Educational interventions for improving primary caregiver complementary feeding practices for children aged 24 months and under.
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ABSTRACT:
SUBMITTER: Arikpo D
PROVIDER: S-EPMC6494551 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionChildhood undernutrition is a major public health problem especially in low and middle-income countries (LMIC). The prevalence of early introduction of complementary feeding, low meal frequency, and low dietary diversity are frequent in LMICs. The effect of inappropriate complementary feeding practices on the nutritional status of children is not well documented in East African countries including Tanzania. Therefore, this study aimed at determining the effect of inappropriate complementary feeding practices on the nutritional status of children aged 6-24 months in urban Moshi, Tanzania.MethodologyA retrospective cohort study was done using the Pasua and Majengo cohorts of mother-child pairs in urban Moshi who were enrolled from 2002 to 2017. About 3355 mother-child pairs were included in the analysis. Appropriate complementary feeding practices were assessed using WHO IYFP indicators such as age at introduction of solid, semi-solid, or soft foods, minimum dietary diversity, and minimum meal frequency. Nutritional status (stunting, wasting, and underweight) was determined. Multilevel modeling was applied to obtain the effect of inappropriate complementary feeding practices on the nutritional status of children and to account for the clustering effect of mothers and children and the correlation of repeated measures within each child.ResultsMajority of the children (91.2%) were given soft/semi-solid/solid foods before six months of age, 40.3percent had low meal frequency, and 74percent had low dietary diversity. Early introduction of complementary food at age 0-1 month was statistically significantly associated with higher risks of wasting and underweight (ARR 2.9, 95%CI 1.3-6.3; and ARR 2.6, 95% CI 1.3-5.1 respectively). Children with low minimum meal frequency had higher risks of stunting, wasting, and underweight (ARR 2.9, 95%CI 2.3-3.6; ARR 1.9, 95%CI 1.5-2.5 and ARR 1.9, 95%CI 1.5-2.4 respectively). Children with low minimum dietary diversity were more likely to be stunted than is the case with their peers who received the minimum dietary diversity (ARR 1.3, 95% CI 1.01-1.6).ConclusionThere were a high proportion of children, which were fed inappropriately; Inappropriate complementary feeding practices predisposed children to undernutrition. Our study supports the introduction of complementary feeding, providing minimum dietary diversity, and minimum feeding frequency at six months of age as important in improving the nutritional status of the children.
| S-EPMC8118559 | biostudies-literature
Project description:ObjectivesPoor complementary feeding practices have consistently contributed to the burden of child undernutrition in Indonesia. This study aimed to estimate the prevalence and predictors of the time of the introduction of solid, semi-solid, and soft foods (ISSSF), minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD).MethodsWe analyzed 4804 last-born infants aged 6-23 months from the 2017 Indonesia Demographic and Health Survey, which employed multistage cluster random sampling. The outcomes were calculated based on the 2021 World Health Organization/United Nations Children's Fund guidelines. The predictors of the 4 complementary feeding indicators were assessed using multivariate Poisson regression with robust variance adjusting for potential confounders and study design.ResultsThe prevalence of ISSSF, MDD, MMF, and MAD was 86.1%, 54.3%, 71.8%, and 37.6%, respectively, with younger children less likely to meet 3 out of the 4 outcomes. Parental education, the presence of a birth attendant, and maternal media consumption were among the predictors of MDD and MAD. Children from families with higher income were more likely to meet MDD than those from low-income households (adjusted prevalence ratio [aPR], 1.16; 95% confidence interval [CI], 1.05 to 1.28). Living in an urban area was positively associated with MMF (aPR, 1.09; 95% CI, 1.04 to 1.15) and MAD (aPR, 1.12; 95% CI 1.02 to 1.24). In eastern regions, the prevalence of children achieving MDD and MAD was lower than in those living in Java and Bali.ConclusionsIt is crucial that more attention and efforts are made to improve the recommended practices throughout Indonesia, since the prevalence of adequate complementary feeding practices remains low.
