Young Child Feeding Practices Research Articles

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

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

Infant and young child feeding practice among mothers-child pair in irrigated and non-irrigated areas of Dangila district, Northwest Ethiopia, 2020: a community based comparative cross-sectional study

BackgroundThe issue of Infant and Young Child Feeding practices was widespread; it was estimated that infants were not exclusively breastfed in the first six months of life. Complementary foods were frequently provided too soon or too late, and they were often nutritionally deficient. Even, there are nutrition-sensitive activities like irrigation schemes, evidence on infant and young child feeding practices between irrigated and non-irrigated areas is scarce or limited.ObjectiveTo assess the prevalence of infant and young child feeding practices among 0–23 months of age children in irrigated and non-irrigated areas of Dangila District, North-west Ethiopia, 2020.MethodsA community based comparative cross-sectional study was conducted from Dec 1, 2020, to Jun 1, 2020. A stratified sampling technique was implemented to select 823 mothers with children age 0–23 months from irrigated (411) and non-irrigated (412) kebeles. Data were collected using structured questionnaires. Multivariable logistic regression was used to identify the associated factors of infant and young child feeding practice. Adjusted odds ratios with a 95% CI were used to determine the degree of association between the independent and outcome variables. A p-value < 0.05 was used as a cutoff point to declare statistically significant variables with the outcome variable.ResultsAmong 823 households visited, 802 respondents with a response rate of 97.8% in irrigated and 96.11% in non-irrigated areas gave complete responses. The overall prevalence of good IYCF practice was 62.5% (95% CI: 34.2, 41.3), and it shows a significant difference between irrigated (72.2%) and non-irrigated areas (52.8%). Moreover, the study identified that education primary and above (AOR = 1.889, 95% CI: 1.38, 2.648) knowledge above mean (AOR = 2.347, 95% CI: 1.555, 3.542), positive attitude (AOR = 1.716, 95% CI: 1.139, 2.587), PNC follow-up (AOR = 1.606, 95% CI: 1.154, 2.360), women’s decision-making power (AOR = 1.840, 95% CI: 1.226, 2.763), and multiple delivery (AOR = 0.352, 95% CI: 0.213, 0.583) were significant factors for IYCF among 0–23 month-old children.Conclusion and recommendationsThe infant and young child feeding practice among 0–23 month-old children was better in an irrigated area than in a non-irrigated area. Promoting irrigation practices, empowering women, and strengthening postnatal care are recommended interventions to increase infant, young, and child feeding practices in the study area.

Diet quality and nutritional status of HIV-exposed children aged between 6 and 18 months in the Greater Accra Region of Ghana

IntroductionHIV-exposed children, even when uninfected, have a greater risk of malnutrition than unexposed counterparts. WHO guidelines recommend children aged 6–23 months be fed a variety of foods to meet nutrient requirements. This study aimed to determine infant and young child feeding (IYCF) practices among HIV-exposed children under 2 years old enrolled in a dietary intervention and to explore correlates of the IYCF indicators and associations between IYCF and nutritional status.MethodologySix hundred and eighty mother–child pairs were recruited from 19 health facilities from the Greater Accra Region. The sociodemographic data, anthropometry, hemoglobin, and dietary intake were recorded.ResultsNinety-five percent of HIV-positive mothers breastfed their babies, and 53% initiated breastfeeding in a timely manner. Around one in five mothers (21%) introduced liquids other than breastmilk to their children within the first 2 days of birth, and only around one in four children (26%) aged 12–23 months had received breast milk on the day before assessment. Ninety-three percent of babies between 6 and 8 months had been introduced to solid, semi-solid, or soft foods. Eighteen percent of children reached the threshold for Minimum Dietary Diversity (MDD) by eating from over five of eight food groups. Fifty-four percent received Minimum Meal Frequency (MMF), eating between 2 and 4 meals in a day. Eleven percent received the Minimum Acceptable Diet (MAD). Thirty-two percent were anemic. Underweight and stunting were 12 and 11%, respectively. Children of mothers aged 31–40 years were more likely to meet the MDD and MAD [OR = 2.8, 95%CI (1.185, 6.519), p &amp;lt; 0.05 and OR = 2.8, 95%CI (1.256, 6.279), p &amp;lt; 0.05] compared to children of mothers aged 30 years or less or aged above 40 years. Children from households earning more than GHS 500 were more likely to meet MMF than those from households earning less. No associations were found between IYCF and nutritional status.ConclusionFindings highlight the need for nutrition programs to educate HIV-exposed children’s caregivers on optimal feeding practices. The importance of continued breastfeeding and dietary diversity needs to be highlighted. Affordable, iron-rich foods should be promoted. Special attention should be paid to younger, less educated, and lower socioeconomic status mothers.

