Infant And Young Child Feeding Research Articles

La nutrition au Zimbabwe contemporain: une analyse situationnelle

Background: Malnutrition in all its forms continues to be a global public health challenge affecting mostly women and children in Africa. The socioeconomic consequences of poor nutrition are far-reaching and cross-generational. Objective: To provide an update on the nutrition situation in Zimbabwe in the context of the United Nations 2030 sustainable development agenda. Key findings: In Zimbabwe, the leading nutrition problems include high levels of childhood stunting, micronutrient deficiencies (Vitamin A, Iron, Zinc, and Selenium) affecting mostly children younger than 5 years and women aged 15-49 years. This paper presents evidence on the emergence of obesity and associated complications like diabetes, hypertension, and several cancers in addition to the traditional problem of undernutrition burden “multiple burden of malnutrition”. These nutrition challenges can be attributed to poor breastfeeding and infant and young child feeding (IYCF) practices, the low dietary diversity affecting mostly rural households and nutrition transition. Cultural and religious beliefs are barriers to the adoption of appropriate breastfeeding and IYCF practices. Conclusion: The multiple burden of malnutrition exists in Zimbabwe. Although there is political, commitment and multisectoral initiatives to address malnutrition and food insecurity, the declining socio-economic situation and the COVID-19 associated restrictions are worsening the situation and poor households are getting more vulnerable. Considering that Zimbabwe’s economy is agriculture-based there is a need to put emphasis on promoting nutrition-sensitive agriculture initiatives and urgently implement the Food-Based Dietary Guidelines (FBDGs) to propel the adoption of healthy lifestyles and dietary behaviors. Keywords: Stunting, Breastfeeding, IYCF, Micronutrient deficiency, SDGs, COVID-19, Zimbabwe.

Improving nutritional status among urban poor children in sub-Saharan Africa: An evidence-informed Delphi-based consultation.

In sub‐Saharan Africa (SSA), rapid urbanisation coupled with the high prevalence of infant and young child (IYC) undernutrition in low‐income settings means that interventions to support IYC nutrition are a priority. Little is known about how urbanisation influences IYC feeding (IYCF) practices, and evidence‐based interventions to improve IYC health/nutrition in the urban poor are lacking. Therefore, this research aimed to (a) systematically review evidence on interventions for improving the nutritional status of IYC aged 6–23 months living in urban poor areas (PROSPERO CRD42018091265) and (b) engage stakeholders to identify the highest ranking evidence gaps for improving IYCF programmes/policies. First, a rapid systematic review was conducted. This focused on the literature published regarding nutrition‐specific and nutrition‐sensitive complementary feeding interventions in urban poor areas, specifically low‐income informal settlements, in low‐ and middle‐income countries (LMICs). Six intervention studies met the review inclusion criteria. Intervention adherence was generally high, and indicators of maternal knowledge and IYC nutritional intake typically increased because of the interventions, but the impact on anthropometric status was small. Second, stakeholders working across SSA were engaged via a Delphi‐based approach to identify priority areas for future intervention. Stakeholders reported that a situational analysis was required to better understand IYCF in urban poor areas, particularly the causes of IYC undernutrition, and highlighted the need to involve local communities in defining how future work should proceed. Together, these findings indicate a need for more evidence regarding IYCF and the factors that drive it in urban poor areas across LMIC settings, but particularly in SSA.

Impact Evaluation of a Comprehensive Nutrition Program for Reducing Stunting in Children Aged 6–23 Months in Rural Malawi