| S-EPMC9742402 | biostudies-literature
Project description:BACKGROUND:The aim of this study was to assess dietary intakes and complementary feeding practices of children aged 6-24?months who are from Bangladeshi ancestry and living in Tower Hamlets, London, and determine the feasibility of a larger, population-representative study. METHODS:Questionnaires for demographic variables and feeding practices, and 24-h dietary recalls were administered to 25 mothers to determine whether it would be feasible to conduct a similar study on a representative sample size of the same population. Data from both tools were used to determine adequacy of complementary feeding practices through the WHO indicators and an infant and child feeding index score as well as overall macronutrient and micronutrient intake. RESULTS:Four children had varying suboptimal complementary feeding practices: two children failed to achieve the minimum dietary diversity, one child was being fed cow's milk before the age of 1?year, and one scored 'poor' on the infant and child feeding index. Most notably, the mean protein intake (39.7?g/day, SD 18.2) was higher than RNIs for all age groups (P?=?0.001). Vitamin D intake was below recommendations (P?=?0.006) for the 12-24-month age group. For the 10-12-month age group, zinc intake fell below recommendations (P?=?0.028). For the 6-9-month combined age group, iron and zinc intakes were below recommendations (P?=?0.021 and P?=?0.002, respectively). CONCLUSIONS:Given the feasibility of this study, the results obtained require a large-scale study to be conducted to confirm findings. Our initial results indicated that children from Bangladeshi heritage may not be meeting nutritional requirements; thus, a future intervention tailored to the needs of the Bangladeshi population may be required to improve aspects of complementary feeding practices and nutrient intakes of those children.
| S-EPMC7048146 | biostudies-literature
Project description:BackgroundThere are many risk factors for stunting, and studies most often corroborate complementary feeding practices as a significant risk factor. Information on the prevalence of optimal complementary feeding practices and factors that lend to caregivers meeting their requirements in Kisoro district, a district with high stunting rates, is mostly lacking.MethodologyAn analytical cross-sectional study that used secondary data from a USAID-funded project. Entries for 384 caregivers of children aged 6-23 months in Kisoro district were abstracted from the project database. The data was analysed using SPSS version 20. The association between independent factors and optimal complementary feeding practices was determined using multivariable logistic regressions at the three levels of the Socio-Ecological Model.FindingsAlthough 95% of the infants were introduced to semi-solid foods promptly, their diet was nutritionally inadequate as evidenced by the low minimum dietary diversity of 4.43%. Some of the key covariates associated with these outcomes included, the type of occupation (AOR = 21.21; CI = 2.03-221.26; p = 0.011), community groups (AOR = 0. 43; CI = 0.22-0.83; p = 0.012), not being married (AOR = 13.25; CI = 1.76-100.25; p = 0.012), age of the child (AOR = 2.21; CI = 1.1-4.45; p = 0.026); among others.ConclusionThe prevalence of MAD and MDD was very low in Kisoro district, even compared to national figures, putting these children at a very high risk of stunting. Increased advocacy is needed to support the community-level implementation of the IYCF guidelines.
| S-EPMC9379229 | biostudies-literature
Project description:Background: Optimizing linear growth in children during complementary feeding period (CFP) (6-24 months) are critical for their development. Several interventions, such as micronutrient and food supplements, deworming, maternal education, and water, sanitation and hygiene (WASH), could potentially be provided to prevent stunting, but their comparative effectiveness is currently unclear. In this study, we evaluated comparative effectiveness of interventions under these domains on child linear growth outcomes of height-for-age z-score (HAZ) and stunting (HAZ <-2SD) Methods: For this study, we searched for low- and middle-income country (LMIC)-based randomized clinical trials (RCTs) of aforementioned interventions provided to children during CFP. We searched for reports published until September 17, 2019 and hand-searched bibliographies of existing reviews. We performed random-effects network meta-analysis (NMA) for HAZ and stunting. Results: The evidence base for our NMA was based on 79 RCTs (96 papers) involving 81,786 children. Among the micronutrients, compared to standard-of-care, iron + folic acid (IFA) (mean difference =0.08; 95% credible interval [CrI]: 0.01, 0.15) and multiple micronutrients (MMN) (mean difference =0.06; 95%CrI: 0.01, 0.11) showed improvements for HAZ; MMN also reduced the risks for stunting (RR=0.86; 95%Crl: 0.73, 0.98), whereas IFA did not (RR=0.92; 95%Crl: 0.64, 1.23). For food supplements, flour in the caloric range of 270-340 kcal (RR=0.73; 95%Crl: 0.51, 1.00) and fortified lipid-based nutrient supplements (LNS) containing 220-285 kcal (RR=0.80; 95%Crl: 0.66, 0.97) decreased the risk of stunting compared to standard-of-care, but these interventions and other food supplements did not show improvements for HAZ. Deworming, maternal education, and WASH interventions did not show improvements for HAZ nor stunting. Conclusion: While we found micronutrient and food supplements to be effective for HAZ and/or stunting, the evidence base for other domains in this life stage was limited, highlighting the need for more investigation. Registration: PROSPERO CRD42018110449; registered on 17 October 2018.