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

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

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

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

Prevalence and predictors of minimum acceptable diet (MAD) feeding among tribal children aged 6–23 months in India

ABSTRACT Minimum acceptable diet (MAD) that combines minimum dietary diversity (MDD) and minimum meal frequency (MMF) is one of the eight core indicators for assessing infant and young child feeding (IYCF) practices for children aged 6–23 months. With low MAD, young children and infants are more susceptible to undernutrition. The study assesses the prevalence and predictors of MAD among tribal children aged 6–23 months in India. Descriptive, bivariate, and multivariate analyzes were performed on data from 6326 tribal children of the National Family Health Survey (2019–21). Stata was used for the analyzes, with a 5% significance level. Only 12% of tribal children were fed with a MAD, while 24% had MDD and 34% MMF. Children aged 18–23 months had a three times higher chance of MAD than their 6–8 months counterparts. Children receiving Integrated Child Development Services (ICDS), children of mothers with ten or more years of schooling, children whose mothers were exposed to mass media, and whose mothers had 4+ antenatal care visits in their last pregnancy had a higher likelihood of MAD. The study concludes that MAD among tribal children aged 6–23 months is unsatisfactory and varies significantly by socio-demographic characteristics, suggesting targeted intervention.

Minimum acceptable diet and associated factors among 6–23 months children in rural households with irrigated users and non-irrigated users in Ethiopia: a comparative cross-sectional study

IntroductionPoor quality of complementary foods is a key contributor to undernutrition even with optimal breastfeeding. Minimum Acceptable Diet (MAD) has tremendous health and nutrition benefits but only 12% of Ethiopian children’s feeding practices meet its standards. The Ethiopian government has recently increased efforts to expand nutrition-sensitive irrigation to improve child nutrition. However, the impact that irrigation has brought on the minimum acceptable diet practice of children below two years has not yet been studied. The aim of this study was to compare the magnitude of MAD practice and associated factors among children aged 6–23 months in households with irrigated users and non-users of North Mecha district, Ethiopia.MethodsA community-based comparative cross-sectional study was employed among 824 mother-child pairs. For infant and young child feeding practices, the data collection tools were adapted from the World Health Organization’s standardized questionnaire developed in 2010. X2 test was used to compare the MAD practices of irrigated users’ and non-irrigated users. Bivariate and multivariable logistic regression analyses were performed to see the predictor variables. p-value < 0.05 was taken to declare statistical significance.ResultsThe present study showed that the MAD practice of under two children in irrigated users is significantly higher than non-users (X2 = 13.91, P <.001). Maternal involvement in decision-making [AOR = 4.37, 95% CI: (2.05,9.33)], initiation of breastfeeding [AOR = 5.29, 95% CI: (2.393,11.672)], and history of illness [AOR = 4.10, 95%CI: (1.48,11.38)] were independent predictors for MAD practice among irrigated users. Whereas, maternal involvement in decision making [AOR = 4.71, 95% CI: ( 2.28, 9.75)], place of delivery [AOR = 2.51, 95% CI: ( 1.14, 5.55)], postnatal care (PNC) follow-up [AOR = 3.01, 95%CI: (1.57, 5.77)] and growth monitoring and promotion (GMP) service utilization [AOR = 4.64, 95% CI: (2.40, 8.95)] were the independent predictors among the non-users.ConclusionMAD practice was much higher in irrigated users than in non-irrigated users. Involvement in a decision, place of delivery, PNC, and GMP are independent predictors of MAD in children from non-irrigated households. The study suggested that expanding access to irrigation to households may be the best approach to improve child nutrition.

