IYCF Practices Research Articles

Assessment of Infant and Young Child Feeding Practices and its Relation with Nutritional Status of Under Two Children: A Community Based Study at Malda Town, West Bengal

Background: Correct practices of nutrition remains the cornerstone to combat the problem of under nutrition among the children. Most important of them is propriety of breast feeding. Its initiation within an hour of birth is important for both mother and child as the first breast milk (colostrums) is considered to be highly nutritious and has antibodies that protect the new-born from serious diseases. The study was conducted to assess the IYCF practices among the under two children and the relationship between the aforesaid practices and the nutritional status of the study participants of a district town of West Bengal. Methods: It was a community based observational study, cross-sectional in design conducted among children aged less than twenty four months in a district town of West Bengal using cluster sampling method among 390 participants. Results: The study revealed that less than half (47.9%) of mothers initiated breast feeding within one hour of birth. Exclusive breast feeding rate at 6 months was 68.3% and 84.3%mothers were continuing breast feeding at two years age of the child. Optimal diversity of food was seen among 30.3% eligible children. The proportion of underweight and stunting was 40.7% and 43.6% respectively and were significantly related to initiation of breast feeding in one hour, adequate food diversity, adequate meal frequency, age adjusted minimum acceptable diet and exposure to bottle feeding. Conclusion: The study reiterates that appropriate feeding practices in first two years of life are crucial to attain proper growth of the children in their later life.

Situational analysis of undernutrition and selected infant and young child feeding practices (IYCF) in young children of Somanath Gir, Gujarat

: Undernutrition in young children is a cause of concern, maternal education, and IYCF practices, lack of nutrition knowledge are some of the key aspects for poor nutritional status of young children.To assess themagnitude of under nutrition and IYCF practices of young children (3-5 Y) of Somnath gir, Gujarat.: 120 mother and child pairs were randomly enrolled from the selected Anganwadi centers and preschool oSomnath gir f . Information on socioeconomic aspects,IYCF practices were elicited from mothers of young children through pre tested semi structured questionnaire. Height and weight and MUAC of these children were measured using standard methods.nutritional status was assessed using WHO growth standard 2006. Sixteen percent of the households had Below Poverty Card (BPL) 70.8% were other backward class. The educational attainment was limited for respondent mothers. Around 2.5 percent of the surveyed mothers never attended schools, and 45.8 percent had attended until grade 7. 57 % of the children were male. The overall stunting prevalence among children less than 60 months of age in the survey areas was 11.1 percent (<-2SD). As per MUAC cut-off for children, only 1.39% are at higher risk between 37-60 months of age. (MUAC <11.5cm). One-half of the children were breastfed immediately after the birth, and 48.3% children were breastfed within one hour of the birth. Only 64.2% children were given colostrum (yellow milk) which is known as “Immunity booster for the child”. Eighteen percent of the children were fed with pre-lacteals. Breastfeeding till the completion of 6 months were attained by 95.8% children. 78.3% children mothers’ reported the initiation of complementary feeding at right age i.e. after completion of 6 months of age. Conclusion: Under nutrition in young children needs to be prevented. Mothers of young children needs to be sensitized for optimal IYCF practices.

Assessment of breastfeeding practices in lactating mothers: more road to cover

Background: The mother’s milk is the best gift nature has provided. It is complete nourishment for babies. The World Health Organization (WHO) recommends that infants be exclusively breastfed for the first six months, followed by breastfeeding along with complementary foods for up to two years of age or beyond. Absence of remarkable progress in indicators of breastfeeding suggest that certain gaps still exist which restrict achievement of national development goals. These gaps could have resulted from unawareness and lack of knowledge regarding appropriate IYCF practices. Appropriate intervention in terms of awareness programmes may help in achieving the national development goals.Methods: A cross sectional hospital based study was conducted over a period of 3 months. Lactating mothers in post natal ward were questioned using self-administered breastfeeding knowledge questionnaire about their knowledge, attitude and practices of breastfeeding.Results: Total of 100 lactating mothers were enrolled. Majority of the mothers were in the age group of 20-25 years (72%), 65% of mothers were from rural area. only 27% mothers practiced initiation of breastfeeding after birth. 62% of mothers initiated breastfeeding after 30 minutes of birth. 10% mothers gave prelacteal feeds, honey was the most commonly given prelacteal feed. 90% of the mothers fed their baby colostrum. 90% of mothers knew that breast milk is ideal feed for newborn.Conclusions: The primary care givers need to implement strategies to educate mothers about breastfeeding in antenatal and post natal checkups to enhance good breastfeeding practice thereby reducing infant mortality and morbidity. A special strategy to reach out to poor socio economic status and illiterate mothers is need of the hour.

