Recommended Infant Feeding Practices Research Articles

Infant Feeding for Persons Living With and at Risk for HIV in the United States: Clinical Report.

Pediatricians and pediatric health care professionals caring for infants born to people living with and at risk for HIV infection are likely to be involved in providing guidance on recommended infant feeding practices. Care team members need to be aware of the HIV transmission risk from breastfeeding and the recommendations for feeding infants with perinatal HIV exposure in the United States. The risk of HIV transmission via breastfeeding from a parent with HIV who is receiving antiretroviral treatment (ART) and is virally suppressed is estimated to be less than 1%. The American Academy of Pediatrics recommends that for people with HIV in the United States, avoidance of breastfeeding is the only infant feeding option with 0% risk of HIV transmission. However, people with HIV may express a desire to breastfeed, and pediatricians should be prepared to offer a family-centered, nonjudgmental, harm reduction approach to support people with HIV on ART with sustained viral suppression below 50 copies per mL who desire to breastfeed. Pediatric health care professionals who counsel people with HIV who are not on ART or who are on ART but without viral suppression should recommend against breastfeeding. Pediatric health care professionals should recommend HIV testing for all pregnant persons and HIV preexposure prophylaxis to pregnant or breastfeeding persons who test negative for HIV but are at high risk of HIV acquisition.

Feasibility, acceptability and lessons learned from an infant feeding intervention trial among women living with HIV in western Kenya

BackgroundThe World Health Organization recommends mothers breastfeed exclusively for the first six months of their infant’s life. However, women living with HIV in low resource settings face many barriers to recommended infant feeding practices such as fear of HIV transmission and perceived milk insufficiency. Moreover, current support for breastfeeding in this context is often insufficient to overcome these barriers. To support women’s infant feeding experience, we tested a personalized infant feeding support program among perinatal women living with HIV in Kenya.MethodsSupporting Healthy Mothers is a theory and evidence-based multilevel intervention designed to address the mental health burden associated with financial and food insecurity and provide personalized support for optimal infant feeding postpartum. As part of the Supporting Healthy Mothers intervention feasibility trial, between February 23, 2022 and November 9, 2022, twenty mothers received five personalized infant feeding support sessions delivered by a local professional lactation specialist from pregnancy until three months postpartum. Through detailed observations of these sessions, clinical notes and repeated team discussions, we aimed to describe and provide a limited evaluation of these sessions. We identified the strengths and limitations of the lactation support sessions as well as areas for future development.ResultsParticipation in the sessions was high and at three months postpartum all participants reported exclusive breastfeeding as recommended despite experiencing a myriad of challenges. Having face-to-face and frequent early postpartum sessions, being available to field participant concerns between sessions and measuring infant weights at each session were key strengths. Continuing sessions beyond three months postpartum and incorporating family planning and general maternal health counseling topics would enhance these supportive sessions.ConclusionsThe personalized professional infant feeding support sessions were highly acceptable and feasible to implement. In-person sessions, in a clinic setting provided opportunities to evaluate and adjust breastfeeding technique and led to successful exclusive breastfeeding practice. Future interventions should consider integrating with other perinatal care services and offering support on demand and immediately postpartum.Trial registrationSupporting Healthy Mothers was registered with ClinicalTrials.gov Protocol Registration and Results System, posted on February 2, 2022. Identifiers: NCT05219552 Unique Protocol ID: K23MH116807.

