scholarly journals Complementary Feeding Practices and Associated Factors Among Nursing Mothers in Southwestern Nigeria

2020 ◽  
Vol 9 (2) ◽  
pp. 223-231
Author(s):  
Folake Olukemi Samuel ◽  
Ebunoluwa Grace Ibidapo

Background and Objectives: The period of transition from breastfeeding to other foods and liquids, is a very vulnerable period when malnutrition is likely to start in many infants and young children, if appropriate feeding practices are not employed. This study assessed using composite indices, the appropriateness of complementary feeding practices and associated factors among nursing mothers in Ijebu-Ode, Ogun State. Methods: This descriptive cross sectional study was conducted in selected primary health facilities in Ijebu-Ode. Multi stage sampling technique was employed to select 283 mother-child pairs. Data was collected using a pre-tested interviewer administered questionnaire which included the World Health Organization Infant and Young Child Feeding Indicators (WHO IYCF) and the Infant and Child Feeding Index (ICFI). Results: Of the total 283 mother-child pairs studied, 33.6% met minimum meal frequency, 14.5% received minimum dietary diversity (?4 food groups) and 9.2% received minimum acceptable diet when assessed using the WHO IYCF indicators. Overall, appropriate complementary feeding was low (4.2%) and associated (p?0.05) with factors such as antenatal care visits, child welfare clinic attendance and mother’s workplace. On the other hand, the ICFI categorized respondents into low (11.7%), medium (24.7%) and high (63.6%) ICFI scores and were associated (p?0.05) with mother’s education and household size. Conclusion and Global Health Implications: This study revealed a high prevalence of inappropriate complementary feeding practices. The use of composite indices reflected these practices and their associated factors holistically as they revealed different dimensions of complementary feeding. This may be useful for monitoring, evaluation, research and the required advocacy for complementary feeding. Key words: • Appropriate complementary feeding • IYCF indicators • Feeding practices • Infant and child feeding index   Copyright © 2020 Samuel and Ibidapo. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sharon Bagaaya ◽  
Henry Wamani ◽  
Richard Kajura

Abstract Objectives To determine the prevalence of appropriate complementary feeding practices and associated factors among infants and young children 6–23 months in Fort Portal municipality Kabarole Uganda Methods A community based cross sectional study was conducted among 206 mothers/caregivers of infants and young children 6–23 months using both quantitative and qualitative methods. Probability proportionate to population size technique was used to select study subjects. A pretested WHO standard questionnaire for measuring infant and young child feeding practices was adopted for assessing complementary feeding practices. Appropriate complementary feeding was defined as attaining both minimum meal frequency and minimum dietary diversity in the last 24 hours. Prevalence ratios and there 95% confidence intervals were generated. Modified poisson regression analysis method was used to generate factors associated with appropriate complementary feeding. Five focus group discussions were conducted to capture participants perceptions on appropriate complementary feeding practices. Results The prevalence of appropriate complementary feeding was 21.4%. Formal employment (PR: 7.05; CI:1.69-29.36), cohabiting (PR: 2.15; CI: 1.10-4.18) and having no child illness (PR: 1.85; CI: 0.88-4.35) were associated with appropriate complementary feeding. Qualitative results showed that inadequate information and low income as major challenges towards appropriate complementary feeding practices. Conclusions Appropriate complementary feeding practices were low. unless interventions such as; health services access and women entrepreneurship are put in place, the inappropriate complementary feeding practices are unlikely to change. Funding Sources Ministry of Health Uganda. Supporting Tables, Images and/or Graphs


Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1676 ◽  
Author(s):  
Logan Manikam ◽  
Raghu Lingam ◽  
Isabel Lever ◽  
Emma Alexander ◽  
Chidi Amadi ◽  
...  