Qualitative, longitudinal exploration of coping strategies and factors facilitating infant and young child feeding practices among mothers in rural Rwanda

BackgroundMothers in low-income countries face many challenges to appropriately feed their children in the first year such as poverty, food insecurity and high workloads. However, even in the lowest income families there are mothers who succeed to feed their children according to the recommendations. In this paper, we explored the coping strategies that facilitate appropriate breastfeeding and complementary feeding practices among rural Rwandan mothers from birth to one year of a child’s life.MethodsThis qualitative longitudinal study recruited a purposive sample of 17 mothers who followed the infant and young child feeding recommendations (IYCF). They were selected from a larger study of 36 mothers. In-depth interviews were conducted with mothers of the total group (36 mothers) within the first week, at 4th, 6th, 9th and 12th months postpartum. Interviews were audio-recorded, transcribed verbatim and analyzed thematically.ResultsCoping strategies included improving mothers’ own diet for adequate breastmilk production, prioritizing child feeding over livelihood chores, livelihood diversification and mothers’ anticipatory behaviors such as preparing child’s food in advance. Some of those coping strategies were shifting overtime depending on the development of the children. Personal factors such as breastfeeding self-efficacy, religious beliefs and perceived benefits of breastfeeding were among the facilitating factors. Additionally, social support that mothers received from family members, other mothers in the community, Community Health Workers (CHWs) and health professionals played an important role.ConclusionIn challenging contextual conditions, mothers manage to follow the recommended breastfeeding and complementary feeding practices through the interplay of active coping strategies, feeling to be in control and social support. Nutrition promotion interventions that aim to improve IYCF should consider strengthening mothers’ capability in gaining greater control of their IYCF practices and the factors facilitating their appropriate IYCF practices.

Feeding Practice and Nutritional Status of Under Five Children: A Cross Sectional Descriptive Study in a Slum Community of West Bengal

Background: Adequate nutrition during infancy and early childhood is the key for the development of each child to reach his/her full human potential. 1 Poor nutrition during the first 1000 days of a child’s life leads to stunted growth which is irreversible. It is also seen to be associated with impaired cognitive ability and reduced school performances.2 Objective: To assess socio demographic profile, feeding practices of mothers/ caregivers, nutritional status of under five children and to find out any association between feeding practice and nutritional status. Methodology: Community based observational descriptive study with cross sectional design was done at Baghbazar slum area in Kolkata among 76 under five children by house to house visit with a predesigned, pretested semi-structured proforma. Anthropometric measurements of them were also done. Data were analysed with SPSS version 16 software. Results: 97.4% of the children were hospital born, 96.1% had birth weight ≥ 2.5 kg. Only 21.1% received breastfeeding within first hour after birth, 71.2% were exclusively breastfed. 23.7% received pre lacteal feeding and 93.4% received colostrum. Timely initiation of complementary feeding was found in 87.9%, 56.06% consumed fast food on regular basis and 59.1% received supplementary nutrition from ICDS center. Feeding during illness was decreased in 81.6%. 18.2% had stunting and it was significantly more in children of lower socio-economic classes (p value 0.010). 15.8% were underweight and it was significantly more in low birth weight children (p value 0.024), whose mothers were less educated (p value 0.017), who did not receive exclusive breast feeding (p value 0.008) and supplementary nutrition from ICDS (p value 0.002). 5.2% were overweight and 2.6% were moderately wasted. Conclusion: Reinforcing nutritional education including IYCF practices are to be stressed.