The prevalence of stunting in central rural Malawi is ∼50%, which prompted a multipronged nutrition program in 1 district from 2014 to 2016. The program distributed a daily, fortified, small-quantity lipid-based nutritional supplement, providing 110kcal and 2.6g of protein to children aged 6-23mo, and behavior change messages around optimal infant and young child feeding (IYCF) and water, sanitation, and hygiene. Our objective was to perform an impact evaluation of the program using a neighboring district as comparison. Using a quasi-experimental study design, with cross-sectional baseline (January-March, 2014; n=2404) and endline (January-March, 2017; n=2453) surveys, we evaluated the program's impact using a neighboring district as comparison. Impact on stunting was estimated using propensity score weighted difference-in-differences regression analyses to account for baseline differences between districts. No differences in mean length-for-age z-score or prevalence of stunting were found at endline. However, mean weight, weight-for-length z-score, and mid-upper arm circumference were higher at endline by 150g, 0.22, and 0.19cm, respectively, in the program compared with the comparison district (all P<0.05). Weekly reports of high fever and malaria were also lower by 6.4 and 4.7 percentage points, respectively, in the program compared with the comparison district (both P<0.05). There was no impact on anemia. Children's dietary diversity score improved by 0.17, and caregivers' infant and young child feeding and hand-washing practices improved by 8-11% in the program compared with the comparison district (all P<0.05). An impact evaluation of a comprehensive nutrition program in rural Malawi demonstrated benefit for child ponderal growth and health, improved maternal IYCF and hand-washing practices, but a reduction in stunting prevalence was not observed.

Knowledge, attitudes and practices of mothers and caregivers on infant and young child feeding in peri-urban zones of Bobo-dioulasso in Burkina Faso

Knowledge, attitudes and practices(KAP) of mothers/caregivers on infant and young child feeding are key factors for optimal nutritional status, health and growth of the children. A community-based, cross-sectional descriptive study was conducted during January 2017 to assess the knowledge, attitudes and practices on infant and young child feeding (IYCF) of mothers/ caregivers who lived in peri-urban areas of Bobo-Dioulasso, Burkina-Faso.This study was carried out before a nutrition education-based intervention and included 245 mothers/ caregivers that were randomly selected in the peri-urban communities of Bobo-Dioulasso. A semi-structured interviewer-administered questionnaire developed based on Food and Agriculture Organization knowledge, attitudes and practices assessment method was used to collect KAP and socio-economic data. Analyses were performed using SPSS version 20. For this study, authorization was obtained from the regional directorate of health of the Hauts-Bassins region. Verbal consent was obtained after the participants had been informed about the study objectives. Among the 245 study participants, 55.1% were aged less than 30 years. More than 3 out of 4 mothers/caregivers (76.3%) were Muslim and 59.2% of them were illiterate. Almost all mothers/caregivers (98.8%) had adequate knowledge for breastfeeding and 87.9% of them knew about exclusive breast feeding up to 6 months. In addition, 91.8% of mothers/caregivers reported that they gave colostrum at birth. Furthermore, 67.5% of the mothers started breastfeeding within one hour after delivery. Based on mothers/caregivers’ report on complementary foods consumed by 6-59 months children in the previous 24h before the interview, cereals were the most reported consumed food group (89.8%) followed by meat and fish products (28.6%). This study found that mothers/caregivers had adequate knowledge about IYCF in general. However, mothers/caregivers’ practice of complementary feeding was inappropriate. Cereals were the food group consumed by most of children aged 6-59 months raising the needs for interventions, such as cooking demonstrations during postnatal visits in health facilities,to improve complementary feeding in this population.

Maternal Knowledge, Attitudes, and Practices of Complementary Feeding and Child Undernutrition in the Vakinankaratra Region of Madagascar: A Mixed-Methods Study.