| S-EPMC7096089 | biostudies-literature
Project description:ObjectiveIn Ethiopia, only 51% of the infants start complementary feeding on time. Therefore this study is aimed to determine the time to initiate complementary feeding and associated factors among mothers with children aged 6-24 months in Tahtay Maichew district, northern Ethiopia. A retrospective follow up study was conducted among 639 mothers who had children aged 6-24 months. Bi-variable and multi-variable Cox regressions were conducted and statistical significance was declared at P-value < 0.05 and 95% confidence level.ResultsThe median age for the initiation into complementary feeding was 6.00 months. Being government employee [AHR = 1.67, 95% CI 1.10-2.53], having educated husband [AHR = 2.08, 95% CI 1.22-3.86], birth preparedness [AHR = 3.74, 95% CI 1.49-9.94], growth monitoring [AHR = 5.79, 95% CI 2.60-12.88], ability to know exact time to introduce complementary feeding [AHR = 4.93, 95% CI 1.94-12.50], and paternal support [AHR = 4.99, 95% CI 2.02-12.34] were significantly associated with the time to initiate into complementary feeding. Therefore, establishing breast feeding centres at work place and extending maternity leave for reasonable months are important to improve timely initiation into complementary feeding.
| S-EPMC6332614 | biostudies-literature
Project description:BackgroundInappropriate complementary feeding practices are a major contributor to poor nutritional status of children under 2 years old in Ethiopia. The Ethiopian Ministry of Health recommends that continued breast feeding beyond 6 months should be accompanied by consumption of nutritionally adequate, safe and appropriate complementary foods. The aim of this study was to determine the prevalence of initiation of complementary feeding at 6 months of age and its associated factors among mothers of children aged 6 to 24 months in Addis Ababa, Ethiopia.MethodsA cross-sectional study was conducted during January and February of 2017 among 600 mothers with children aged 6 to 24 months in Addis Ababa City. The study participants were selected using systematic random sampling technique through a multistage sampling technique. Data were collected using a pre-tested and structured questionnaire by trained data collectors. Data were entered and analyzed using EpiInfo 7 and SPSS version 21, respectively. We used multivariable binary logistic regression to model the associations of selected independent variables with initiation of complementary feeding at 6 months of age.ResultsApproximately 83% of mothers initiated feeding of complementary foods to their child at 6 months of age. This practice was associated with maternal education (primary education v. no education) Adjusted Odds Ratio (AOR) (95%CI): 2.26(1.19, 4.43)), and home delivery of the child (AOR (95%CI): 0.32 (0.12, 0.82)).ConclusionMost mothers in the study initiated feeding of complementary foods to their children at 6 months of age. To further improve complementary feeding practices, mothers should be educated on the benefits of introducing complementary feeding at 6 months of age and the consequences of early or late initiation of complementary feeding on child health.
| S-EPMC7050790 | biostudies-literature
Project description:Despite the critical importance of complementary feeding, large proportions of children in developing countries are sub-optimally fed during 6–23 months of age. In Ethiopia, even though the government has been rolling out infant and young child feeding (IYCF) guidelines, the proportion of mothers adhering to the recommended optimal practices and its associated factors have not been assessed in different agro-ecological areas. Hence, the present study aimed to determine optimal complementary feeding practices and associated factors in three agro-ecological rural districts (high, mid and lowland) of southwest Ethiopia. A community-based cross-sectional study was carried out among 845 mothers-index young children 6–23 months Jimma zone. Multistage sampling was employed to select the study participants. Structured and pretested questionnaires were used to collect data and entered into Epi Data V.1.4.4.0. The data were analysed using SPSS version 20. Binary and multivariable logistic regressions were used to identify factors associated with optimal child-feeding practices. The significance of the association was determined at P < 0⋅05. The overall proportion of optimal complementary feeding practice (OCFP) was 9⋅4 % at 95 % CI (7⋅19, 11⋅08). The timely initiation of complementary feeding, minimum meal frequency, minimum dietary diversity and minimum acceptable diet was 52⋅2, 64⋅1, 17⋅2 and 12⋅2 %. Multivariable logistic regression showed that being in the highland districts, having good maternal knowledge, and mothers having primary school education, having a family size of less than six were positively associated with optimal complementary feeding practices. The findings showed that OCFP was low, especially in the midland agro-ecological districts.