A study on infant and young child feeding practices among mothers attending the immunisation clinic of a tertiary care hospital, Kolkata, West Bengal

Background: Age appropriate feeding practices is an essential determinant of physical growth as well as mental health of under-five children. WHO and UNICEF have formulated the infant and young child feeding practices guidelines to enhance appropriate feeding practices in infants and young children.Methods: A descriptive, observational, cross-sectional study was conducted in the immunization clinic of KPC medical college and hospital from October to December 2018 among children in 0-23 months age group. The mothers were interviewed regarding their sociodemographic details as well as the IYCF practices as per WHO.Results: It was found that appropriate practices in terms of prelacteal feeding, colostrum feeding; early initiation of breast feeding and exclusive breast feeding was present in 78.4%, 80%, 77.5% and 50% children respectively. Timely initiation of complementary feeding was found in 81%, breast feeding was continued upto 1 year in 68.8% and consumption of iron rich or iron fortified food was found in 54.5% children. Appropriate practices in terms of minimum meal frequency, minimum dietary diversity and minimum appropriate diet were found in 49.7%, 27% and 32.3% children respectively. Sex wise distributions have found significant association with minimum dietary diversity and minimum acceptable diet. Age wise distribution revealed significant association with minimum dietary frequency, minimum dietary diversity and minimum acceptable diet (p<0.005).Conclusions: Thus infant and young child feeding practices were not satisfactory. Mothers should be made aware about the appropriate feeding practices and health education should be given regarding correct child feeding practices.

Profile of sever acute malnutrition children admitted at nutritional rehabilitation centre at tertiary care treatment centre of Gujarat

Background: Sever acute malnutrition (SAM) may be major obstacle for India to achieve targeted Infant Mortality Rate and under five mortality rate. Malnutrition and infection form vicious cycle and contributes towards mortality. So, malnutrition prevention is major objective of government. Study of malnourished children helps to know aetiology and their response to treatment. The objective of study is to understand clinic-demographic profile of SAM children.Methods: It is retrospective secondary data analysis study. For the purpose of this analysis, we retrieved the data of all children with SAM admitted from 1 January, 2018 to 31 December, 2018 to NRC. At the NRC, a physician conducted a clinical examination in children to detect the presence/absence of medical complications during their admission and these data were available in case sheet.Results: A total of 162 children, aged 6-59 months were referred to the NRC. Around fourty seven percentage of children were in age group 6–12 months Majority of children were in age group of 7 months to one year of age. Majority of children were admitted based on weight of height criteria (Z score < 3SD). Mean admission weight is lower in female compare to male children.Conclusions: Faulty weaning practises and delay in weaning in some cases predisposes later half of infancy period to undernutrition. So, proper health education and good IYCF practices prevent children from undernutrition.

Safeguarding nutritional opportunities of first 1000 days of life during a pandemic: infant and young children feeding practices in the context of COVID-19 in India

Children have milder clinical course and better prognosis from SARS-Co-V-2 infection. But the after-effects of this pandemic can have severe repercussions on nutrition of children, especially those who are already malnourished. Poor nutrition in the first 1,000 days of a child’s life can lead to stunted growth, which is associated with impaired cognitive ability and reduced school and work performance. Misconceptions about breastfeeding, food insecurity hampering the procurement of nutritious food, competing household needs, psychological trauma that affects child care practices and disruption or reduced utilization of routine nutrition services can negatively impact infant feeding during the pandemic. If nutrition related factors contributed to about 45% of global under-5 mortality before the onset of COVID-19, the figures can increase if appropriate infant and young child feeding practices are not followed. Years of dedicated work has resulted in the infant feeding indicators we cite today. Efforts should be made to prevent backsliding, resulting in increased child malnutrition and mortality. Appropriate measures at the right time to protect, promote and support optimal IYCF practices and thereby safeguard the nutritional benefits of the first 1000 days of life during this pandemic, will pay rich dividends in terms of a healthier next generation.