ABSTRACTBackgroundData are limited on how feeding knowledge and practices relate to child undernutrition in the highlands of Madagascar.ObjectivesThis study assessed maternal knowledge and practices of complementary feeding and their associations with anthropometrics of children aged 6–23 mo in the Vakinankaratra region of Madagascar.MethodsKnowledge was assessed using WHO recommendations on child feeding, and WHO infant and young child feeding (IYCF) indicators were used to evaluate feeding practices. Child growth was measured as length-for-age, weight-for-age, and weight-for-length z-scores using the 2006 WHO growth standards. A z-score less than −2 was classified as child undernutrition. Logistic regression models were used to determine associations between independent variables and outcomes. Focus group discussions among mothers and in-depth interviews with key informants were conducted; barriers and facilitators of optimal feeding practices were identified using a thematic analysis approach.ResultsMaternal knowledge scores regarding child feeding averaged 6.4 of 11. Better knowledge scores were associated with higher odds of appropriate complementary feeding practices before and after covariate adjustments. The proportions of children achieving the minimum dietary diversity (35.8%), minimum acceptable diet (30.2%), and consuming meat, fish, and poultry (14.1%) were low. Only consumption of iron-rich foods was associated with lower odds of underweight (adjusted OR = 0.3; 95% CI: 0.1, 0.7; P < 0.05). None of the IYCF indicators were associated significantly with stunting or wasting. Maternal attitudes about complementary foods, as well as mothers’ workload and very low income, were identified as barriers to optimal feeding practices. Maternal perceived benefits of giving appropriate complementary foods as well as their positive relationship with the community health workers were the main facilitators of optimal child feeding.ConclusionsIntegrated nutrition-sensitive interventions addressing these barriers while enhancing the facilitators are critical in promoting better feeding practices in the Vakinankaratra region.

Unintended consequences of programmatic changes to infant and young child feeding practices in Bangladesh.

BRAC, an international development organization, implemented a home‐fortification programme from 2014 to 2018 in Bangladesh. This study aimed to understand the unintended consequences of programmatic changes that occurred during the implementation of the programme on the prevalence of good infant and young child feeding (IYCF) practices and other associated factors. We used pooled data from eight cross‐sectional surveys and data from a series of qualitative investigations carried out as part of a mixed‐methods evaluation approach. A total of 6,479 caregivers of children aged 6 to 23 months participated in the surveys. The prevalence of good IYCF practices increased from baseline (42.1%) to midline (45.3%), but it decreased at the endline survey (31.9%). Qualitative investigations identified several reasons for low IYCF practices at the programme level, such as the withdrawal of community health worker (CHW) incentives for promoting IYCF, providing incentives for the home‐fortification of micronutrient powder (MNP) and changing the focus from IYCF promotion to MNP promotion. A multivariable generalized estimating equation model for pooled data revealed that caregivers were 28% (adjusted risk ratio [ARR]: 0.72, 95% CI [0.67, 0.78]) less likely to maintain good IYCF practices during the period when CHWs were not incentivized to promote IYCF compared to the period when CHWs were incentivized to promote it. The prevalence of good IYCF practices decreased from both baseline and midline to the endline survey due to the unintended consequences of the programmatic changes. An integrated intervention strategy to promote the home‐fortification of MNP and IYCF could be helpful to avoid unintended negative consequences of programmatic changes.

Double burden of malnutrition and its association with infant and young child feeding practices among children under-five in Thailand.

This study examined the prevalence of stunting-overweight and socio-demographic determinants among children under-five years of age, as well as associations with infant and young child feeding (IYCF) among children aged 6-23 months. Secondary data analysis based on the Thailand Multiple Indicator Cluster Survey 2015-2016. Cross-national study. Nationally representative sample of children under-five years of age (n 12 313). The prevalence of wasting, stunting, overweight and stunting-overweight was 5·3, 10·5, 10·1 and 1·6 %, respectively. In multivariate analyses, children under 6 months, children from low and middle wealth tertiles, and children living in rural areas were prone to being wasted. Male children, low wealth tertile and a non-Thai speaking household head were positively and children aged 48-59 months and a one-child household were inversely associated with stunting. Children from a low wealth tertile were less likely to be overweight, while older age, male children and children from a one-child household were more likely to be overweight. Stunting-overweight was associated with children aged 24-47 months, male children, mothers having secondary education, a one-child household, a non-Thai speaking household head and an urban area. In terms of IYCF indicators, despite no association with stunting and stunted-overweight children, current breast-feeding and inadequate meal frequency were associated with being wasting, while current breast-feeding and dietary diversity were inversely associated with being overweight. This study revealed the double burden of malnutrition at the individual and population levels among Thai children under-five, which calls for concrete integrated interventions to tackle all forms of malnutrition.