Pathways linking social support, self-efficacy, and exclusive breastfeeding among women in northern Uganda

ABSTRACT Despite improvements in infant feeding practices over the past two decades, the prevalence of exclusive breastfeeding (EBF) is below global targets. Social support can create an enabling environment for recommended infant feeding practices such as EBF, but the types of social support most important for sustained EBF and their potential mechanisms of action have not been thoroughly characterized. We therefore aimed to assess the relationship between EBF-specific social support, EBF self-efficacy, and EBF at 1 and 3 months among postpartum women in northern Uganda. Women (n = 238, 36.2% living with HIV) were recruited during pregnancy. EBF, social support, and EBF self-efficacy were assessed at 1 and 3 months postpartum. Path analysis was used to assess relationships between these factors. Most mothers exclusively breastfed to 1 (80.8%) and 3 months postpartum (62.9%). EBF-specific, but not general, social support differed by EBF status. EBF-specific social support was associated with higher odds of EBF, which was almost fully mediated by EBF self-efficacy. That is, there was evidence that social support primarily influences EBF through its association with self-efficacy. In sum, EBF-specific social support and self-efficacy likely promote EBF and are modifiable factors that can be intervened upon.

Mothers' feeding practices among infants (4-12 months) and associated factors: a cross-sectional study in Saudi Arabia.

A global target of increasing exclusive breast-feeding (EBF) to at least 50% by the year 2025 was set by the WHO for infants under 6 months. The lowest prevalence in the world was found in the Eastern Mediterranean region in 2010-18 and little is known about the status of mothers' feeding practices in Saudi Arabia. The present study aimed to assess mothers' actual feeding and weaning practices used with their infants by the mothers' different age groups. The present study was conducted among 247 mothers of infants aged 4-12 months who were attending public well-baby clinics. Quantitative data were obtained by nutritionists using an electronic semi-structured questionnaire about mothers' feeding practices. Only 5·3% of mothers engaged in EBF, 44·9% breast-fed their infants after an hour of birth, while 92·7% of infants had ever been breast-fed. The average intent/plan to continue breast-feeding was 4·9(±3·1) months. Younger mothers introduced weaning food around 4 weeks earlier than older mothers (mean differences were -0·4, 95% CI -0·71, -0·13; P = 0·031). A total of 64·3% of infants received complementary feeding before completing 17 weeks. Maternal age group and delivery mode were the only factors associated with the early introduction of complementary feeding. A total of 69·2% of the mothers believed that 'it is a good time' and 61·1% felt that 'infants are hungry and need other sources of food'. Online sources and family advice were the top sources of information on mothers' feeding practices. Provision of professional advice about EBF and optimal weaning practices are significant areas for improvement in terms of compliance with recommended infant feeding practices.

Infant feeding practices and its associated factors among HIV positive mothers attending public health institutions at Gondar Town, Northwest Ethiopia, 2019: An institutional based cross-sectional study

IntroductionFour out of ten infants born become infected with the human immunodeficiency virus during pregnancy, childbirth and breastfeeding in developing countries. Several factors are responsible for these, including practising mixed feeding that contributes to mother-to-child transmission and is unpreventable. Besides, it can cause diarrhoea, pneumonia and malnutrition, leading to morbidity and mortality. ObjectivesThis study aimed to assessinfant feeding practices and associated factors among human immunodeficiency virus-positive mothers attending public health institutions in Gondar Town. MethodsAn institutional-based cross-sectional study was conducted. A census method was employed. Data were collected by using a structured questionnaire. The data were entered by Epi Info version 7 and analyzed with SPSS version 20. The data were analyzed by using binary logistic regression. Those variables with a P-value of ≤ 0.05 were considered significantly associated with infant feeding practice. ResultThe overall infant feeding practice was 94 % [95CI (91.4–96.3)]. Being in the age category of 18–24 years [AOR = 2.34,95 % CI(1.26–10.56)], rural residence [AOR = 8.08, 95 %CI (2.45–21.62)], having social support [AOR = 1.82, 95 %CI (1.43–6.55)], disclosing HIV status [AOR = 4.67, 95 %CI (1.67–20.88)], having no pregnancy-related problem [AOR = 2.61, 95 %CI(1.23–7.96)] were significantly associated. Conclusion and recommendationIn the current study, recommended infant feedingpracticeswereoptimal. Age, place of residence, social support, disclosure of HIV status, and absence of pregnancy-related problems during pregnancy were significantly associated with outcome variables. Mothers should follow recommended infant feeding practices andpayspecialattentiontourbandwellers.

