scholarly journals An Integrated Infant and Young Child Feeding and Micronutrient Powder Intervention Does Not Affect Anemia, Iron Status, or Vitamin A Status among Children Aged 12–23 Months in Eastern Uganda

2020 ◽  
Vol 150 (4) ◽  
pp. 938-944 ◽  
Author(s):  
Nicole D Ford ◽  
Laird J Ruth ◽  
Sarah Ngalombi ◽  
Abdelrahman Lubowa ◽  
Siti Halati ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Young Child ◽  
Vitamin A ◽  
Deficiency Anemia ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Micronutrient Status ◽  
Infant And Young Child ◽  
Eastern Uganda ◽  
Soda Ash

ABSTRACT Background Micronutrient powders (MNP) can reduce iron deficiency and anemia in children. Objective We evaluated the impact of an integrated infant and young child feeding (IYCF)–MNP intervention on anemia and micronutrient status among children aged 12–23 mo in Eastern Uganda. The intervention focused on MNP distribution, IYCF education, and caregiver behavior change. Methods Population-based cross-sectional surveys representative of children aged 12–23 mo in Amuria (intervention) and Soroti (nonintervention) districts were collected in June/July 2015 at baseline (n = 1260) and 12 mo after implementation at endline in 2016 (n = 1490). From pooled capillary blood, we assessed hemoglobin, malaria, ferritin, retinol binding protein (RBP), C-reactive protein, and ɑ1-acid glycoprotein. Ferritin and RBP were regression-adjusted to correct for inflammation. Caregivers reported sociodemographic characteristics and MNP knowledge and practices. Linear regression estimated the difference-in-difference (DiD) effect of MNP on hemoglobin, ferritin, and RBP, and logistic regression estimated DiD effect of MNP on anemia (hemoglobin <11.0 g/dL), iron deficiency (ferritin <12.0 µg/L), iron deficiency anemia (hemoglobin <11.0 g/dL and ferritin <12.0 µg/L), and vitamin A deficiency (VAD; RBP equivalent to <0.70 µmol/L retinol: <0.79 µmol/L at baseline and RBP <0.67 µmol/L at endline). Results In Amuria, 96% of children had ever consumed MNP versus <1% of children in Soroti. Fifty-four percent of caregivers reported organoleptic changes when MNP were added to foods cooked with soda ash. Adjusting for age, sex, malaria, recent morbidity, and household-level factors, the intervention was associated with −0.83 g/dL lower hemoglobin (95% CI, −1.36, −0.30 g/dL; P = 0.003) but not with anemia, ferritin, iron deficiency, iron deficiency anemia, RBP, or VAD. Conclusions Despite high program fidelity, the intervention was associated with reduced hemoglobin concentrations but not with change in anemia or micronutrient status among children aged 12–23 mo in Eastern Uganda. Contextual factors, such as cooking with soda ash, might explain the lack of effectiveness.

scholarly journals Effects of lipid-based nutrient supplements and infant and young child feeding counseling with or without improved water, sanitation, and hygiene (WASH) on anemia and micronutrient status: results from 2 cluster-randomized trials in Kenya and Bangladesh

2019 ◽  
Vol 109 (1) ◽  
pp. 148-164 ◽  
Author(s):  
Christine P Stewart ◽  
Kathryn G Dewey ◽  
Audrie Lin ◽  
Amy J Pickering ◽  
Kendra A Byrd ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Control Group ◽  
Lower Prevalence ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Nutrient Supplements ◽  
Micronutrient Status ◽  
Infant And Young Child ◽  
Cluster Randomized ◽  
Prevalence Of Anemia