Maternal knowledge on dietary diversity, child feeding and sanitation practices – A cross-sectional study in north Karnataka

For improving nutrition status and decreasing infant mortality in all countries, the Global Strategy for Infant and Young Child Feeding (IYCF) recognizes appropriate infant feeding practices to be crucial. To evaluate the nutritional status of children residing in urban slums and to correlate their feeding and sanitary practices of children with child’s nutritional health status. A cross-sectional study was done by interviewing mothers of 120 apparently healthy children aged 1-5 years availing primary care. The day to day practices related to feeding, sanitary practices and child health were enquired. Dietary pattern of the child was collected by 24 hr recall and dietary score was calculated Using Individual Dietary Diversity Score (IDDS). 78.3% mothers breastfed their children. 10% prematurely initiated and 31% delayed the initiation of complementary foods. The meal frequency of the children is 3 times per day in 55% households, 2 times and 4 times per day in 25% household each. 71.7% families had good dietary diversity. However diet of the child detoriated drastically during bouts of illness. The practice of washing hands with soap and water before eating and after defecation was routinely practiced by only 57.5% children. The anthropometric measurements of the children revealed that 58.3% of them were underweight (30.8% severely), 40% of them were wasted (21.6% severely) and 59.1% were stunted (29% severely). Improvement in child care and feeding practices positively impact nutritional status of children. However these interventions need to be implemented at the household level using positive deviance approach and behavioural change communication strategies.

Evaluation of a Package of Behaviour Change Interventions (Baduta Program) to Improve Maternal and Child Nutrition in East Java, Indonesia: Protocol for an Impact Study.

BackgroundOver the past decade, the prevalence of stunting has been close to 37% in children aged <5 years in Indonesia. The Baduta program, a multicomponent package of interventions developed by the Global Alliance for Improved Nutrition, aims to improve maternal and infant nutrition in Indonesia.ObjectiveThis study aims to assess the impact of the Baduta program, a package of health system strengthening and behavior change interventions, compared with the standard village health services on maternal and child nutrition.MethodsThe impact evaluation uses a cluster randomized controlled trial design with 2 outcome assessments. The first uses cross-sectional surveys of mothers of children aged 0-23 months and pregnant women before and after the interventions. The second is a cohort study of pregnant women followed until their child is 18 months from a subset of clusters. We will also conduct a process evaluation guided by the program impact pathway to assess coverage, fidelity, and acceptance. The study will be conducted in the Malang and Sidoarjo districts of East Java, Indonesia. The unit of randomization is the subdistricts. As random allocation of interventions to only 6 subdistricts is feasible, we will use constrained randomization to ensure balance of baseline covariates. The first intervention will be health system strengthening, including the Baby-Friendly Hospital Initiative, and training on counseling for appropriate infant and young child feeding (IYCF). The second intervention will be nutrition behavior change that includes Emo-Demos; a national television (TV) advertising campaign; local screening TV spots; a free, text message service; and promotion of low-cost water filters and hygiene practices. The primary study outcome is child stunting (low length-for-age), and secondary outcomes include length-for-age Z scores, wasting (low weight-for-length), anemia, child morbidity, IYCF indicators, and maternal and child nutrient intakes. The sample size for each cross-sectional survey is 1400 mothers and their children aged <2 years and 200 pregnant women in each treatment group. The cohort evaluation requires a sample size of 340 mother-infant pairs in each treatment group. We will seek Gatekeeper consent and written informed consent from the participants. The intention-to-treat principle will guide our data analysis, and we will apply Consolidated Standards of Reporting Trials guidelines for clustered randomized trials in the analysis.ResultsIn February 2015, we conducted a baseline cross-sectional survey on 2435 women with children aged <2 years and 409 pregnant women. In February 2017, we conducted an end-line survey on 2740 mothers with children aged <2 years and 642 pregnant women. The cohort evaluation began in February 2015, with 729 pregnant women, and was completed in December 2016.ConclusionsThe results of the program evaluation will help guide policies to support effective packages of behavior change interventions to prevent child stunting in Indonesia.International Registered Report Identifier (IRRID)RR1-10.2196/18521