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

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

Baby-friendly workplace initiatives in child feeding practice as predictors of infant and young child anthropometric indices in public health facilities of Southern Ethiopia

BackgroundBaby-friendly workplace is an effective evidence based initiative developed by the World Health Organization to protect and support maternal knowledge, beliefs, and confidence in infant and young child feeding practices. However, studies that show the effect of the baby-friendly workplace initiative on the nutritional status of infant and young children are not available in Ethiopia. Therefore, this study aimed to assess the nutritional status among baby friendly initiatives service utlizers and non utlizers children age 6–24 months in public health facilities of Southern Ethiopia.MethodsWe conducted a comparative cross-sectional study from 1 to 30 June 2022 among 220 mothers with children aged 6–24 months. Data were collected through face-to-face interviews using a structured questionnaire. Data were entered into Epidata Software version 4.2 and then exported to IBM SPSS version 26 software for analysis. Chi-square and Fisher exact test were used to assess the differences between users and non-users of the baby friendly workplace initiative. Logistic regression model was used to determine the association between dependent and independent variables. Adjusted odds ratio (AOR) with a 95% confidence interval was computed. P-values < 0.05 at a 95% confidence level were considered statistically significant.ResultThe mean (SD) scores of weight for age (WAZ), height for age (HAZ), and weight for height (WHZ) were − 0.38 (1.34),-0.17(2.62) and-0.35 (1.84) respectively. After adjusting for covariates, children aged 6–24 months who did not use baby friendly workplace initiatives were 2.26 times more likely to have stunting compared to the users of baby friendly workplace initiative (AOR 2.26, 95% CI: 1.05, 4.88). However, both wasting (AOR: 0.42; 95% CI:0.13, 1.37) and underweight (AOR: 1.09; 95% CI: 0.45, 2.60) were not significantly associated with the use of baby friendly workplace initiatives.ConclusionThe use of baby friendly work place initiatives was successful in improving nutritional status, specifically chronic malnutrition in children. Strengthening and scaling up the baby friendly work place initiative program has the potential to reduce chronic malnutrition in Ethiopia and other similar settings with high burden of malnutrition areas, by implementing it in public facilities.

IJCM_17A: Infant and young child feeding practices among Refugees in Gangavalli block of Salem district: cross-sectional study.

Background: Refugees often face worse health outcomes due to barriers including language, cultural differences, inaccessibility to health care services. World Health Organization works around the globe to secure the health of refugees &amp; migrants and to achieve universal health coverage through implementation of “Health and Migration Programme” (2020). Children are more vulnerable &amp; easily prone to malnutrition in refugee &amp; migrant population. Infant and Young child feeding practice is a key area to improve child survival and promote healthy growth. Objectives: 1. To estimate the prevalence of early initiation of breastfeeding and exclusive breastfeeding of refugee children under two years of age. 2. To determine the factors influencing the feeding practices of children under 2 years among refugee children. Methodology: A Cross-sectional study was conducted among 97 refugee children under two years of age in Gangavalli block of Salem district over period of 1month (September 2023). Data collection was done using interviewer administered semi-structured questionnaire and statistical analysis done-IBM SPSS Version 21. Results: Early initiation of breastfeeding (within 1 hour of birth) was done in 53.6% children (52 out of 97). Only 26.8% children received Exclusive breastfeeding for more than 5 months of age. 64.9% children initiated on complementary feeding around 6-8 months of age. 76.3% children received semi-solid foods/soft foods during weaning. Only 5% children have Minimum Diet Diversity. Conclusion: The low rates of early initiation of breastfeeding and exclusive breastfeeding for over 5 months of age highlight a concerning trend. Additionally, the delayed initiation of complementary feeding with minimal diet diversity in majority of children suggests a critical need for targeted interventions to improve and promote appropriate infant and young child feeding practices within this vulnerable population.