Sub-optimal nutrition among South Asian (SA) children living in high-income countries is a significant problem. High rates of obesity have been observed in this population, and differential complementary feeding practices (CFP) have been highlighted as a key influence. Our aim was to undertake a systematic review of studies assessing CFP in children under two years of age from SA communities living in high-income countries, including dietary diversity, timing, frequency and promotors/barriers. Searches covered January 1990–July 2018 using MEDLINE, EMBASE, Global Health, Web of Science, BanglaJOL, OVID Maternity and Infant Care, CINAHL, Cochrane Library, POPLINE and World Health Organisation (WHO) Global Health Library. Eligible studies were primary research on CFP in SA children aged 0–2 years. Search terms were “children”, “feeding” and “South Asian”, and derivatives. Quality appraisal used the Evidence for Policy and Practice Information (EPPI) Weight of Evidence scoring. From 50,713 studies, 13 were extracted with ten from the UK, and one each from the USA, Canada and Singapore. Sub-optimal CFP were found in all studies. All ten studies investigating timing reported complementary feeding (CF) being commenced before six months. Promoters/barriers influencing CFP included income, lack of knowledge, and incorrect advice. This is the first systematic review to evaluate CFP in SA children living in high-income countries and these findings should inform the development of effective interventions for SA infants in these settings.


2020 ◽  
Vol 4 (11) ◽  
Author(s):  
Hasina Rakotomanana ◽  
Deana Hildebrand ◽  
Gail E Gates ◽  
David G Thomas ◽  
Fanjaniaina Fawbush ◽  
...  

ABSTRACT Background Data are limited on how feeding knowledge and practices relate to child undernutrition in the highlands of Madagascar. Objectives This study assessed maternal knowledge and practices of complementary feeding and their associations with anthropometrics of children aged 6–23 mo in the Vakinankaratra region of Madagascar. Methods Knowledge was assessed using WHO recommendations on child feeding, and WHO infant and young child feeding (IYCF) indicators were used to evaluate feeding practices. Child growth was measured as length-for-age, weight-for-age, and weight-for-length z-scores using the 2006 WHO growth standards. A z-score less than −2 was classified as child undernutrition. Logistic regression models were used to determine associations between independent variables and outcomes. Focus group discussions among mothers and in-depth interviews with key informants were conducted; barriers and facilitators of optimal feeding practices were identified using a thematic analysis approach. Results Maternal knowledge scores regarding child feeding averaged 6.4 of 11. Better knowledge scores were associated with higher odds of appropriate complementary feeding practices before and after covariate adjustments. The proportions of children achieving the minimum dietary diversity (35.8%), minimum acceptable diet (30.2%), and consuming meat, fish, and poultry (14.1%) were low. Only consumption of iron-rich foods was associated with lower odds of underweight (adjusted OR = 0.3; 95% CI: 0.1, 0.7; P < 0.05). None of the IYCF indicators were associated significantly with stunting or wasting. Maternal attitudes about complementary foods, as well as mothers’ workload and very low income, were identified as barriers to optimal feeding practices. Maternal perceived benefits of giving appropriate complementary foods as well as their positive relationship with the community health workers were the main facilitators of optimal child feeding. Conclusions Integrated nutrition-sensitive interventions addressing these barriers while enhancing the facilitators are critical in promoting better feeding practices in the Vakinankaratra region.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1012-1012
Author(s):  
Ayushi Jain ◽  
Muneer Kalliyil ◽  
Satish Agnihotri

Abstract Objectives Infant and Young Child Feeding practices, mainly, complementary feeding in children between 6 months and two years of age, is found to be sub-optimal and emerge as the weakest link in improving child nutrition outcomes in India. Minimum Acceptable Diet (MAD), comprising of two sub-indicator – Minimum Dietary Diversity (MDD) and Minimum Meal Frequency (MMF), serves as an essential indicator to understand the diet adequacy pattern in children. The objective of this study was thus to investigate the role of MDD-MMF dyad in influencing the nutritional outcomes in children and its pattern across regions in India. Methods Data was obtained from the National Family Health Survey – 4 (NFHS-4) from the DHS Program website. The prevalence of MMF and MDD was calculated for 640 districts in India. The MMF and MDD were classified into three categories - high, medium and low based on equal percentile distribution of their prevalence range. Districts with high MMF and high MDD formed one cohort. Similarly, eight other cohorts were created based on their performance on MMF and MDD indicator. The prevalence of Stunting (St), Wasting (Wa) and Underweight (Uw) in children between 6 months and two years of age was then calculated for each of the nine cohorts. The districts were also mapped based on their cohort category to study the variation across regions in India. Results All three anthropometric indicators – stunting, wasting and underweight showed significant decline moving across low MMF- low MDD cohort (40% St; 26.2% Wa; 37.1% Uw) to medium MMF – medium MDD cohort (38.6% St; 23.8% Wa; 35.4% Uw) to high MMF – high MDD cohort (29% St; 15.5% Wa; 19.2% Uw). Second, the importance of minimum dietary diversity in improving nutritional outcomes was revealed, as opposed to minimum meal frequency, which shows improvement only when it reaches a certain threshold. Third, mapping revealed sharp differences across various regions in MMF-MDD pattern, especially in the states like Odisha, Assam and Andhra Pradesh. States in the central region performed poorly on complementary feeding indicators, specifically diet diversity. Conclusions The study highlights the importance of optimal complementary feeding practices in improving nutrition outcomes and the need to consider the regional heterogeneities while promoting IYCF practices in India. Funding Sources None.