Complementary Feeding Status of Children Residing in Urban Slum of East Delhi

International Journal of Medicine and Public Health,2020,10,3,126-129.DOI:10.5530/ijmedph.2020.3.27Published:September 2020Type:Original ArticleComplementary Feeding Status of Children Residing in Urban Slum of East DelhiShyambhavee Behera, Khan Amir Maroof, and Pradeep Kumar Tiwari Shyambhavee Behera1, Khan Amir Maroof2,*, Pradeep Kumar Tiwari2 1Department of Community Medicine, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, INDIA. 2Department of Community Medicine, University College of Medical Sciences, Delhi, INDIA. Abstract:Background: Feeding practices both in terms of quality as well as quantity is of great importance in the initial years of life for the optimal growth especially the “critical window period”. Urban slum dwellers are at higher risk of poor child feeding status. The study aims to assess the IYCF indicators related to complementary feeding in an urban slum of East Delhi and to explore its association with the socio-demographic factors. Methodology: A cross-sectional study was conducted in an urban slum of Sunder Nagari in East Delhi. One hundered and eighty one children between 6-24 months of age were included in the study. The infant and young child feeding (IYCF) status data was collected using pretested and pre-validated questionnaire adapted from the standard WHO-IYCF questionnaire. Socio-demographic characteristics were also recorded. Chi-square tests were applied to explore the association of socio-demographic variables with IYCF status. Results: Early initiation of breastfeeding was practiced in around half of the children. Minimum Dietary Diversity (MDD), Minimum Meal Frequency (MMF) and Minimum Acceptable Diet (MAD) was found to be 17.7%, 69.1% and 16.6%, respectively. These complementary feeding indicators were found to be better (p<0.05) among higher age group children, mothers with higher level of education and middle socio-economic class in comparison to lower socioeconomic section of the study population. Conclusion: Infant and young child feeding practices were found to be poor in the present study. More impetus is needed to promote IYCF practices in urban slums. Keywords:complementary feeding, IYCF indicators, Minimum Acceptable Diet, Minimum Dietary Diversity, Minimum Meal FrequencyView:PDF (270.29 KB)

Systematic review of infant and young child feeding practices in conflict areas: what the evidence advocates

BackgroundBreast feeding in conflict settings is known to be the safest way to protect infant and young children from malnourishment and increased risk of infections. This systematic review assesses the...

Association between Infant and Young Child Feeding (IYCF) Indicators and the Nutritional Status of Children (6-23 Months) in Northern Ghana.

Although recommended infant and young child feeding (IYCF) practices have been found to be protective against undernutrition in some settings, there is no finality yet due to inconsistencies in the literature. A cross-sectional survey of 581 mother-child pairs was conducted in northern Ghana in June 2018. The association between IYCF indicators and child undernutrition (stunting and wasting) were assessed. The descriptive analysis showed that 66.4% of the children (6–23 months) were introduced to complementary feeding in a timely manner, 69.4% met the minimum meal frequency, and 38.9% met the minimum acceptable diet daily. The prevalence of stunting, wasting, underweight and overweight was 33.2%, 14.1%, 27% and 2.6%, respectively. From the multivariable binary logistic regression, child gender, child age group and source of power for lighting the household were significantly associated with wasting. Intake of iron-rich foods, child age group, and maternal height were significantly associated with stunting after adjusting for confounders. The prevalence of the compliance with IYCF indicators was relatively high. None of the individual IYCF indicators showed significant association with undernutrition, except intake of iron-rich foods for stunting. Nutrition-specific interventions targeted at improving IYCF practices, dietary diversification and intake of nutrient-rich meals, should be adopted and scaled up to address undernutrition in northern Ghana.