IJCM_96A: Assessment of infant and young child feeding practices among Mothers attending maternal and child health clinic in Gulbarga Institute of medical Sciences, Kalaburagi - A Cross-sectional study

Background: Infant and young child feeding is the foundation for a child’s growth and development. Over a third of the undernourished children in the world live in India. A thorough comparison between NFHS 5 and its previous report suggests that, exclusive breast-feeding among infants under 6 months of age in Kalaburagi has decreased to 45.1% from 52%, which is concerning. Furthermore, the total number of children aged 6 to 24 months receiving an adequate diet is mere 15.4%. Despite strong data supporting the advantages of breast-feeding, the rate of breast-feeding is not high enough, indicating significant gaps that require identification and attention. Objectives: (1) To assess infant and young child feeding practices among mothers attending MCH clinic. (2) To determine the morbidities associated with feeding practices. Methodology: An institutional-based cross-sectional study was conducted among 400 mothers (by considering the prevalence of exclusive breastfeeding as 45.1%) of children aged 0-24 months attending the MCH clinic at Gulbarga Institute of Medical Sciences using convenience sampling technique for a period of 2 months i.e., October and November 2023. Data was collected by using the WHO IYCF practices indicators questionnaire followed by interpretation in the MS Excel sheet. Data analysis will be done by using SPSS software (version 16). The results will be expressed in terms of percentages, tables and graphs using appropriate statistical tests. Results: The overall prevalence of early (within 1 h of delivery) initiation of breastfeeding was found to be 57.75%, and that of exclusive breastfeeding among 0-6 months infants was 49%. 64% of children received continued breastfeeding at one year old, Minimum dietary diversity, Minimum meal frequency, and Minimum acceptable diet were achieved by only 28.6%, 13.20%, 13.2%. Statistically significant association between exclusive breast feeding and diarrhoea(p=&lt;0.0001) and ARTI(p=0.0001),Bottle feeding and Diarrhoea(p=&lt;0.0008) and ARTI(&lt;0.05), Minimum dietary diversity and Diarrhoea(p=0.02) were found. Conclusion: Poor feeding practices among children were found to have significant association with diarrhoea and ARTI. The factors influencing IYCF practices are multifaceted, hence appropriate measures must be taken at earliest.

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

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

A systematic review of dietary data collection methodologies for diet diversity indicators.

The purpose of the current study was to critically assess the gaps in the existing methodologies of dietary data collection for diet diversity indicators. The study proposed the importance of smartphone application to overcome the drawbacks. The review paper identified and assessed the conventional methodologies used in diet diversity indicators including Minimum Dietary Diversity for Women (MDD-W), Minimum Dietary Diversity of Infant and Young Child Feeding Practices (IYCF-MDD), and Household Dietary Diversity Score (HDDS). The 80 research studies from 38 countries were critically assessed on the basis of their research aim, study design, target audience, dietary data collection methodology, sample size, dietary data type, dietary data collection frequency, and location point of dietary data collection. Results indicated that most studies employed interviewer-administered 24-h recall assessing the dietary diversity. The review paper concluded that smartphone application had potential to overcome the identified limitations of conventional methodologies including recall bias, social-desirability bias, interviewer training, and cost-time constraints.