Use of Mobile Health in Infant and Young Child Nutrition: A Formative Study in Rural Maharashtra

Undernutrition is a major public health problem for under 5 years of age children in India. Approximately 41% and 21% of under 5 years of age children are stunted and wasted respectively. Despite the known importance of age appropriate infant and young child feeding practices for child nutrition, the rates of these practices remain poor in India. The major determinants for inappropriate IYCF practices are beliefs and knowledge of parents and caregivers. These can be effectively addressed through counselling by mobile Health technology as mobile phones are widely available and have a high penetration across the country. This formative research explored the perceptions of caregivers regarding infant feeding practices, feasibility of mobile phone for counselling and targeted messaging to mothers on appropriate infant feeding. We conducted in-depth interviews, focus group discussions and key informant interviews. The data were translated, transcribed and analysed using a thematic approach. We found that rural households have at least one mobile phone with good network connectivity. Utilizing mobile phones for counselling was found to be acceptable in the community, provided that the advice given is affordable, tailored to their cultural beliefs and socio-economic status.

Minimum Diet Diversity and Minimum Meal Frequency – Do They Matter Equally? Understanding IYCF Practices in India

Abstract Objectives Infant and Young Child Feeding practices, mainly, complementary feeding in children between 6 months and two years of age, is found to be sub-optimal and emerge as the weakest link in improving child nutrition outcomes in India. Minimum Acceptable Diet (MAD), comprising of two sub-indicator – Minimum Dietary Diversity (MDD) and Minimum Meal Frequency (MMF), serves as an essential indicator to understand the diet adequacy pattern in children. The objective of this study was thus to investigate the role of MDD-MMF dyad in influencing the nutritional outcomes in children and its pattern across regions in India. Methods Data was obtained from the National Family Health Survey – 4 (NFHS-4) from the DHS Program website. The prevalence of MMF and MDD was calculated for 640 districts in India. The MMF and MDD were classified into three categories - high, medium and low based on equal percentile distribution of their prevalence range. Districts with high MMF and high MDD formed one cohort. Similarly, eight other cohorts were created based on their performance on MMF and MDD indicator. The prevalence of Stunting (St), Wasting (Wa) and Underweight (Uw) in children between 6 months and two years of age was then calculated for each of the nine cohorts. The districts were also mapped based on their cohort category to study the variation across regions in India. Results All three anthropometric indicators – stunting, wasting and underweight showed significant decline moving across low MMF- low MDD cohort (40% St; 26.2% Wa; 37.1% Uw) to medium MMF – medium MDD cohort (38.6% St; 23.8% Wa; 35.4% Uw) to high MMF – high MDD cohort (29% St; 15.5% Wa; 19.2% Uw). Second, the importance of minimum dietary diversity in improving nutritional outcomes was revealed, as opposed to minimum meal frequency, which shows improvement only when it reaches a certain threshold. Third, mapping revealed sharp differences across various regions in MMF-MDD pattern, especially in the states like Odisha, Assam and Andhra Pradesh. States in the central region performed poorly on complementary feeding indicators, specifically diet diversity. Conclusions The study highlights the importance of optimal complementary feeding practices in improving nutrition outcomes and the need to consider the regional heterogeneities while promoting IYCF practices in India. Funding Sources None.

Mainstreaming and Scaling Up Nutrition Best Practices in a Nation-Wide Primary Healthcare Model of Bangladesh: Implementation Lessons Learned