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

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

Persistent Inadequacies in Infant and Young Child Feeding Practices and Their Determinants

Background: Malnutrition is a major public health problem and is directly associated with poor infant and young child feeding (IYCF) practices. The study aimed to identify the inadequacies in the feeding practices for children aged 0-23 months through a cross-sectional KAP survey. Methods: Data was collected on demographic indicators, IYCF practices, 24 hours dietary recall, childhood illnesses and anthropometrics and compared with WHO guidelines. Results: Only 44.8% mothers timely initiated breastfeeding, 57% fed colostrum and 32.9% practiced exclusive breastfeeding. Only 63.2% children were breastfed beyond first year and 42.2% up to second year. Nearly half of the children were introduced to complementary feeding at 6-8 months. Minimum meal frequency (MMF) was offered to 57.5%, minimum dietary diversity (MDD) to 53.2% and minimum acceptable diet (MAD) to 37.1%. Prevalence of childhood illnesses was high. Prevalence of stunting, wasting and underweight was 19.1%, 4% and 11.4%, respectively. Mother’s working status was positively associated with timely initiation of breastfeeding (OR 1.82; 95% CI 1.17, 2.83) and MDD (OR 1.53; 95% CI 0.93, 2.51) but inversely associated with exclusive breastfeeding (OR 0.52; 95% CI 0.16, 1.66). Colostrum was given by mothers with better socioeconomic status (OR 1.3; 95% CI 0.84, 2.04) and higher education level (OR 1.22; 95% CI 0.71, 2.08). Socioeconomic status directly affected MDD (OR 2.32; 95% CI 1.40, 3.83) and MAD (OR 1.51; 95% CI 0.90, 2.54). The health status of children was positively impacted by exclusive breastfeeding (OR 2.33; 95% CI 0.89, 6.14), timely introduction of complementary feeding (OR 1.39; 95% CI 0.86, 2.26), MMF (OR 1.38; 95% CI 0.82, 2.32) and MAD (OR 1.30, 95% CI 0.77, 2.20) and negatively impacted by bottle feeding (OR 0.79; 95% CI 0.50, 1.27). Conclusions: The mothers showed moderate to low compliance to WHO IYCF indicators despite high educational status. The inadequacies in IYCF practices demand for immediate awareness interventions.

Development and Testing of Responsive Feeding Counseling Cards to Strengthen the UNICEF Infant and Young Child Feeding Counseling Package.

BackgroundThe UNICEF Community-based Infant and Young Child Feeding Counseling Package (C-IYCFCP) currently has limited responsive feeding (RF) content, thus limiting dissemination of RF messages within infant and young child feeding (IYCF) counseling.ObjectivesThis project 1) developed counseling cards based on existing evidence-based RF guidelines and 2) tested their feasibility in Ghana.MethodsFive RF counseling cards were developed focusing on eating with family; introducing new foods; hunger/satiety cues; food texture; and calming a child. Four focus group discussions (FGDs) were conducted with adult mothers and fathers of children younger than 3 y of age to assess the cultural appropriateness of the cards and accompanying key messages. The feasibility of including cards as part of IYCF counseling was tested via 1) systematic observation of 8 group education sessions utilizing the cards with the same target audience and 2) in-depth interviews with health care providers involved in IYCF training and/or counseling.ResultsFGD findings guided changes to all cards to ensure comprehension and cultural appropriateness. The group education sessions suggested that the counseling cards provided important RF messages that are specific, clear, and feasible to implement. Health care providers strongly endorsed the need for and utility of the RF counseling cards and felt they were feasible and important to integrate into the C-IYCFCP currently being used to deliver IYCF training and counseling in Ghana.ConclusionsThe counseling cards have a strong potential to add key RF dimensions to IYCF training and counseling in Ghana.

