge aspect, mothers have knowledge about IYCF in improving children's quality of life. From the skills aspect, the majority of mothers are already skilled in carrying out the ability to practice providing good and correct positions and attachments, but a small number of mothers still need to do a lot of practice to improve these practical skills. For menu preparation skills, all participants can prepare menus properly and correctly according to the stages of infant and young child feeding.

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.

Cognitive Interviewing to Improve Infant and Young Child Dietary Assessments in the Nepal Demographic and Health Survey

BackgroundThe Demographic and Health Survey (DHS) is the primary source of nationally representative nutrition data for many countries and is important in shaping national nutrition policy, advocacy, and research. Without careful testing and adaptation to local contexts, findings are at risk of inaccurately representing respondents’ behaviors and key nutritional indicators. ObjectivesThis study used a cognitive interviewing approach to assess mothers’ comprehension, retrieval, judgment, and response to the infant and young child feeding (IYCF) dietary assessment module questions in the Nepal DHS-8 Woman’s Questionnaire. MethodsA cross-sectional qualitative study was conducted in December 2021, using semistructured cognitive interviews, among 54 mothers of children 6–23 mo of age across 3 regions of Nepal. Interviews were analyzed to identify issues in participant understanding of questions, as well as cognitive challenges or benefits of a longer introduction to the IYCF dietary assessment module, as compared with the original shorter introduction and challenges or benefits to using closed-ended compared with open-ended questions. ResultsCognitive challenges were identified, including issues with judgment of certain food categories resulting in misclassification, comprehension of certain concepts, and comprehension of certain instructions for the dietary assessment that resulted in the variability of food and liquids recalled by mothers. ConclusionsThese findings carry substantial implications for the measurement of the diet quality of infants and young children (IYC) in Nepal, and similar cognitive challenges may exist in other contexts. Although this current study is not able to answer the exact extent to which the accuracy and precision of IYCF indicators are affected by these cognitive challenges, these findings indicate that current measurements may be subject to over or underestimation and there is a need for further research in this area to understand the degree of measurement error related to these challenges.