ABSTRACTBackgroundAnemia in young children is a global health problem. Risk factors include poor nutrient intake and poor water quality, sanitation, or hygiene.ObjectiveWe evaluated the effects of water quality, sanitation, handwashing, and nutrition interventions on micronutrient status and anemia among children in rural Kenya and Bangladesh.DesignWe nested substudies within 2 cluster-randomized controlled trials enrolling pregnant women and following their children for 2 y. These substudies included 4 groups: water, sanitation, and handwashing (WSH); nutrition (N), including lipid-based nutrient supplements (LNSs; ages 6–24 mo) and infant and young child feeding (IYCF) counseling; WSH+N; and control. Hemoglobin and micronutrient biomarkers were measured after 2 y of intervention and compared between groups using generalized linear models with robust SEs.ResultsIn Kenya, 699 children were assessed at a mean ± SD age of 22.1 ± 1.8 mo, and in Bangladesh 1470 participants were measured at a mean ± SD age of 28.0 ± 1.9 mo. The control group anemia prevalences were 48.8% in Kenya and 17.4% in Bangladesh. There was a lower prevalence of anemia in the 2 N intervention groups in both Kenya [N: 36.2%; prevalence ratio (PR): 0.74; 95% CI: 0.58, 0.94; WSH+N: 27.3%; PR: 0.56; 95% CI: 0.42, 0.75] and Bangladesh (N: 8.7%; PR: 0.50; 95% CI: 0.32, 0.78; WSH+N: 7.9%, PR: 0.46; 95% CI: 0.29, 0.73). In both trials, the 2 N groups also had significantly lower prevalences of iron deficiency, iron deficiency anemia, and low vitamin B-12 and, in Kenya, a lower prevalence of folate and vitamin A deficiencies. In Bangladesh, the WSH group had a lower prevalence of anemia (12.8%; PR: 0.74; 95% CI: 0.54, 1.00) than the control group, whereas in Kenya, the WSH+N group had a lower prevalence of anemia than did the N group (PR: 0.75; 95% CI: 0.53, 1.07), but this was not significant (P = 0.102).ConclusionsIYCF counseling with LNSs reduced the risks of anemia, iron deficiency, and low vitamin B-12. Effects on folate and vitamin A varied between studies. Improvements in WSH also reduced the risk of anemia in Bangladesh but did not provide added benefit over the nutrition-specific intervention.These trials were registered at clinicaltrials.gov as NCT01590095 (Bangladesh) and NCT01704105 (Kenya).

scholarly journals Tracking of infant and young child feeding practices among 9- to 24-month-old children in Nepal: the MAL-ED Birth Cohort Study

2017 ◽  
Vol 21 (2) ◽  
pp. 355-364 ◽  
Author(s):  
Marianne S Morseth ◽  
Liv Elin Torheim ◽  
Mekdes K Gebremariam ◽  
Ram K Chandyo ◽  
Manjeswori Ulak ◽  
...  
Keyword(s):  
Young Child ◽  
Vitamin A ◽  
Dietary Diversity ◽  
Economic Status ◽  
Weighted Kappa ◽  
Birth Cohort Study ◽  
Meal Frequency ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Infant And Young Child

AbstractObjectiveThe present study aimed to assess infant and young child feeding (IYCF) practices and the tracking of dietary diversity score (DDS), intakes of Fe- and vitamin A-rich foods and meal frequency in a peri-urban area in Nepal. Furthermore, to explore whether sociodemographic factors were associated with tracking patterns of these IYCF practices.DesignLongitudinal study. Monthly food intake was measured by 24 h recall. Four time slots were used (9–12, 13–16, 17–20 and 21–24 months). Tracking of IYCF practices was investigated using generalized estimating equations (GEE) models and Cohen’s weighted kappa. Multinominal logistic regression was used to identify determinants for tracking of the IYCF practices.SettingBhaktapur municipality, Nepal.SubjectsChildren (n 229) aged 9–24 months, randomly selected.ResultsPrevalence of minimum meal frequency was higher than for minimum dietary diversity at all time slots. Tracking based on absolute measures (GEE models) was moderate for DDS (0·48) and meal frequency (0·53), and low for intakes of Fe- (0·23) and vitamin A-rich (0·35) foods. Tracking based on rank measured was moderate for DDS and meal frequency, and fair for Fe- and vitamin A-rich foods. Low socio-economic status significantly increased the odds (OR; 95 % CI) of tracking of low v. high DDS (3·31; 1·44, 7·60) and meal frequency (3·46; 1·54, 7·76).ConclusionsLow tracking for intakes of Fe- and vitamin A-rich foods implies that interventions to improve these IYCF practices must address underlying causes for irregular intake to have sustainable effects.