| S-EPMC10052435 | biostudies-literature
Project description:Introduction: Complementary feeding is an important stage in a child’s development as it provides the necessary nutrients for optimal growth and development. However, improper handling, storage, and preparation of complementary foods can result in contamination by microorganisms, leading to foodborne illnesses and malnutrition. Therefore, this study aimed to determine hygienic practices during complementary feeding and associated factors among mothers of children aged 6–24 months in Wolaita Sodo town, southern Ethiopia. Methods: A community-based, cross-sectional study was undertaken among mothers/caregivers of children aged 6–24 months from December 1–30, 2022. A total of 602 participants were recruited using a simple random sampling procedure. The hygienic practice of complementary feeding was assessed based on a related seven items questionnaire (Cronbach’s alpha 0.72). Data were entered into Epi-data version 4.6 and analyzed using Statistical Package for Social Science version 26. Multivariable binary logistic regression was used to identify the statistically significant factors associated with proper hygienic practice of complementary feeding. Variables with a p-value of <0.05 in the multivariable logistic regression analysis model were considered statistically significant. Results: The study indicated that 42.0%, (95% confidence interval (CI): 38, 45.8) of the mothers/caregivers of children aged 6–24 months had proper hygienic practices during complementary feeding. Mothers who could read and write (adjusted odd ratio (AOR): 3.36, 95% CI (1.53, 7.41)) and those who had completed primary school (AOR: 1.7, 95% CI (1.02, 2.85)), media exposure (AOR: 3.38, 95% CI (2.1, 5.4)), and attitude toward hygienic practice (AOR: 3.29, 95% CI (2.2, 4.91)) were independent predictors of hygiene practices during complementary feeding. Conclusion: This study found that the prevalence of hygiene practices during complementary feeding was relatively low. Being educated, access to media, and positive attitudes toward hygienic practices were predicting factors. As a result, strengthening training and counseling services for mothers regarding complementary feeding and processing is recommended.
| S-EPMC10467249 | biostudies-literature
Project description:The World Health Organization's (WHO) standardized questionnaire for assessing infant and young child feeding practices does not include commercial baby cereals (CBC), which are derived from several food groups and are fortified with micronutrients. We examined how different scenarios for classifying CBC affect estimates of the quality of complementary feeding in children ages 6-23 months in Vietnam in 2014 (n = 4811). In addition to the WHO standardized 24-h recall questionnaire for infant and young child feeding, we asked mothers about the consumption of CBC. The five resulting scenarios were S1 - omitted CBC; S2 - CBC classified as grains; S3 - as grains and dairy; S4 - as grains, dairy and fruit/vegetables; and S5 - as grains, dairy, fruit/vegetables and any others. Including CBC resulted in 4-11 percentage points higher in the prevalence of children who were fed each of the six food groups compared with what was reported in the WHO standardized questionnaire. Minimum dietary diversity (% fed ≥ 4 out of the 7 food groups) was higher in S5 (90%) than in S1 (84%), S2 (84%), S3 (85%) and S4 (86%). Minimum acceptable diet was also higher in scenarios S5 (80%) than in S1 (74%), S2 (75%), S3 (75%) and S4 (77%). Consumption of iron-rich foods was 94% when CBC was accounted, which was higher than the alternative scenario (89%). In summary, when CBC were included, population-level estimates of dietary quality were higher than when CBC were omitted. Guidance is required from the WHO about how to account for the consumption of CBC when estimating the quality of complementary feeding.
| S-EPMC6865973 | biostudies-literature