Assessment of Feeding Patterns for Children below Two Years of Age in PHCCs in Karbala

Abstract Breastfeeding is considered the healthiest start for babies. Breast milk should be the only food offered to infants for the first six months of life. The first two years of age are very important for the child's growth and development, Poor feeding patterns in children may lead to their undernutrition, which is a major public health problem. Objectives: To investigate and document the prevailing feeding patterns practiced by care givers for children under the age of two in Primary Health Care Centers (PHCCs) within Karbala. To identify factors influencing caregivers' decisions regarding the choice of feeding practices for infants and young children attending PHCCs in Karbala. Patients &amp; Methods: This is a cross-sectional study. A convenient sample included 680 mothers of children below two years of age, and the mothers' ages were more than thirteen years. The study was carried out at ten PHCCs in Karbala City from January 5–28, 2023. Results: The results showed that the majority of children (63%) were breast feeding and most of the mothers were housewives, There was a significant relationship between the type of feeding and type of labor (p=0.000*). Conclusion: Breastfeeding was the most common feeding pattern among children included in the study, but still, there were baby’s bottle feeding without real indication for using it. Recommendation: Encouraging breastfeeding and increasing awareness about it among women of childbearing age.

Study of Factors Associated with Inappropriate Complementary Feeding Among Children Aged 6 to 23 Months, Western Health Region of the Gambia, 2020

Introduction: Inappropriate complementary feeding practices are a major cause of morbidity and mortality in the first two years of life. The aim was to investigate factors associated with inappropriate complementary feeding practices among mothers of children aged 6-23 months in the Western Health Region of The Gambia. Methodology: This was a cross-sectional, descriptive and analytical study conducted from 14 September to 14 October 2020. The study population consisted of mothers of children aged 6 to 23 months attending reproductive and child health clinics and enrolled in the &amp;quot;Every Child Counts - My Child Project&amp;quot; immunization and vaccination program. Simple random sampling was used to select participants using the project. Data were collected by means of a questionnaire administered by telephone interview and concerned the socio-demographic characteristics of the mothers, the professional and economic characteristics of the parents, the socio-demographic characteristics of the children, diet and complementary feeding practices. Results: The mean age of the mothers was 28.3 (±5.4) years and that of the children 14.2 (±4.8) months. Minimum dietary diversity was 33.3%, minimum meal frequency 88% and minimum acceptable dietary intake 14.5% for all children aged 6-23 months. Non-respect of minimum dietary diversity was associated with the child&amp;apos;s female sex, with an OR = 16.3 [1.83-145.7], with the occurrence of both diarrhea and Acute Respiratory Infection (ARI) in the two weeks preceding the survey, with an OR = 27.2 [4.26-39.8], and with the child&amp;apos;s birth in a public health facility, with an OR = 55.1 [1.53-197.7]. Children whose mothers were aged between 25 and 34 and whose fathers did not work had a higher risk of non-respect of the dietary diversity, with OR = 54.1 [2.4 6- 118.5] and OR = 22.5 [2.32 - 31.9] respectively. The factors associated with non-respect of the minimum meal frequency were the advanced age of the children: 12 to 17 months with an OR= 28.6 [1.65 - 49.5] and 18 to 23 months with an OR= 18.9 [1.67 - 215.0] and a history of both ARI and diarrhea with an OR=. 52,9 [1,61 - 173,7]. Non-respect of the minimum acceptable dietary intake was associated with older children aged 18 to 23 months OR= 14.4 [2.25- 93.0] and those whose mothers had vocational training OR=.24.2 [1.27- 46.3]. Conclusion: Complementary feeding practices are not very satisfactory. It is important to strengthen nutrition education in order to improve infant and young child feeding practices.

Complementary feeding practices for children aged 6-23 months in early childhood education institutions in urban China: A cross-sectional study.