A systematic review and meta-analysis on adoption of WHO-recommended infant feeding practices among HIV positive mothers in Ethiopia

BackgroundThe prevalence of the World Health Organization (WHO) recommended infant feeding practices for HIV exposed infants is low in developing countries. There is no nationwide representative study was done in Ethiopia. Therefore, this study aimed to assess the pooled prevalence of WHO-recommended infant feeding practices among HIV-positive mothers in Ethiopia.MethodsEMBASE, PubMed, Google Scholar, CINHAL, Web of Science, Cochrane library, and hand searches of references were extensively searched to find out the primary articles. This study was included in all primary articles published in peer review journals regarding the recommended infant feeding practices in Ethiopia. Reviewers were used a standardized Microsoft Excel format to extract the data and analyzed it with Stata 11 version software. The pooled prevalence of recommended infant feeding practices among HIV exposed infants was estimated by a random-effect model. The sources of variation between the studies were identified by the I2 statistics test. Furthermore, the source of heterogeneity was checked by subgroup and meta-regression analyses. Sensitivity analysis was also carried out for included articles to identify extreme values that affect the outcome of pooled results.ResultsA total of twenty-one articles were included in this study. The random effect pooled prevalence of WHO-recommended infant feeding practices in Ethiopia was 82.76% (95% Confidence Interval [CI]: 75.4, 90.11) with the heterogeneity of I2 = 93.7 with a value of p < 0.001. The subgroup analysis result showed that the highest prevalence of WHO-recommended infant feeding practices was observed in the retrospective cohort study design, 89.45%, and the lowest prevalence was found in cross-sectional studies, 80.67%. Mothers who disclosed their HIV serostatus to their spouses OR = 2.88(2.27, 3.66) and attended antenatal care visits OR = 4.62(3.13, 6.83) were more likely to follow the WHO-recommended infant feeding practices than their counterparts.ConclusionTwo out of ten HIV exposed infants received mixed feeding in Ethiopia. Health professionals should support and counsel HIV positive mothers to disclose their HIV serostatus to their spouses and advertisements in general or community health workers can get this message out to encourage using antenatal care services during the pregnancy period were recommended to increase the adoption of WHO recommended infant feeding practices and decrease their infant’s risk of morbidity, including HIV infection.

Short inter-pregnancy interval: why is it still high among women in Dar es Salaam?

Introductionin Tanzania, for the past decade, there has been a rising trend of women with short inter-pregnancy interval (IPI) (16% to 19%). Short IPI is associated with poor maternal and neonatal outcomes. We aimed to determine the factors associated with short IPI among women attending antenatal clinic (ANC) at Mnazi Mmoja Hospital, Dar es Salaam, Tanzania.Methodsa cross-sectional study was conducted in September 2018 at Mnazi Mmoja hospital among women receiving ante-natal care. A total of 530 women were included in the analysis. Analysis was conducted through SPSS version 24 computer program using descriptive analyses to determine the IPI and characteristics thereof, and logistic regression analysis to examine factors associated with IPI among pregnant women. Associations with a p-value < 0.05 were considered statistically significant.Resultstwenty-two percent of the women attending ANC in Mnazi Mmoja hospital had short IPI. Short IPI was associated with young (<25years) age (AOR=2.67, 95% CI=1.23-5.79); non-use of a contraceptive method (AOR=2.05, 95%CI=1.22-3.45); breastfeeding for less than 6 months (AOR=3.45, 95% CI=1.17-10.13) and having an antecedent dead child at the time of index conception (AOR=3.38, 95% CI=1.15-9.93).Conclusionabout 1 in every 5 women attending ANC in Dar es Salaam had a short IPI. Addressing short IPI will complement the government´s efforts to improve maternal indicators in Tanzania and areas with similar contexts. Such efforts should emphasize in adherence to recommended infant feeding practices, women at a younger reproductive age group, those with a history of pregnancy loss, and strengthening contraception use among women of reproductive age.

