Factors Associated With Feeding And Caregiving Practices For Children Under Five In Lowland Nepal: A Community-Based Cross-Sectional Survey

Author(s):  
Sophiya Dulal ◽  
Audrey Prost ◽  
Surendra Karki ◽  
Dafna Merom ◽  
Bhim Prasad Shrestha ◽  
...  

Abstract Background: While nurturing care, including adequate nutrition and responsive caregiving and early learning, is critical to early childhood development, national surveys in Nepal highlight inequalities in feeding and parental caregiving practices. This study aimed to document and analyse infant and young child feeding (IYCF) and cognitive and socio-emotional caregiving practices among caregivers of children under age five in Dhanusha district, Nepal. Methods: We used a subset of data from the MIRA Dhanusha cluster randomised controlled trial, including mother-child dyads (N=1360) when children were aged 0-12 months and a follow-up survey of the same mother-child dyads (N=1352) when children were 7-59 months. We used World Health Organization IYCF indicators and questions from the Multiple Indicator Cluster Survey-4 tool to obtain information on IYCF and cognitive and socio-emotional caregiving practices, respectively. We collected data on breastfeeding practices in a postpartum 6-week questionnaire and on complementary feeding and caregiving practices in the follow-up survey. Using multivariable logistic regression models, potential explanatory household, parental and child-level variables were tested to determine their independent associations with IYCF and caregiving indicators. Results: The prevalence of feeding indicators varied. Ever breastfed (99%), exclusive breastfeeding in past 24-hours at 0-12 months (89%), and vegetable or fruit consumption (84%) were common, and minimum dietary diversity reached 63%. Problem areas were early initiation of breastfeeding (16%), feeding of colostrum (67%), no pre-lacteal feeding (53%), timely introduction of complementary feeding (56%), and animal-source food consumption (29%). Amongst caregiving indicators, access to books (7%), early stimulation and responsive caregiving (11%), and access to early childhood education (27%) were of particular concern, while 64% had access to toys and 71% received adequate care. Only 38% of children were developmentally on track. Younger children from poor households with young mothers who had not received antenatal visits and delivered at home were at risk of poor IYCF and caregiving practices. Conclusions: Poor IYCF and cognitive and socio-emotional caregiving practices are widely prevalent in lowland Nepal, which highlights the importance of improved integrated nutrition and caregiving interventions in resource-constrained settings.

2017 ◽  
Vol 23 (3) ◽  
pp. 193-202 ◽  
Author(s):  
Kalkidan Hassen Abate ◽  
Tefera Belachew

Background: The generation of cash from agricultural products is the mainstay of the livelihood of many households in developing countries. However, critics of cash cropping have highlighted its influence on dietary diversity and availability of food at the household level, eroding the potential for optimal child caring practices. Methods: A community-based cross-sectional survey was carried out in three randomly selected coffee-producing districts of Jimma Zone in southwest Ethiopia. The underlying causes of malnutrition, food access, hygiene and care were assessed using the household food insecurity access scale, morbidity reports and infant and young child feeding practice core indicators of the World Health Organization. Anthropometric data were converted into weight for age, height for age, body mass index for age and weight for height Z-scores to determine child nutritional outcomes. Results: Prevalence of underweight, wasting, stunting and thinness were 14.2%, 9.1%, 24.1% and 9.9%, respectively. Multivariable logistic regression showed that children with suboptimal meal frequency were more than three times more likely to develop wasting (AOR = 3.3, p < 0.0001). Female children were twice as likely to develop wasting compared with males (AOR = 2.00, 4.1, p = 0.05). Children with suboptimal dietary diversity were almost four times as likely to develop stunting (AOR = 3.95, p < 0.0001). Those who were not exclusively breastfed during their first 6 months were almost five times as likely to develop stunting (AOR = 4.66, p < 0.0001). Conclusions: The findings imply that in coffee-producing areas, child caring practices are stronger independent predictors of nutritional status than wealth or economic indicators alone.