Author(s):  
Magdel E. Rossouw ◽  
Morna Cornell ◽  
Mark F. Cotton ◽  
Monika M. Esser

Background: Optimal infant- and young child–feeding practices are crucial for nutritional status, growth, development, health and, ultimately, survival. Human breast milk is optimal nutrition for all infants. Complementary food introduced at the correct age is part of optimal feeding practices. In South Africa, widespread access to antiretrovirals and a programme to prevent mother-to-child transmission of HIV have reduced HIV infection in infants and increased the number of HIV-exposed uninfected (HEU) infants. However, little is known about the feeding practices and nutritional status of HEU and HIV-unexposed (HU) infants.Objective: To assess the feeding practices and nutritional status of HIV-exposed and HIV-unexposed (HU) infants in the Western Cape.Design: Prospective substudy on feeding practices nested in a pilot study investigating the innate immune abnormalities in HEU infants compared to HU infants. The main study commenced at week 2 of life with the nutrition component added from 6 months. Information on children’s dietary intake was obtained at each visit from the caregiver, mainly the mother. Head circumference, weight and length were recorded at each visit. Data were obtained from 6-, 12- and 18-month visits. World Health Organization feeding practice indicators and nutrition indicators were utilised.Setting: Tygerberg Academic Hospital, Western Cape. Mothers were recruited from the postnatal wards.Subjects: Forty-seven mother–infant pairs, 25 HEU and 22 HU infants, participated in this nutritional substudy. Eight (17%) infants, one HU and seven HEU, were lost to follow-up over the next 12 months. The HEU children were mainly Xhosa (76%) and HU were mainly mixed race (77%).Results: The participants were from poor socio-economic backgrounds. In both groups, adherence to breastfeeding recommendations was low with suboptimal dietary diversity. We noted a high rate of sugar- and salt-containing snacks given from a young age. The HU group had poorer anthropometric and nutritional indicators not explained by nutritional factors alone. However, alcohol and tobacco use was much higher amongst the HU mothers.Conclusion: Adherence to breastfeeding recommendations was low. Ethnicity and cultural milieu may have influenced feeding choices and growth. Further research is needed to understand possible reasons for the poorer nutritional and anthropometric indicators in the HU group.Keywords: Feeding practices; Nutritional status; HIV-exposed


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247602
Author(s):  
Muhammad Ali ◽  
Muhammad Arif ◽  
Ashfaq Ahmad Shah

Premature mortality and undernutrition rates in Pakistan are among the highest in the world. Inadequate infant and young child feeding are the major causes of premature mortality and undernutrition. Yet, very little is known about the determinants of complementary feeding practices in Pakistan. Therefore, this study aims to identify the determinants of inadequate complementary feeding practices among children aged 6 to 23 months in Pakistan by using the latest nationally representative data from the Pakistan Demographic and Health Survey (2017–18). The results show that only 12% of children consume a minimum acceptable diet, 21% achieve minimum dietary diversity, and 38% reach minimum meal frequency. Multivariate regression analysis shows that child age, child weight at birth, mother’s access to newspapers/magazines at the individual level, wealth at the household level, and prenatal visits at the community level are significant predictors of complementary feeding practices among children aged 6–23 months in Pakistan. These findings show that, in addition to poverty alleviation, raising awareness through health practitioners, increasing access to media, and expanding access to child and maternal healthcare can improve complementary feeding practices in Pakistan. This consequently reduces premature mortality and undernutrition.