Indonesia Infant and Young Child Feeding Practice: The Role of Women’s Empowerment in Household Domain

Previous studies showed the significant association between women&amp;rsquo;s empowerment and infant and young child feeding (IYCF) practice. Only around 40% of Indonesian children met adequate IYCF practice. Hence, each dimension of women&amp;rsquo;s empowerment in the household domain must be explored.&#x0D; &#x0D; We carried out a dataset of the 2017 Indonesia Demographic and Health Survey, with samples of 4,880 mothers of reproductive age in a marriage relationship with their last-born child aged 6-23 months. Logistic regression was applied.&#x0D; &#x0D; Mother with legal asset ownerships had lower odds of her child meeting (aOR: 0.83; 95% CI: 0.72, 0.95) minimum dietary diversity (MDD), (aOR: 0.75; 95% CI: 0.65, 0.87) minimum meal frequency (MMF) and (aOR: 0.74; 95% CI: 0.61, 0.90) minimum acceptable diet (MAD). Mother who could control her own earnings had higher odds of her child meeting MDD (aOR: 1.52; 95% CI: 1.32, 1.74) and MAD (aOR: 1.62; 95% CI: 1.34, 1.94). Employed mother had higher odds of meeting MMF (aOR: 1.58; 95% CI: 1.38, 1.82). Mother who did not approve of intimate partner violence was more likely to feed her child with MDD (1.39 times), MMF (1.41 times) and MAD (2.04 times). Mother with three or more parity had lower odds of her child meeting MDD (aOR: 0.81; 95% CI: 0.79, 0.93), MMF (aOR: 0.84; 95% CI: 0.72, 0.99) and MDD (aOR: 0.80; 95% CI: 0.65, 1.00).&#x0D; &#x0D; Mother who did not approve towards domestic violence, was working, controlled her assets and had a maximum of two parity was associated with official IYCF recommendation.

An interpersonal nutrition campaign and maternal knowledge and childhood feeding practices: a case study from mothers in rural Indonesia

BackgroundThe purpose of this study was to examine the extent to which a national nutrition communication campaign (NNCC) intervention providing interpersonal communication (IPC) was associated with improved knowledge and behaviors related to feeding practices among mothers with children under two years of age in rural Indonesia.MethodsData came from a follow-up, cross-sectional survey of 1734 mothers. Key outcomes of interest were minimum meal frequency, minimum dietary diversity and minimum acceptable diet, as defined by the World Health Organization. Associations between exposure to the NNCC intervention and infant and young child feeding (IYCF) knowledge and behaviors were analyzed using adjusted linear and logistic regression, controlling for age, education, and income.ResultsA total of 525 mothers reported exposure to IPC interventions (30.3%). Participation in IPC was associated with increased knowledge of feeding practices (p < .0001). Separately, knowledge of feeding practices was related to achieving recommended behavioral practices of minimum meal frequency (p = 0.019), dietary diversity (p = 0.013), adequate diet (p < .001).ConclusionThese findings underscore the value of increasing maternal knowledge of IYCF practices through IPC interventions as a way to improve behavioral practices and address stunting in rural Indonesia.

Regional Analysis of Associations between Infant and Young Child Feeding Practices and Diarrhoea in Indian Children.

Studies on the association between infant and young child feeding (IYCF) practices and diarrhoea across regional India are limited. Hence, we examined the association between IYCF practices and diarrhoea in regional India. A weighted sample of 90,596 (North = 11,200, South = 16,469, East = 23,317, West = 11,512, Central = 24,870 and North-East = 3228) from the 2015–2016 National Family Health Survey in India was examined, using multivariate logistic regressions that adjust for clustering and sampling weights. The IYCF indicators included early initiation of breastfeeding (EIBF), exclusive breastfeeding (ExcBF), predominant breastfeeding (PBF), bottle feeding (BotF), continued breastfeeding (BF) at one-year, continued BF at two years, children ever breastfed and the introduction of solid, semi-solid or soft foods (ISSSF). Diarrhoea prevalence was lower among infants who were BF within one-hour of birth and those who were exclusively breastfed. Multivariate analyses revealed that continued BF at one and two years, and infants who were introduced to complementary foods had a higher prevalence of diarrhoea. EIBF and ExcBF were protective against diarrhoea in the regions of North, East and Central India. PBF, BotF and ISSSF were risk factors for diarrhoea in Central India. Continued BF at two years was a risk factor for diarrhoea in Western India. Findings suggested that EIBF and ExcBF were protective against diarrhoea in Northern, Eastern and Central India, while PBF, BotF, continued BF at two years and ISSSF were risk factors for diarrhoea in various regions in India. Improvements in IYCF practices are likely to reduce the burden of diarrhoea-related morbidity and mortality across regions in India.