Appropriate infant and young child feeding (IYCF) plays a crucial role in promoting the healthy growth of children. Currently, many Chinese urban parents are seeking care of children from the early childhood education (ECE) institutions, however, little is known about the feeding practices of infants and young children in ECE institutions. This study aims to investigate the complementary feeding practices for Chinese urban children aged 6-23 months in ECE institutions and explore potential factors influencing their feeding practices. This cross-sectional study was conducted among primary caregivers of children aged 6-23 months in ECE institutions across 31 provinces in China from 1 March to 30 April 2023. Convenience sampling was used to recruit caregivers from centres of Gymboree Play & Music (an ECE institution). Self-administered questionnaires were designed using the online survey tool Sojump and distributed through WeChat platform, which collected information on 1) children's complementary feeding practices; 2) food frequency of seven food groups; 3) caregivers' feeding knowledge and practices; 4) frequency of children attended ECE classes and the primary caregivers' daily nurturing care time; 5) source of information on complementary feeding. A total of 2731 children and their caregivers were surveyed, with 416 children aged 6-11 months and 2315 children aged 12-23 months. The prevalence of minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) was 59.4, 60.6, and 39.2%, respectively. Only 17.3% caregivers believed that continued breastfeeding should be at two years or above, and 29.5% children were continuously breastfed at 12-23 months (CBF). The proportion of non-responsive feeding practices among caregivers ranged from 28 to 64%. Except for CBF, the prevalence of other key complementary feeding practices was higher among children who attending ECE classes than those not attending ECE classes (all P < 0.05). Moreover, children aged 12-23 months who received long-nursing care time (≥4h/d) had significantly higher MMF and MAD prevalence than those in short-nursing care time group (MMF = 66.2 vs. 58.8%, P = 0.0003; MAD = 44.2 vs. 38.3%, P = 0.0047). The complementary feeding practices of children aged 6-23 months in ECE institutions in urban China remained suboptimal, and non-responsive feeding practices among caregivers were common. The attendance of ECE classes and the caregivers' daily nurturing care time could be beneficial in ensuring children to comply with complementary feeding recommendations.

Women’s involvement in intra-household decision-making and infant and young child feeding practices in Central Asia

This paper examines the relationship between women’s empowerment and infant and young child feeding practices in Central Asia using Demographic and Health Survey datasets collected during 1995–2017. We employ a measure of women’s empowerment with three dimensions that is available for many recent surveys as well as a measure of decision-making power over use of one’s own income present for income-earning mothers in all surveys. We identify a positive association between a woman’s decision-making power—a measure of her instrumental agency—and adherence to World Health Organization–recommended feeding practices. We find little significant association between a woman’s attitude toward domestic violence, or her degree of social independence, and adherence to recommended feeding practices. Our results further show that the association between women’s decision-making power and feeding practices varies little with child gender, whether or not she cohabitates with her mother-in-law, or household wealth. We thus provide evidence from Central Asia that policies and programs intended to empower women can improve child feeding practices, with similar benefits across a variety of household types.

What shapes parental feeding decisions over the first 18 months of parenting: Insights into drivers towards commercial and home-prepared foods among different socioeconomic groups in the UK

Infants born into families experiencing socioeconomic disadvantage follow a high-risk trajectory for obesity and poor health in later life. Differences in early childhood food experiences may be contributing to these inequalities. This study aimed to explore the factors that influence parental decisions on when, how and what food to introduce over the first 18 months of their child's life and identify differences according to families' social position. Particular attention was given to social and environmental determinants within and outside the home. This research utilised a longitudinal qualitative methodology, with interviews and photo-elicitation exercises completed by participants when their children were 4–6; 10–12 and 16–18 months of age. Participants were parents (61 mothers; 1 father), distributed across low, medium and high socioeconomic position (SEP). During analysis, observable differences in factors directing parents to home-prepared or commercial foods were identified. Factors that undermined the provision of home-prepared meals included lack of time after returning to work, insufficient support from partners, uncertainty around infant and young child feeding (defined as the introduction and provision of solids) and an implicit trust in the messaging on branded products. These factors directed parents towards commercial foods and were most persistent among families experiencing socioeconomic disadvantage due to barriers accessing formal childcare, less flexible working conditions and fathers being less involved in infant feeding. To facilitate an enabling environment for healthy infant and young child feeding practices and address dietary inequalities, immediate steps that policy makers and healthcare providers can take include: i) changing the eligibility criteria for shared parental leave, ii) aligning claims on commercial infant food labels with international best practices, and iii) improving access to formal childcare.