The Relationship Between Nutritional Knowledge in Mothers and Recommended Infant Feeding Practices in Children 0–24 Months in the Lubombo region of eSwatini

Abstract Objectives The purpose of this study was to determine if nutritional knowledge is associated with recommended infant feeding practices among mothers in the Lubombo region of eSwatini. Methods In April 2019, we conducted a cross-sectional survey to assess knowledge and practices among mothers (18–49 years) with at least one young child (0–24 months) in the Siphofaneni Tinkhundla (Administrative subdivision) of the Lubombo region of eSwatini. Community health workers invited mothers to a central meeting location were quantitative data was collected through one-on-one interviews. The questionnaire was broken up into four sections: 1) Sociodemographic, 2) Household Food Security Assessment, 3) Nutrition Practices, and 4) Nutrition Knowledge. Mothers were 18–48 years of age (mean: 26.95; SD: 6.5). We used logistic and multivariate regression to measure the association between breastfeeding practices and nutrition knowledge, and the association between diet diversity and nutrition knowledge. Results A total of 164 mothers completed the questionnaire. Participants were 18–48 years of age (mean: 26.95; SD: 6.5). Their children were 0–24 months of age (mean: 10.4; SD: 6.3). The total nutrition knowledge score ranged from 8 to 44 (mean: 21.8; SD: 6.14). Approximately 92% had heard of exclusive breastfeeding; of those mothers, 87% were able to properly explain the practice. Ninety three % of infants 0–5 months were breastfed, but less than half of those were exclusively breastfed. Exclusive breastfeeding practices were not significantly associated with nutrition knowledge. The mean for the Minimum Diet Diversity score was 3.7 (SD 1.38). Diet Diversity scores and nutrition knowledge were significantly associated (P = .011) after adjusting for infant sex, maternal education and household size. Conclusions Education alone may not be sufficient for the adoption of recommended infant feeding practices among mothers. Future research should explore sociocultural and economic factors that may play a role in influencing recommended infant feeding practices. Funding Sources This study was funded by the Fulbright U.S. Student Program.

Attitude Towards Infant Feeding Among Health Workers in Calabar, Nigeria

<i>Background</i>: Effective practice of recommended infant feeding methods is key to child survival strategy in sub-Saharan Africa. Attitude towards infant feeding has been shown to be a significant determinant of practice. For health workers, attitude may determine the propensity to counsel mothers towards adoption and adherence to recommended infant feeding practices. This study aimed at assessing health workers’ attitude towards infant feeding. <i>Methods</i>: This was a cross-sectional descriptive study carried out in April 2019. Leslie Kish formula was used to recruit 225 health workers in Calabar to participate in the study. Ethical approval was obtained from the Cross River State Research and Health Ethics Committee. A validated self-administered IOWA infant feeding attitude scale was utilized in this study. Using the scale, attitude was categorized as positive for breastfeeding, neutral, and positive for formula feeding. Data was analysed using SPSS version 21.0, and p-value was set at 0.05. <i>Result</i>: Two hundred and twenty-five respondents completed the questionnaire. Female: male ratio was 1:0.24, the commonest age group (43.1%) was 31 to 40 years old, and 60% of respondents were nurses. Most respondents (52.9%) had neutral attitude, while 44.0% had positive attitude for breastfeeding, and 3.1% had positive attitude towards formula feeding. Age group, religion, profession, and ethnicity did not significantly influence attitude towards breastfeeding (p>0.05). <i>Conclusion</i>: Neutral attitude towards breastfeeding was common among health workers. This has implications for successful implementation of the recommended breastfeeding initiative towards improvement in child survival especially in resource-poor settings. Regular re-training of health workers is needed, especially through continuing educational effort by the various health professional bodies.