2019 ◽  
Vol 45 (1) ◽  
Author(s):  
Zegeye Abebe ◽  
Amare Tariku ◽  
Gashaw Andargie Bikes ◽  
Molla Mesele Wassie ◽  
Kedir Abdela Gonete ◽  
...  

Abstract Background Improving infant and young child feeding practices is critical to improved nutrition, health, and development of children. Ethiopia adopted the WHO recommendations of child feeding practices and developed the national guideline. In spite of this fact, only few children start and received appropriate complementary feeding based on the recommendation. Therefore, the study aimed to determine dietary diversity score and its associated factors among under five children at Dabat Health and Demographic Surveillance System site (HDSS), northwest Ethiopia. Methods A cross-sectional community based study was carried out from February to June 2016. All children aged 6–59 months old who lived in HDSS site were included in the survey. Odds ratio (OR) with the corresponding 95% confidence interval (CI) was calculated to show the strength of association. Finally, variables with a P-value of < 0.05 were considered statistically significant.. Results In this study, a total of 3433 children were included. About 34.87% (95%CI: 33.27, 36.49%) of the children received adequately diversified diet. The odds of receiving adequately diversified diet was higher among children whose mother had secondary and above education (AOR = 6.51; 95%CI: 4.95, 8.56), had antenatal care (AOR = 1.90; 95%CI: 1.60, 2.26) and postnatal care visits (AOR = 1.31; 95%CI: 1.00, 1, 72), and children who feed with their family (AOR = 1.39; 95%CI: 1.17, 1.65). However, a lower dietary diversity score was observed among younger children; 6–11 months old (AOR = 0.59; 95%CI: 0.41, 0.85), and children from food insecure household (AOR = 0.76; 95%CI: 0.63, 0.92). Conclusions Diversified diet feeding practice is low in Dabat HDSS site. Age of the child, maternal education, antenatal and postnatal care visits, and household food insecurity were significantly associated with dietary diversity of children. Hence, ensuring household food security and enhancing the coverage of maternal health care utilization are recommended to increase dietary diversity of children.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Jannat ◽  
M Rahman ◽  
K Agho ◽  
S Parvez ◽  
D Merom

Abstract Issue Child undernutrition in urban slums is the most serious but least addressed health problem in many LMICs including Bangladesh. Slum children are deprived of adequate feeding as advocated by WHO. Face-to-face contact to monitor adherence to child feeding recommendations is costly. We aimed to identify if a visual aid for self-monitoring, in the form of a pictorial calendar, could assist illiterate slum mothers to self-regulate their child feeding behaviours and increase adherence to recommended child feeding practices. Description of the practice: A mixed method study was conducted (Randomised Controlled Trial + semi-structured qualitative interviews) over four weeks in a slum area of Dhaka city. Thirty-four mothers to child aged 6-23 months having &lt;5 years of education were recruited. Mothers randomized to intervention arm (n = 17) received an hour of complementary feeding education along with a pictorial calendar and color-coded stickers representing food groups. The control arm received the education session only. The primary outcome was Minimum Dietary Diversity (MDD: ≥4 food groups in past 24 hours); the Generalised Estimation Equations (GEE) with a log link and binomial family was used to test treatment by time interactions. Results The proportion of achieving MDD was more common (RR 1.2, 95%CI 0.8, 1.8) among mothers from intervention arm compared to control mothers. Intervention mothers were more likely to identify the appropriate food groups compared to control mothers. More than 80% of the mothers completed the calendar for all 28 days of study duration. During qualitative interviews, most mothers (4/5) stated that the pictorial calendar acted as a reminder for them. Lessons An encouraging tendency towards better complementary feeding and better knowledge was seen among the intervention mothers compared to controls. Future research with a larger sample is needed to establish the significance of effect size. Key messages Pictorial calendar appeared to help sustain knowledge and improve feeding practices. Self-monitoring using a pictorial calendar could be a good visual aid for low-educated mothers from low socio-economic status.