Time to death and its predictors among Ethiopian under-five children: cluster-level shared frailty survival analysis using the 2019 Ethiopian mini demographic health survey

Introduction: Reducing under-five mortality to less than 25 per 1000 live births by 2030 is one of the Sustainable Development Goals introduced in 2016. However, several countries are still falling short of their targets. In Ethiopia, one out of every 19 children dies before reaching the age of five. Thus, this study aims to identify the time to death and its predictors among under-five children in Ethiopia. Methods: The data were retrieved from the 2019 Ethiopian Mini Demographic and Health Survey data set. Descriptive statistics and survival curves were applied. Shared frailty survival analysis was employed to determine the predictors of under-five mortality. Statistical significance was declared at p-value &lt;0.05. Result: The under-five mortality rate was found to be 59 deaths per 1000 live births with an estimated mean survival time of 57.6 months (95%CI: 57.38, 57.85). A child born into a family of seven or more had an 85% lowered risk of dying (AHR = 0.15, 95% CI: 0.05, 0.44). The risk of mortality among children born in the birth order of five or above was 3 times higher (AHR = 3.00, 95%CI: 1.70, 5.21) compared to those born in the birth order of one to four. The estimated risk of death among under-five children born less than 24 months interval was 2.68 times higher (AHR=2.68, 95%CI: 1.71, 4.21). Never breastfed was also a significant predictor of under-five child death (AHR = 2.76, 95%CI: 1.46, 5.23). Conclusion: Birth order, family size, preceding birth interval, and never breastfed history were significant predictors of under-five child mortality. Health policies should focus on keeping the spirit of a continuum of care to improve the health of the child and the health of the family as a whole. Health care providers should intervene in the community to maximize optimal infant and young child feeding practices.

Prevalence of Children Aged 6 to 23 Months Who Did Not Consume Animal Milk, Formula, or Solid or Semisolid Food During the Last 24 Hours Across Low- and Middle-Income Countries

The introduction of solid or semisolid foods alongside breast milk plays a vital role in meeting nutritional requirements during early childhood, which is crucial for child growth and development. Understanding the prevalence of zero-food children (defined for research purposes as children aged 6 to 23 months who did not consume animal milk, formula, or solid or semisolid food during the last 24 hours) is essential for targeted interventions to improve feeding practices. To estimate the percentage of zero-food children in 92 low- and middle-income countries. This cross-sectional study analyzed nationally representative cross-sectional household data of children aged 6 to 23 months from the Demographic and Health Surveys and the Multiple Indicator Cluster Surveys conducted between May 20, 2010, and January 27, 2022. Data were obtained from 92 low- and middle-income countries. Standardized procedures were followed to ensure data comparability and reliability. Both percentage and number of zero-food children were estimated. The outcome studied was defined as a binary variable indicating children aged 6 to 23 months who had not been fed any animal milk, formula, or solid or semisolid foods during the 24 hours before each survey, as reported by the mother or caretaker. A sample of 276 379 children aged 6 to 23 months (mean age, 14.2 months [95% CI, 14.15-14.26 months]) in 92 low- and middle-income countries was obtained, of whom 51.4% (95% CI, 51.1%-51.8%) were boys. The estimated percentage of zero-food children was 10.4% (95% CI, 10.1%-10.7%) in the pooled sample, ranging from 0.1% (95% CI, 0%-0.6%) in Costa Rica to 21.8% (95% CI, 19.3%-24.4%) in Guinea. The prevalence of zero-food children was particularly high in West and Central Africa, where the overall prevalence was 10.5% (95% CI, 10.1%-11.0%), and in India, where the prevalence was 19.3% (95% CI, 18.9%-19.8%). India accounted for almost half of zero-food children in this study. In this cross-sectional study of 276 379 children aged 6 to 23 months, substantial disparities in the estimates of food consumption across 92 low- and middle-income countries were found. The prevalence of zero-food children underscores the need for targeted interventions to improve infant and young child feeding practices and ensure optimal nutrition during this critical period of development. The issue is particularly urgent in West and Central Africa and India.