Factors Associated with Compliance with World Health Organization-Recommended Infant-Feeding Practices by Mothers with HIV Infection in Northwest Ethiopia

The World Health Organization has recommended either exclusive replacement feeding or exclusive breastfeeding options for HIV-exposed infants for the first 6 months of life. The purpose of this study was to assess the factors associated with noncompliance with these recommendations among a population of HIV-infected mothers of young infants in Bahir Dar City, Amhara Regional State, Ethiopia. An institutional based cross-sectional study was conducted from March 1 to May 15, 2018. A structured interview was conducted with 213 HIV-positive mothers. Descriptive statistics were used to show the frequency distributions of factors associated with noncompliance with World Health Organization-recommended infant-feeding practices. Both bivariate and multivariate logistic regression analyses were performed to identify the variables predictive of infant-feeding practices. All mothers were undergoing antiretroviral therapy. Only 83.5% claimed to be following World Health Organization-recommended infant-feeding practices. Bivariate analysis showed that high school or greater educational status [Adjusted odds ratio (AOR) = 3.6 (95% CI = 4.2, 9.5)], having attended antenatal visits [AOR = 6.7 (95% CI = 5.6, 10.9)] and postnatal follow-up visits [AOR = 6.9 (95% CI = 4.2, 9.3)], and disclosure of HIV status to their spouse [AOR = 8.2 (95% CI = 6.2, 10.7)] were associated with adherence to recommended infant-feeding practices. The prevalence of recommended infant feeding practices among HIV-exposed infants in the study area was suboptimal compared with the ≥90% recommended by the World Health Organization. Higher educational status of the mother, antenatal and postnatal follow-ups, and disclosure of HIV status to spouses were predictors of adherence to the recommended infant-feeding practices. Although not yet proven in a prospective clinical trial, providing more education for women, improving attendance at antenatal and postnatal follow-up visits, encouraging the disclosure of HIV status to spouses, and educating mothers about proper infant-feeding options during follow-up visits may all be useful to increase compliance.

The participation of fathers in breastfeeding process: knowledge, beliefs, and practices in Kisumu, Kenya

Fathers' support is an essential component in ensuring success in improving infant feeding practices which have the overall impact of reducing infant mortality rates by 19%. Fathers are usually not targeted with information on infant feeding at the health facility or community level. Fathers have been identified as lacking knowledge, hence, not able to support the recommended infant feeding practices. The study was conducted in Kisumu East Sub County, Kisumu County, which was selected because of the high infant mortality rate in the region. A nutrition education intervention strategy was employed targeting the fathers with information on breastfeeding and complementary feeding through an experimental study in which 290 father-and-mother to be paired were recruited. There was randomization of study participants into either intervention group (145 pairs) where nutrition education was given, or control group (145 pairs) where nutrition education was not given. Recruitment was of all the women who were 6 months pregnant and attending antenatal clinic at Kisumu County Hospital between January-April 2016. The women gave the contacts of the father-to-be, which enabled follow- up to reach the fathers. Quantitative data were collected from the fathers through a pre-tested structured questionnaire that explored their knowledge of breastfeeding pre-intervention. Qualitative data were collected through focus group discussions to assess knowledge, beliefs, and practices on breastfeeding pre-intervention and post-intervention (9 months later).Results did not show any significant differences in the knowledge level on breastfeeding of fathers in the intervention and control group pre-intervention (p>0.05).Significant differences were observed post-intervention on knowledge levels on initiation of breastfeeding within an hour of birth (p =.01), continuation of breastfeeding for 2 years and beyond (p =.02) and exclusive breastfeeding (p =.02)and group affiliation. A Wilcoxon signed-rank test showed a statistically significant change in knowledge of the fathers in the intervention after receiving the nutrition education sessions (Z = -10.181, p = 0.000). The group discussions showed that fathers largely saw their role as the provision of food for maternal and infant feeding pre-intervention in both groups, while fathers reported additional roles postintervention in the intervention group including being a source of motivation and information to the mother. In conclusion, fathers have low knowledge levels on breastfeeding process which in turn affects their influence on breastfeeding practice. Nutrition education involving the fathers increases their knowledge on breastfeeding and influence to breastfeeding practice ultimately contributing to improved breastfeeding practices. Key words : Father, support, inclusion, breastfeeding, nutrition education, knowledge, Kisumu, Kenya

Infant feeding practice and associated factors among HIV positive mothers in Debre Markos Referral Hospital East Gojam zone, North West Ethiopia.