2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Haimanot Abebe ◽  
Molla Gashu ◽  
Aynalem Kebede ◽  
Habtemariam Abata ◽  
Alex Yeshaneh ◽  
...  

Abstract Introduction The health and growth of children less than two years of age can be affected by the poor quality of complementary foods and poor feeding practices even with optimal breastfeeding. In Ethiopia, empirical evidence on the minimum acceptable diet and its associated factors is limited. Therefore, this study was aimed to assess the level of minimum acceptable diet and its associated factors among children aged 6–23 months in Addis Ababa Ethiopia. Methods An institution-based Cross-sectional study was conducted among a total of 575 mother-child pairs. A simple random sampling technique was used to recruit participants. For infant and young child feeding practices, the data collection tools were adapted from world health organizations’ standardized questionnaire which is developed in 2007. Data entry and analysis were performed using EPI data version 3.1 and SPSS version 20 respectively. Bivariable and multivariable logistic regression analyses were performed to determine predictor variables. Statistical significance was declared at p-value < 0.05. Result In this study, the level of minimum acceptable diet was found to be 74.6%.. About 90.6 and 80.2% of the children received minimum meal frequency and dietary diversity respectively. Having a husband secondary and above educational level [AOR = 4.789(95%CI:1.917–11.967)], being a housewife [AOR = 0.351(95% CI: 0.150–0.819)], having a history of more than three postnatal follow-ups [AOR = 2.616(95%CI:1.120–6.111], Having mothers age between 25 and 34 years [AOR = 2.051(95%CI:1.267–3.320)], being male child [AOR = 1.585(95%CI:1.052–2.388)] and having children age between 18 and 23 months [AOR = 3.026(95%CI:1.786–5.128)] were some of the factors significantly associated with a minimum acceptable diet. Conclusion In this study, the minimum acceptable diet among children aged 6–23 months was significantly associated with the educational status of the husband, mother’s occupation, history of postnatal follow-up, age of the mother, sex of the child, and age of the child. Thus, attention should be given to educating the father, empowering mothers to have a job, promoting gender equality of feeding, and counseling on the benefit of postnatal care visits. In addition, the ministry of health should work on educating and advocating the benefit of feeding the recommended minimum acceptable diet to break the intergenerational cycle of malnutrition.


2020 ◽  
Author(s):  
VICTOR MOGRE ◽  
Kingsley B Appiah ◽  
Ernest K Cheyuo ◽  
Abdul-Mumin Alhassan ◽  
Martin A Ayanore ◽  
...  

Abstract Background Appropriate complementary feeding is critical for optimal nutrition in infant and young children as it ensures their growth, health and development to attain their full potential. However, evidence shows children from developing countries do not meet the core indicators for appropriate complementary feeding. We evaluated mothers’ competency in infant and young child feeding recommendations and their association to complementary feeding practices among children aged 6–23 months.Methods This cross-sectional study included 200 children aged 6–23 months and their mothers/care givers recruited during the child welfare clinics of two health facilities in Ghana. Data was collected using a structured questionnaire. Multivariate logistic regression was used to assess determinants of appropriate diet.Results Sixty-eight percent of the mothers knew the recommended duration of continued breastfeeding, 56.5% how to ensure dietary diversity and enrich their children’s diets and 94% (n = 188) had positive attitude towards recommended infant and young child feeding practices. Majority of the mothers (92%, n = 183) practiced continued breastfeeding, 10.5% of the children met minimum diet diversity score, 39.5% minimum meal frequency and 8.5% received minimum acceptable diet. Determinants of receipt of minimum adequate diet were: having high knowledge in child feeding recommendations (100% vs. 0.0; p < 0.001) and child’s father reportedly earning enough financially (AOR = 12.1 (1.32–109.72; p = 0.027).Conclusion Poor complementary feeding practices were common and mother’s knowledge levels regarding infant and young child feeding recommendations as well as the income levels of the child’s father were important determinants of appropriate diet. Nutrition education should emphasis on improving mothers’ nutrition knowledge regarding infant and young child feeding and supporting mothers to overcome barriers to feed their children with appropriate complementary foods.


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