Abstract Objectives The objective of the implementation research was to evaluate the effectiveness of a maternal and child nutrition-focused multi-component intervention, and assess the feasibility of incorporating it into an existing PHC program. Methods A cluster randomized impact evaluation compared the impact in terms of coverage of intervention, consumption of diversified foods and macro- and micronutrients during pregnancy, and early breastfeeding practices. A similar study was conducted among pregnant (n = 600) and recently delivered women (n = 2000) which examined factors influencing maternal nutrition practices. Cross-sectional surveys (2015 & 2016) were (n = 1000 women & 700 husbands) conducted to document the impact of husbands’ support on women's supplement intake and dietary diversity. Three subsequent cross-sectional studies (2013, 2014 & 2015) were conducted to evaluate the impact of a large scale SBCC program aimed at maternal dietary behavior and IYCF practices. A cRCT among 900 pregnant women assessed the relationship between maternal nutrition education and infant birthweight. Results Results showed that good nutrition knowledge was the key maternal factor associated with higher consumption of IFA (β = 32.5, 95% CI: 19.5, 45.6) and calcium (β 31.9, 95% CI: 20.9, 43.0) and diverse diet (OR = 1.8, 95% CI: 1.0 ± 3.1). The mean dietary diversity score of pregnant women increased from 4.28 + 1.08 to 4.76 + 1.16. About 83% of the respondents-initiated breastfeeding within an hour of childbirth, which was 62% at baseline. Less than a fifth (18%) of the children were eating a minimally acceptable diet at baseline, which reached to 52% by endline. Study showed that husbands support played a critical role for the women to increase supplement intake and dietary diversity. Nutrition counselling during pregnancy increased mean birthweight by 127.5 g (95% CI: 11.1 to 243.9; P = 0.032) and the risk of LBW was reduced by 54% (relative risk (RR): 0.43; 95% CI: 0.25 to 0.75; P = 0.003). Conclusions Integration of nutrition intervention into the existing health programme was feasible and well-implemented. Although differences in coverage and counselling quality most explained most impacts, all intervention elements particularly CHW training and performance were likely important to achieving impact. Funding Sources BRAC.

Dietary practices, WASH conditions, and disease occurrence among children below five years in households of Nangabo, Wakiso district, Uganda

Amidst various global and local interventions, children below five years still die of preventable illnesses. This study aimed to evaluate the impact of dietary practices on disease cases and the various factors that contribute to diseases among children below five years in households Nangabo, Wakiso district-Uganda.This was a cross-sectional descriptive study. A total of 100 households with children below five years were randomly selected from the different villages of Nangabo sub-county.The study found out that 54% of households (HHs) had 3–5 members, 72% headed by fathers, 56% of HHs heads were in business and transport, and 88% had 1–2 children below five years. All HHs had toilets, but 90% did not have tip water taps for washing hands after using the toilet, 62% had proper sanitation, and 82% got water from taps and tanks. 34% of HHs had children falling sick monthly, where 84% of them had children affected by flu, cough, and malaria. 90% of HHs purchased food, 54% had 3 meals a day, and 60% did not separate children's food when cooking. However, 95% of those who separately cooked children's food used boiling and steaming as primary cooking methods. 58% of HHs had children fed by themselves, but only 4% had children sharing plates, and 84% had a daily dietary-diversity score of 3/6 and above. There was a negative correlation between HHs daily dietary-diversity score and the incidence of diseases among children, −0.06 (0.66), although it was not statistically significant.Increasing knowledge towards IYCF practices followed by improved sanitation, hygiene, and access to clean water is critical for prevention and control for childhood diseases among HHs.

High confidence, yet poor knowledge of infant feeding recommendations among adults in Nova Scotia, Canada.

In Canada, adherence to the national ‘Nutrition for Healthy Term Infants' recommendations of infant and young child feeding (IYCF; 0‐24 months) is suboptimal. While maternal knowledge of IYCF is commonly assessed, that of the general public has rarely been explored. Our objective was to assess the knowledge of, and confidence in answers to, Canadian IYCF recommendations among a diverse sample of adults in Nova Scotia, Canada. Between March and May 2018, a self‐administered questionnaire examining IYCF knowledge, self‐rated confidence, and sociodemographic information was conducted among Nova Scotians (≥19 years) in public locations. We surveyed 229 adults; 60% (n=134) were women. Mean (95% CI) age was 44 (41,46) years, 73% self‐identified as white, 77% were born in Canada, and 69% were parents. Knowledge deficits were: age to terminate breastfeeding (18.3 (16.7,19.9) months; recommendation: ≥24 months), age to introduce solids (9.2 (8.2,10.2) months; recommendation: 6 months), vitamin D supplementation (10% correct), and optimal complementary foods (only 37% indicated iron‐rich foods). Correct IYCF knowledge was lower among men, non‐parents, young adults (19‐29 years) and low‐income adults (<$50,000/year). Mean self‐rated confidence (out of 10) was high (7.2 (6.9,7.5)), and not different (p>0.05) between correct and incorrect responses for: best food for a newborn, age to terminate any breastfeeding, and age to start family meal foods. We found low knowledge of IYCF guidelines, yet high confidence in responses regardless of accuracy, among adults in Nova Scotia. General public knowledge deficits may contribute to an unsupportive culture around IYCF practices and low adherence to current recommendations.