IntroductionThe dilemma posed between lifesaving benefit and risk of transmission through breast feeding complicates infant feedings among communities grossly affected by HIV/AIDS. According to the world health organization’s guideline which was revised in 2010, exclusive breast feeding and exclusive replacement feeding are the recommended infant feeding practices for HIV positive mothers. The aim of this study was to assess infant feeding practice and associated factors among HIV positive mothers in Debre Markos Referral Hospital, North West Ethiopia.MethodsAn institutional based cross sectional study was conducted from May to September 2013. A Randomly selected 260 HIV positive mothers were included. The data were collected by using a pretested and structured questionnaire. Bivariate and multivariate analysis were performed to check association and to control confounders.ResultsFrom a total of 260 HIV positive mothers, 85.8% of them were feeding their children based on the recommended feeding way of infant feeding practice with the remaining percentage 14.2% were practicing mixed feeding. In multivariate analysis mothers attending high school and above AOR = 5.3 [95% CI = 1.25-22.1], having antenatal care follow up AOR = 5.5 [95% CI = 1.5-20.16], being on anti-retro viral therapy AOR = 6.5 [95% CI = 1.88-22.51] and disclosure of HIV status AOR = 7.1 [95% CI = 1.26-39.76] were found to be independently associated with infant feeding practice.ConclusionThis study revealed that large proportion of HIV positive mothers had followed the recommended infant feeding practice and significantly high number of mothers had practiced mixed feeding. Educating mothers, increasing ANC utilization, counseling mothers to start ART, encouraging and supporting mothers to disclose their HIV status were recommended.

Prenatal Anxiety and Infant Feeding Outcomes: A Systematic Review.

Prenatal anxiety may negatively affect infant health in multiple domains, including infant feeding. However, the relationship between prenatal anxiety and infant feeding is not well understood. Given the benefits of recommended infant feeding practices, clarifying this relationship is important. This review was conducted to examine the relationship between prenatal anxiety and infant feeding outcomes. Electronic searches were performed in relevant databases. A hand search of selected journals and reference lists of included articles was then conducted. All studies were considered that provided information related to infant feeding outcomes and anxiety during pregnancy. Quality assessment and data extraction were conducted by 2 reviewers; 99 studies were identified, of which 6 were eligible. No associations were found between prenatal anxiety and breastfeeding initiation or breastfeeding in any quantity. However, relationships between high levels of prenatal anxiety and a reduction in both breastfeeding intention and breastfeeding exclusivity were identified. The review was limited by the small number of studies included. Sample sizes lacking power and heterogeneous measures and definitions all significantly affected the comparability of findings. It is concluded that there is insufficient evidence to clarify the relationship between prenatal anxiety and infant feeding outcomes.

Infant Feeding Practices of Emirati Women in the Rapidly Developing City of Abu Dhabi, United Arab Emirates.

Rapid economic and cultural transition in the United Arab Emirates (UAE) has been accompanied by new challenges to public health; most notably a rapid rise in chronic disease. Breastfeeding is known to improve health outcomes in adulthood, is associated with reduced risk of developing chronic disease, and is therefore an important public health issue for this rapidly increasing population. Factors associated with infant feeding practices were examined in a cohort of 125 Emirati women and their infants, with data collected at birth and 3, 6 and 15 months postpartum by questionnaires and interviews. Participants were recruited in the Corniche Hospital, the main maternity hospital in the city of Abu Dhabi. Factors affecting the duration of breastfeeding and the introduction of complementary foods were investigated using univariate and multivariate statistics. Recommended infant feeding practices, such as exclusive breastfeeding for the first six months of life and timely introduction of appropriate complementary foods, were poorly adhered to. Factors implicated in early cessation of breastfeeding included: time to first breastfeed, mother’s education level, employment status and early introduction of complementary foods.