scholarly journals An Integrated Enhanced Infant and Young Child Feeding (IYCF) and Micronutrient Powder Intervention Improved Select IYCF Practices Among Caregivers of Children Aged 12–23 Months in Eastern Uganda

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Nicole D Ford ◽  
Laird J Ruth ◽  
Sarah Ngalombi ◽  
Abdelrahman Lubowa ◽  
Siti Halati ◽  
...  
Keyword(s):  
Young Child ◽  
Complementary Feeding ◽  
Household Wealth ◽  
Bottle Feeding ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Micronutrient Powder ◽  
Infant And Young Child ◽  
The Impact ◽  
Eastern Uganda

ABSTRACT Background There is little evidence of the impact of integrated programs distributing nutrition supplements with behavior change on infant and young child feeding (IYCF) practices. Objective We evaluated the impact of an integrated IYCF/micronutrient powder intervention on IYCF practices among caregivers of children aged 12–23 mo in eastern Uganda. Methods We used pre-post data from 2 population-based, cross-sectional surveys representative of children aged 12–23 mo in Amuria (intervention) and Soroti (nonintervention) districts (n = 2816). Caregivers were interviewed in June/July at baseline in 2015 and 12 mo after implementation in 2016. We used generalized linear mixed models with cluster as a random effect to calculate the average intervention effect on receiving IYCF counseling, ever breastfed, current breastfeeding, bottle feeding, introducing complementary feeding at age 6 mo, continued breastfeeding at ages 1 and 2 y, minimum meal frequency (MMF), minimum dietary diversity, minimum acceptable diet (MAD), and consumption of food groups the day preceding the survey. Results Controlling for child age and sex, household wealth and food security, and caregiver schooling, the intervention was positively associated with having received IYCF counseling by village health team [adjusted prevalence difference-in-difference (APDiD): +51.6%; 95% CI: 44.0%, 59.2%]; timely introduction of complementary feeding (APDiD: +21.7%; 95% CI: 13.4%, 30.1%); having consumed organs or meats (APDiD: +9.0%; 95% CI: 1.4%, 16.6%) or vitamin A–rich fruits or vegetables (APDiD: +17.5%; 95% CI: 4.5%, 30.5%); and MMF (APDiD: +18.6%; 95% CI: 11.2%, 25.9%). The intervention was negatively associated with having consumed grains, roots, or tubers (APDiD: −4.4%; 95% CI: −7.0%, −1.7%) and legumes, nuts, or seeds (APDiD: −15.6%; 95% CI: −26.2%, −5.0%). Prevalences of some IYCF practices were low in Amuria at endline including MAD (19.1%; 95% CI :16.3%, 21.9%). Conclusions The intervention had a positive impact on several IYCF practices; however, endline prevalence of some indicators suggests a continued need to improve complementary feeding practices.

scholarly journals Infant and Young Child Feeding Practices in Urban Philippines and Their Associations with Stunting, Anemia, and Deficiencies of Iron and Vitamin A

2013 ◽  
Vol 34 (2_suppl1) ◽  
pp. S17-S34 ◽  
Author(s):  
Fabian Rohner ◽  
A. Woodruff Bradley ◽  
J. Aaron Grant ◽  
A. Yakes Elizabeth ◽  
May Antonnette O. Lebanan ◽  
...  
Keyword(s):  
Young Child ◽  
Vitamin A ◽  
Feeding Practices ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Child Feeding Practices ◽  
Infant And Young Child

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

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jeanine Ahishakiye ◽  
Lenneke Vaandrager ◽  
Inge D. Brouwer ◽  
Maria Koelen
Keyword(s):  
Social Support ◽  
Young Child ◽  
Coping Strategies ◽  
Low Income ◽  
Complementary Feeding ◽  
Feeding Practices ◽  
Personal Factors ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Infant And Young Child