Impact of UNICEF’s Community Infant and Young Child Feeding (C-IYCF) Counselling Package on Priority IYCF Practices in Nigeria (P16-038-19)

ObjectivesUNICEF’s Community Infant and Young Child Feeding (C-IYCF) Counselling Package (the Package), was launched by in 2010 to equip community workers for IYCF promotion. Though the Package was in use in at least 68 countries at the end of 2014, no formal evaluation of the Package had been conducted. In response, we evaluated the impact of the Package, when implemented at scale, on priority IYCF practices in Nigeria. MethodsIn collaboration with the Kaduna State Ministry of Health, two local government areas (LGA) (one intervention and one comparison) were selected. Intervention planning and implementation followed guidance provided in the Package. The Package was implemented in every ward of the intervention LGA for 18 months. It involved training 78 health workers and 238 community volunteers, community sensitization and mobilization events, support group meetings, home visits, review meetings, and supportive supervision. A baseline survey of mothers of children under two was conducted in early 2015 and the endline 2 years later in both LGAs. Survey instruments included modules on household characteristics and socioeconomic status, women’s agency, as well as breastfeeding knowledge, attitudes, and practices. ResultsIn the intervention LGA, the rate of early initiation of breastfeeding had increased by 10.4 percentage points more than in the comparison LGA, even after controlling for child, mother and household level covariates (P < 0.001). Similarly, the net adjusted change in the exclusive breastfeeding rate was 10.8 percentage points in favor of the intervention LGA (P < 0.01). No significant changes were observed on other IYCF practices ConclusionsThe Package was effective at improving early breastfeeding initiation and exclusive breastfeeding. Other IYCF practices that are more sensitive to economic downturns and food prices may require a more sustained multi-sectoral investment with greater saturation. Additional research studying the impact of the Package, when implemented at scale in alternative contexts and after longer periods of implementation, is needed. Funding SourcesThis evaluation was funded by USAID (Cooperative Agreement AIDOAA-A-11-00031 (SPRING)), and by funding and technical support from the UNICEF with leadership of the Federal Ministry of Health of Nigeria.

Determinants of Infant and Young Child Feeding Practices of Rural Farming Households in Bauchi State, Nigeria (P18-108-19)