Factors associated with Early Initiation of Breastfeeding in Western Nepal.

The initiation of breastfeeding within one hour of birth has numerous nutritional and immunological benefits and has been found to reduce neonatal mortality. This community-based prospective cohort study aimed to report the rate of, and factors associated with, early initiation of breastfeeding in Western Nepal. The rate of early initiation of breastfeeding was reported, and associations between early initiation and independent variables were tested by Chi-square test, followed by multiple logistic regression. Of the 735 mother-infant pairs, a total of 310 (42.2%) reported early initiation. Mothers who were assisted by traditional attendants during childbirth, delivered by caesarean section, from ethnically disadvantaged families and had delivered low birth weight infants, were less likely to initiate breastfeeding early whereas the mothers who were from the poorest families and did not introduce prelacteal feeds to their infants were more likely to initiate breastfeeding within the first hour. Skills-training to support breastfeeding as part of the training of skilled birth attendants and other health workers is likely to promote recommended infant feeding practices.

Determinants of complementary feeding practices among Nepalese children aged 6–23 months: findings from demographic and health survey 2011

BackgroundThe adoption of inappropriate feeding practices is one of the reasons for under nutrition in Nepal and elsewhere. The objective of this study was to describe the rate of and identify the factors associated with providing the World Health Organization (WHO) recommended infant feeding practices of minimum dietary diversity, minimum meal frequency and minimum acceptable diet in Nepal amongst young children between 6–23 months in 2011.MethodsData from Nepal Demographic and Health Survey (NDHS) 2011 was used. Prevalence of minimum dietary diversity, minimum meal frequency and minimum acceptable diet was obtained by using descriptive statistics. A Chi-square test (χ2) followed by multiple logistic regression analyses were used to determine the adjusted effect of potential factors on the outcome variables.ResultsOf the 698 children aged 6–23 months; while 535 (76.6%) received the minimum meal frequency, only 212 (30.4%) children received the minimum dietary diversity, and 185 (26.5%) received an acceptable diet. Children of older mothers (>35 years); educated mothers and fathers; and mothers from all the development regions except the Mid-western region were more likely to have been provided with the recommended dietary diversity. Children of mothers who had attended ≥4 antenatal visits and who lived in the Eastern region were more likely to provide their child with the recommended meal frequency. Children of mothers, who attended ≥ 4 antenatal visits, were educated and whose fathers had at least a secondary education were more likely to meet the recommended acceptable diet standards.ConclusionYoung children aged less than two years in Nepal are at risk for not meeting the WHO recommended infant feeding standards given that only about one in three children were provided with the recommended dietary diversity and acceptable diet. This finding suggests that the majority of children are at risk of under nutrition. An appropriate mix of health education and food supplements could be a feasible option for Nepal to improve the number of children who meet the recommended infant feeding guidelines, reduce under nutrition and improve the survival rates of young children.

Food insecurity is associated with attitudes towards exclusive breastfeeding among women in urban Kenya.