Are our babies off to a healthy start? The state of implementation of the Global strategy for infant and young child feeding in Europe

BackgroundTo protect children’s right to optimal nutrition, WHO/UNICEF developed a Global Strategy for Infant and Young Child Feeding, endorsed by all 53 WHO/EURO Member States. The World Breastfeeding Trends Initiative (WBTi) is a tool for monitoring implementation of the Global Strategy. It comprises 15 indicators, ten referring to policies and programmes, and five to feeding practices. Each is scored on a scale of 10, giving a total score of 150 for Global Strategy implementation. To date, 18 WHO/EURO Member States – Armenia, Austria, Belgium, Bosnia and Herzegovina, Croatia, France, Georgia, Germany, Italy, Lithuania, North Macedonia, Malta, Moldova, Portugal, Spain, Turkey, Ukraine and United Kingdom – have conducted a WBTi assessment and produced a report.MethodsBetween June 2018 and May 2019, all 18 WBTi European reports were carefully read and analysed by a group of national WBTi coordinators. Descriptive data analysis, including inter-country comparisons, was conducted using frequencies and percentages. This paper summarises the findings. The full 88-page report will be published on the WBTi website.ResultsThree-quarters of 18 European countries have adequate maternity protection, and two-thirds have breastfeeding initiation rates of 50% or higher. However, ‘Preparedness and planning for appropriate and safe Infant and Young Child Feeding (IYCF) in emergencies’ is seriously neglected. Breastfeeding duration is far below WHO recommendations, with an average of 8.7 months. Only three European countries have a budget allocated for implementing IYCF policies and plans, and a third currently have no Baby-friendly designated maternity facilities. Bottle feeding is prevalent, despite its inherent risks, monitoring of IYCF practices is inadequate, with most countries not routinely collecting data, and violations of the International Code of Marketing of Breast-milk Substitutes are commonplace.ConclusionsEuropean governments are not doing enough to protect, promote and support sound infant and young child feeding practices. Political commitment at the highest level and adequate funding are required to ensure optimal IYCF for Europe’s babies. This report highlights worrying gaps, thereby providing governments, international organisations and other concerned parties with an opportunity to invest in priority areas and, by doing so, hopefully create a better future for our babies.

Nutritional Status and Infant and Young Child Feeding (IYCF) Practices among Buhid Mangyan Tribe, Occidental Mindoro Philippines

Nutritionally adequate and safe complementary feeding starting from the age of 6 months up to 59 months is one of the effective intervention to reduce infant and child morbidity and malnutrition. This study aims to determine the nutritional status of children ages 6-59 months and their caregiver’s infant and young child feeding (IYCF) practices of the Buhid community in Rizal, Occidental Mindoro. The design used in this study was a descriptive cross-sectional carried out between December 2016-February 2017. A survey questionnaire was utilized as an instrument in this study. It includes an anthropometric survey of 6-59 months old and infant and young child feeding practices using WHO and UNICEF IYCF indicators. Vaccination, vitamin A supplementation and deworming coverage were also measured. Findings revealed a prevalence of global acute malnutrition (GAM) at a critical level. There is a low but significant prevalence of stunting and underweight among children. There is a good infant and young feeding practice in the community except for the minimum acceptable diet during complementary feeding. Lastly, there is low BCG and measles vaccination coverage in the community that could be a threat to the impending disease outbreak.