ObjectivesPoor infant and young child feeding practices (IYCF) can undermine the nutrition and health status of individuals in vulnerable households. Bauchi state, Nigeria, has the fourth highest prevalence of child malnutrition in the country, yet over 80% of the population is involved in agriculture. This study evaluated the predictors of IYCF practices of rural farming households in Bauchi state, Nigeria MethodsThis study was conducted in six Local Government Areas of Bauchi state. A total of 720 mothers and fathers were selected from households with at least one child under 5 years. Household socio-demographic features and information on infant and young child feeding (IYCF questionnaire of the World Health Organization), were collected using Open Data Kit Collect, a mobile app. Descriptive statistics were computed, and relationships between variables were evaluated using Spearman’s rank correlation and multivariate analyses. ResultsThe mean age (27.2 ± 7.2 years vs. 41.7 ± 10.6 years) and monthly income (∼$4.85 vs. ∼$39.88) of the mothers and fathers respectively, were different (P < 0.05). Twenty-six (3.9%) mothers and 165 (23%) fathers had completed secondary or post-secondary education. The rates of exclusive (20.7%) and timely initiation (29.0%) of breastfeeding were poor. Only 26.0% of children 6–23 mo. received the minimum acceptable diet (minimum dietary diversity and meal frequency). Mothers’ education was positively correlated with the practice of exclusive breastfeeding, while continued breastfeeding at 15 months of age was positively associated with fathers’ income (P < 0.05). Both mothers’ and fathers’ income and education were positively associated with dietary diversity (P < 0.05). Low income and poor education of mothers were negative predictors of timely initiation of breastfeeding, while mothers’ occupation, household size, and the number of children per household were negative predictors of dietary diversity (P < 0.05). ConclusionsInfant and young child feeding practices in the rural farming area were influenced by parents’ income and education, and were below optimum levels needed to prevent malnutrition. Funding SourcesThis research was funded by Oxfam LINE Project, Nigeria. Supporting Tables, Images and/or Graphs▪▪▪▪

Assessment of under nutrition using composite index of anthropometric failure among under five children of tribal population

Background: Under nutrition is one of the most imperative problems among children that needed to be addressed in the realm of public health. Undernourished children cannot maintain natural biological abilities, such as growth, recuperating from ailments, learning and physical development. Poor feeding practices along with illnesses like diarrhoea, pneumonia, helminthic infections etc. are major determinants of under nutrition in India. The tribal populations in India are identified to be the autochthonous people of the land thereby being one of the major sufferers of under nutrition. This study aimed at finding out the prevalence of under nutrition among under-five children in tribal population in Tiruchirappalli district of Tamil Nadu.Methods: This community based cross-sectional analytical study was done among Malayali Tribes population of Puthur village, Pachamalai Hills, Trichy to determine the prevalence of under-nutrition using CIAF and WHO Z scoring system and its risk factors by multivariate analysis.Results: Out of 100 children, about 85% were undernourished as per CIAF criteria. In the Multivariate analysis, children of employed mother and children who were not given exclusive breast feeding were associated with Under nutrition which was statistically significant (p&lt;0.05).Conclusions: CIAF could be considered as a better measure than any other single index to identify the problem in the community. The study also emphasizes the significance of proper IYCF practices among employed mothers and improvement of MCH services in Tribal population during antenatal and immediate postnatal period to bring down the prevalence of under nutrition.

A cross sectional study on optimal infant and young child feeding practices with reference to WHO indicators in a rural area of Puducherry

Background: Optimal infant and young child feeding practices (IYCF) are essential to address the increasing burden of malnutrition and for the overall development of the children. The present study was conducted to estimate the proportion of optimal infant and young child feeding practices among rural children aged 0 to 23 months and study the associated socio demographic factors.Methods: A community based cross-sectional study was conducted among 360 children in the age group of 0 to 23 months in a rural field practice area of a medical college in Puducherry. Data on IYCF practices were collected using a standardized tool developed by WHO. Core and optional IYCF indicators were calculated. Chi-square test and Fishers’ exact test were used as tests of significance.Results: Almost 88.0% of infants were initiated early on breastfeeding and 90.8% were exclusively breastfed for six months. Children who were continuously breastfed at one year and two years were 77.4% and 22.4% respectively. About 75.0% were introduced with solid or semisolid foods at 6 to 8 months of age. Among children aged 6 to 23 months, 77.3% had the recommended minimum dietary diversity, 81.3% had the minimum meal frequencies, while 57.7% received the minimum acceptable diet and only 39.4% consumed iron rich foods. Gender was significantly associated with the practice of continued breastfeeding at one year, adequate minimum dietary diversity and minimum meal frequency.Conclusions: The core and optional IYCF indicators were acceptably good in the initial six months of life but thereafter showed suboptimal levels, which should be emphasized among the mothers or primary care givers.