This study aimed to document whether food insecurity was associated with beliefs and attitudes towards exclusive breastfeeding (EBF) among urban Kenyan women. We conducted structured interviews with 75 human immunodeficiency virus (HIV)-affected and 75 HIV-status unknown, low-income women who were either pregnant or with a child ≤24 months and residing in Nakuru, Kenya to generate categorical and open-ended responses on knowledge, attitudes and beliefs towards EBF and food insecurity. We facilitated six focus group discussions (FGD) with HIV-affected and HIV-status unknown mothers (n = 50 women) to assess barriers and facilitators to EBF. Of 148 women with complete interview data, 77% were moderately or severely food insecure (FIS). Women in FIS households had significantly greater odds of believing that breast milk would be insufficient for 6 months [odds ratio (OR), 2.6; 95% confidence interval (95% CI), 1.0, 6.8], that women who EBF for 6 months would experience health or social problems (OR, 2.7; 95% CI, 1.0, 7.3), that women need adequate food to support EBF for 6 months (OR, 2.6; 95% CI, 1.0, 6.7) and that they themselves would be unable to follow a counsellor's advice to EBF for 6 months (OR, 3.2; 95% CI, 1.3, 8.3). Qualitative analysis of interview and FGD transcripts indicated that the maternal experience of hunger contributes to perceived milk insufficiency, anxiety about infant hunger and a perception that access to adequate food is necessary for successful breastfeeding. The lived experience of food insecurity among a sample of low-income, commonly FIS, urban Kenyan women reduces their capacity to implement at least one key recommended infant feeding practices, that of EBF for 6 months.

Effects of infant feeding practice on weight gain from birth to 3 years

Objective:The influence of infant feeding practices on weight gain during childhood remains unresolved, with few studies adjusting appropriately for confounding factors. This study examined the effect of breastfeeding initiation, breastfeeding...

Special Supplemental Nutrition Program for Women, Infants, and Children and Infant Feeding Practices

This study examined the association between participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and adherence to 4 American Academy of Pediatrics recommendations on infant feeding. We used data from the Early Childhood Longitudinal Study-Birth Cohort, which is nationally representative of children born in 2001. We estimated regression models to assess relationships between program participation and adherence to American Academy of Pediatrics recommendations on exclusive breastfeeding and the introduction of infant formula, cow's milk, and solid foods. Regression results indicated that WIC participation was associated with a 5.9-percentage point decrease in the likelihood of exclusive breastfeeding for > or = 4 months and a 1.9-percentage point decrease in the likelihood of exclusive breastfeeding for > or = 6 months. Program mothers were 8.5 percentage points less likely than nonparticipants to adhere to the American Academy of Pediatrics recommendation to delay introduction of infant formula until month 6. Program mothers were 2.5 percentage points more likely than nonparticipants to delay the introduction of cow's milk until month 8. Program participants were 4.5 percentage points less likely than nonparticipants to delay the introduction of solid foods for > or = 4 months. However, the difference between participants and nonparticipants disappeared by month 6. Results suggest that, although program participants are less likely to breastfeed exclusively than eligible nonparticipants, program-provided infant formula is an important option for mothers who do not breastfeed exclusively. The program faces the challenge to encourage breastfeeding without undermining incentives to follow other recommended infant feeding practices. Recent changes proposed to the food packages by the US Department of Agriculture Food and Nutrition Service are consistent with the goal of increasing adherence to recommended infant feeding practices among participants.

Infant feeding practices and chronic child malnutrition in the Indian states of Karnataka and Uttar Pradesh

As measured by degree of stunting, close to half of India’s children suffer from chronic malnutrition and about a quarter from severe chronic malnutrition. Data from the 1998–1999 National Family Health Survey (NFHS) are analysed to assess whether recommended infant feeding practices help to alleviate the prevalence of stunting. The evidence supports some recommended practices, including the advice that mother not squeeze the colostrum from her breasts, not use a feeding bottle with a nipple, exclusive breastfeeding for the first 4–6 months and feeding supplementary foods (solids and mushy foods) at about 7 months, and suggests that, for some children, better feeding practices could reduce the prevalence of severe stunting by up to 30%. The paper also examines a range of other issues related to stunting—whether medical supplementations and inoculations have an effect, whether mothers more actively involved in health decisions have less stunted children, and the links between stunting, diarrhoea and anaemia. An explanation is offered for the positive relationship between using oral rehydration salts and stunting.