2021 ◽  
pp. 037957212199812
Author(s):  
Karen Kay Mejos ◽  
Maria Socorro Ignacio ◽  
Rohan Jayasuriya ◽  
Jayashree Arcot

Background: Lack of dietary diversity in complementary feeding contributes to nutrient gaps leading to undernutrition. Food-based strategies have been successfully used to enrich the complementary diets of infants and young children. However, context-specific recommendations based on an objective diet optimization is needed to formulate sound and practical nutritional guidelines. Objectives: The present study aimed to identify problem nutrients in complementary diets and formulate complementary feeding recommendations (CFRs) using linear programming analysis for children aged 6 to 23 months in the rural Philippines. Methods: A cross-sectional survey was conducted in the municipality of Mercedes, Philippines. Dietary intakes of breastfed children 6 to 8, 9 to 11, and 12 to 23 months of age (n = 297) were assessed using a multipass 24-hour recall method with 7-day food consumption frequency. A linear programming tool was used to identify the recommended nutrient intakes that could not be met within the existing local food patterns and develop CFRs that would best fulfil nutrient adequacy for 11 modelled micronutrients. Results: Problem nutrients in the current diets were iron and calcium in any age-group, zinc for 6 to 8 and 9 to 11 months old, and thiamine and folate for 12 to 23 months old children. Adoption of CFRs with 4 to 5 food groups in the diet would ensure the adequacy of 7 to 8 nutrients, depending on the age-group. Conclusion: Within the boundaries of local dietary patterns, adequacy for most nutrients could be achieved by promoting realistic servings of nutrient-dense foods and food groups. The linear programming results provide an evidence-based strategy in designing interventions to improve the quality of Filipino complementary diets.


2021 ◽  
Vol 39 ◽  
Author(s):  
Daniella Garcia Vidal Rodrigues Leonez ◽  
Angélica Rocha de Freitas Melhem ◽  
Daniele Gonçalves Vieira ◽  
Débora Falleiros de Mello ◽  
Paula Chuproski Saldan

ABSTRACT Objective: To verify if there are differences among the complementary feeding indicators of children aged 6-23 months according to the breastfeeding status. Methods: A cross-sectional study was carried out with 1,355 children aged 6-23 months in 2012 to evaluate five indicators proposed by the World Health Organization (WHO) and modified in accordance with Brazilian’s recommendations “Ten steps to a healthy feeding: a feeding guide for children under two years old”. The indicators used were: I. Introduction of solid, semi-solid or soft foods; II. Minimum dietary diversity; III. Minimum meal frequency; IV. Minimum acceptable diet, and V. Consumption of iron-rich foods. To verify differences between the complementary feeding indicators according to breastfeeding status, the F-statistic was used, with p≤0.05 meaning significant. Results: Indicators I, II, and V were similar among breastfed and non-breastfed children; however, indicators III and IV presented a higher proportion of adequacy for non-breastfed children, with 94.9% (CI95% 93.2-96.2) versus 40.3% (CI95% 33.2-47.9) for indicator III, and 57.3% (CI95% 53.2-61.2) versus 23.1% (CI95% 17.4-30.1) for indicator IV. Conclusions: Non-breastfed children have better complementary feeding status, but the indicator III takes into account non-breast milk as a meal for non-breastfed children, which increased the number of dairy meals and influenced indicator IV (calculated from indicators II and III).


2021 ◽  
Vol 6 ◽  
pp. 54
Author(s):  
Sunil S. Bhopal ◽  
Reetabrata Roy ◽  
Deepali Verma ◽  
Divya Kumar ◽  
Bushra Khan ◽  
...  

Background: The World Health Organization and others promote responsive caregiving to support all children to thrive, particularly in low- and middle-income countries. The 14-item Mother’s Object Relations Scales – Short Form (MORS-SF) may be of use in research and public health programmes because of its basis in attachment theory and ability to capture parental feelings towards their child. Methods: We culturally adapted the MORS-SF for use with mothers in the SPRING home visits trial when their infants were 12 months old. The same dyads were assessed using the HOME inventory concurrently and Bayley Scales of Infant Development III (BSID-III) at 18 months of age. Mixed effects linear regression was used to examine associations between MORS-SF (explanatory variable) and HOME-IT, and the cognitive, language and motor domains of BSID-III (outcome variables). Results: 1273 dyads completed all assessments. For the motor and language BSID-III scales and for HOME-IT there were strong and positive associations with the MORS-SF warmth sub-scale, and strong and negative associations with the invasion sub-scale. Important but less strong associations were seen with the BSID-III cognitive scale. Evidence of interaction suggested that both are individually important for child development. Conclusions: This is the first time MORS-SF has been used in India where optimising responsive caregiving is of importance in supporting all children to reach their potential. It is also the first time that the tool has been used in relation to child development. MORS-SF could be a valuable addition to evaluation in early childhood development.


Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1009
Author(s):  
Imelda Angeles-Agdeppa ◽  
Ma. Rosel S. Custodio

Nutrition is an integral part of economic development, since it influences workers’ health and productivity. This study evaluated the usual nutrient intakes and food sources of working adults. We conducted a cross-sectional survey that involved 1264 selected working adults aged 19 to 59 years old from randomly selected job sectors. Quantitative dietary data was collected by a 2-day, non-consecutive 24 h recall, while a dietary diversity questionnaire was used to assess the types and frequency of foods consumed. Physical activity was measured using the World Health Organization global physical assessment questionnaire. The prevalence of inadequate intakes, defined as the percentage of adults with intakes less than the estimated average requirements (EAR) or acceptable macronutrient distribution ranges (AMDR) were estimated using the PC—Software for Intake Distribution Estimation (PC-SIDE) program. The mean daily energy intake of working adults was 1768 kcal/day or 74% of the Estimated Energy Requirements (EER) for this age group. The percentage contribution to the total energy of fats (58%) and proteins (34%) were excessively high. Consumption of fruits and vegetables was only 30% and 40% of the recommended nutrient intake, respectively. Salt intake was 52% above the adequate intake. Nutrient inadequacy was high in almost all nutrients, including iron (99%), folate (97.9%), riboflavin (95.8%), calcium (94.7%), vitamin C (87.3%), and thiamin (76.6%). The top five food sources of energy included rice (35.6%), pork (15.1%), fats and oils (4.7%), chicken (4.4%), and bread (3.8%). Energy and nutrient intakes of working adults is extremely sub-optimal due to the consumption of few nutrient-dense foods. This may pose a triple burden of malnutrition if left unsolved.


Life ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 969
Author(s):  
William E. S. Donkor ◽  
Seth Adu-Afarwuah ◽  
Rita Wegmüller ◽  
Helena Bentil ◽  
Nicolai Petry ◽  
...  

Background: Optimal complementary feeding is critical for adequate growth and development in infants and young children. The associations between complementary feeding and growth have been studied well, but less is known about the relationship between complementary feeding and micronutrient status. Methods: Using data from a national cross-sectional survey conducted in Ghana in 2017, we examined how multiple WHO-recommended complementary feeding indicators relate to anemia and the micronutrient status of children aged 6–23 months. Results: In total, 42%, 38%, and 14% of the children met the criteria for minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD), respectively. In addition, 71% and 52% of the children consumed iron-rich foods and vitamin A-rich foods, respectively. The prevalence of anemia, iron deficiency (ID), iron deficiency anemia (IDA) and vitamin A deficiency (VAD) was 46%, 45%, 27%, and 10%, respectively. Inverse associations between MMF and socio-economic status were found, and MMF was associated with an increased risk of ID (55%; p < 0.013) and IDA (38%; p < 0.002). Conclusion: The pathways connecting complementary feeding and micronutrient status are complex. Findings related to MMF should be further investigated to ensure that complementary feeding programs account for the potential practice of frequent feeding with nutrient-poor foods.


Author(s):  
Shubhanshu Gupta ◽  
Sanjeev Kumar ◽  
Piyush D Swami ◽  
Anjana Niranjan

Background: According to World Health Organization, adolescents constitute about one fifth of the world population, and in India they constitute about 21% of the total population. Most of the surveys show that health status of adolescent girls is at sub-optimal level. Objectives: To assess nutritional status and morbidity pattern among the adolescent girls and to suggest measures for improvement of health status of adolescent girls.  Method: A community based cross-sectional study was carried out among 250 adolescent schoolgirls in Rural and urban field practice area of Jhansi school from January 2017 to July 2014. Results: Among the various morbidities eye problem was seen in maximum no of adolescent girls. Eye problem was present in 44.8% of adolescent girls followed by respiratory 14.7% and ear 13.06% disease. Skin disease was present in 3.2% of adolescent girls, which was more in rural girls 6.7% than in urban girls 1.7%, may be due to better hygienic practice in urban schoolgirls. Conclusions: Rural background, low socioeconomic status, illiteracy, birth rate and order, income and number of members in a family have shown to be significant determinants of morbidity pattern in the adolescent girls. Keywords: Adolescent, anemia, morbidity, vaginal discharge.


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