Infant and young child feeding practices in two provinces of Afghanistan: results from two rounds of large country-lot quality assurance sampling surveys

Background: As per NNS 2013, about 58% of the infants aged 0-5 months were exclusively breastfed. The data also shows that only 41% infants 6-8 months of age were introduced solid, semi-solid and soft foods. Further only 28% of children aged 6-23 months received foods from four or more food groups during last 24 hours preceding the survey. Suboptimal IYCF practices are therefore considered to be an important contributor to the high rates of under nutrition in Afghanistan. The program monitoring at two time points was conducted to inform the program about the current status of the program activities and any course correction required. It was also meant to inform the government and other stakeholders on the feasibility of program strategies in improving IYCF practices and recommendations for scale-up programs.Methods: The program monitoring was performed before and after the (IYCN) program roll out in Wardak and Laghman provinces of Afghanistan. To understand and monitor the status of process and program indicators, a Large Country-Lot Quality Assurance Sampling (LC-LQAS) study design was adopted.Results: Minimum acceptable diet was observed to be 54% (95% CI: 46%, 61%) in the second round, which was 44% (95% CI: 35%, 53%) in the first round.Conclusions: Minimum acceptable diet among the children of age group 6-23 months was found to be consistently doing well in both the rounds. LC-LQAS was found to be an apt method to estimate the IYCN indicators at time points with low resource use.

Study of IYCF Indicators on Practices and Knowledge of Mothers in Rural Areas

The IYCF practices have a great impact on the physical and mental development of the child. The objective of this study was to study the knowledge and compliance to IYCF practices along. The lactating mothers with the children in the age group 0-23 months were studied. Mother’s knowledge level is average about IYCF components; 55.5% mothers have proper knowledge about IYCF practice. 70.9% mothers have knowledge on initiation of breast-feeding within an hour of birth while 50.7% of the mothers initiated breast-feeding within an hour after birth. Exclusive breast-feeding for 6 months was practiced by the mothers of 69.1%. 69.1% of the mothers told that complimentary feeding should start at 6 months.64.6% of the mother will continue breast fed for 2 years of infants and 72.5% mothers practicing age appropriate meal frequency but only 37.3 children have minimum diet diversity.

Determinants of infant and young child feeding practices by mothers in two rural districts of Sindh, Pakistan: a cross-sectional survey

BackgroundInfant and young child feeding (IYCF) practices during the first two years of life are important for the growth and development of a child. The aim of this study was to assess IYCF practices and its associated factors in two rural districts of Pakistan.MethodsA cross-sectional study was conducted in two rural districts of Sindh province, Pakistan as part of a stunting prevention project between May and August 2014. A standard questionnaire on IYCF practices recommended by World Health Organization was used to collect information from 2013 mothers who had a child aged between 0 and 23 months.ResultsOnly 49% of mothers initiated breastfeeding within one hour of birth. Thirty-seven percent of mothers exclusively breastfed their infants for six months. Seventy-percent mothers introduced complementary feeding at 6–8 months of age. Eighty-two percent of mothers continued breastfeeding for at least one year and 75% for at least two years of age. IYCF practices were not significantly different for boys and girls in the study area. Being an employed mother (AOR 2.14; 95% CI 1.02, 4.51) was positively associated with the early initiation of breastfeeding. Children who were born at a health facility (AOR 0.65; 95% CI 0.50, 0.84) and were aged six to eleven months (AOR 0.70; 95% CI 0.54, 0.90) were less likely to be have an early initiation of breastfeeding. Mothers aged 25 to 29 years (AOR 1.83; 95% CI 1.05, 3.18), being literate (AOR 1.79; 95% CI 1.15, 2.78), and higher income (AOR 10.6; 95% CI 4.40, 25.30) were more likely to have an improved dietary diversity. Being an employed mother (AOR 2.18; 95% CI 1.77, 4.03) and higher income were more likely to have minimum acceptable diet (AOR 9.7; 95% CI 4.33, 21.71).ConclusionIYCF practices were below the acceptable level and associated with maternal age, maternal illiteracy, unemployment, and poor household wealth status. Emphasis should be given to improve maternal literacy and reduction in poverty to improve IYCF practices.