Abstract Background Mothers 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. Methods This 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. Results Coping 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. Conclusion In 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.

scholarly journals Mothers’ perceptions on and learning from infant and young child feeding videos displayed in Mother and Child Health Centers in Kenya - a qualitative and quantitative approach

2021 ◽  
pp. 1-38
Author(s):  
Lauriina Schneider ◽  
Mikko Kosola ◽  
Kerttu Uusimäki ◽  
Sari Ollila ◽  
Crippina Lubeka ◽  
...  
Keyword(s):  
Young Child ◽  
Complementary Feeding ◽  
Health Centers ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Infant And Young Child ◽  
Mother And Child Health ◽  
Mother And Child ◽  
And Child Health ◽  
Child Health Centers

Abstract Objective The objective was to explore mothers’ perceptions of educational videos on infant and young child feeding practices, and to assess whether viewing frequencies would influence maternal knowledge, attitudes and feeding practices (KAPs). Design A set of 47 videos were displayed in health centers for 6 months. At three months, we conducted focus group discussions (FGDs) with mothers and at six months, administered KAP-questionnaire-based interviews to mothers. Using a quasi-experimental design we compared groups according to video viewing frequencies. Setting The study was conducted in a slum in Nairobi and a rural area in Machakos, Kenya. We installed TV screens in waiting rooms of six Mother and Child Health Centers, where mothers could choose to watch them. Participants Forty-three mothers with children aged 0 to 48 months participated in six FGDs and 547 mothers of children aged 0 to 23 months in KAP interviews. Results The mothers from the FGDs found the videos acceptable and beneficial. Videos enhanced mothers’ learning and empowered them to support others in learning. The KAP data showed that after adjustments, breastfeeding (p=0.06) and complementary feeding knowledge (p=0.01), complementary feeding attitudes (p=0.08), as well as hygiene knowledge and practices (p=0.003) were better among mothers who had seen videos three to four times, or five or more times, compared to mothers who had seen the videos once or twice. Conclusions Videos were an accepted form of education and were beneficial when watched repeatedly. The videos could be a good addition to current IYCF education efforts in Kenya.

scholarly journals Information seeking of French parents regarding Infant and Young Child Feeding: practices, needs and determinants

2021 ◽  
pp. 1-34
Author(s):  
Sofia De Rosso ◽  
Sophie Nicklaus ◽  
Pauline Ducrot ◽  
Camille Schwartz
Keyword(s):  
Young Child ◽  
Information Seeking ◽  
Parental Education ◽  
Online Survey ◽  
Medical Condition ◽  
Communication Strategy ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Infant And Young Child ◽  
Child Age

Abstract Objective: As part of an update of feeding benchmarks targeting children aged 0 to 3 years, this study aimed to explore parental perceptions, information-seeking practices and needs concerning infant and young child feeding (IYCF) to design an efficient communication strategy. Design: Participants were recruited using the quota sampling to complete an online survey. Effects of parity, child age, prematurity, parental education and financial situation on parents’ responses were evaluated separately. Setting: France. Participants: A nationally representative sample of 1001 parents of children <4 years. Results: Parents whose child had any medical condition affecting feeding (CMC, 17%) were considered separately from healthy children’s parents. All the healthy children’s parents recognized the importance of IYCF for children’s health and growth; however, one-third considered the available advice contradictory and not guilt-free. The most used information sources were healthcare professionals (HCPs, 81%), internet (72%) and parental networks (63%). The most influential sources (mean influence ± SDs) included HCPs (7.7±1.7/10), childcare professionals (7.3±1.8/10) and parental networks (6.9±1.8/10). Parents searched for practical tips for implementing IYCF starting when their child was 5 months old. Differences regarding the type of source used by parents with higher vs. lower educations were small. Search strategies differed according to parity or child age but not to prematurity. The CMC parents reported slightly different practices and needs. Conclusions: Parents receive information from multiple sources, which can lead to confusion when deciding which advice to follow. A public health communication strategy adapted to the current parental needs should target these various sources.

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