scholarly journals Evaluating the Effect of Appropriate Complementary Feeding Practices on Child Growth in Malawi Using Cross-Sectional Data: An Application of Propensity Score Matching

2021 ◽  
Vol 8 ◽  
Author(s):  
Halima S. Twabi ◽  
Samuel O. M. Manda ◽  
Dylan S. Small
Keyword(s):  
Propensity Score ◽  
Young Children ◽  
Propensity Score Matching ◽  
Complementary Feeding ◽  
Feeding Practices ◽  
World Health ◽  
Z Score ◽  
Complementary Foods ◽  
Nutritional Needs ◽  
Infants And Young Children

Introduction: Appropriate complementary foods have been found to provide infants and young children with nutritional needs for their growth and development. In the absence of a randomized control trial (RCT), this study used observational data to evaluate the effect of appropriate complementary feeding practices on the nutritional status of children aged 6–23 months in Malawi using a propensity score matching statistical technique.Methods: Data on 4,722 children aged 6 to 23 months from the 2015–16 Malawi Demographic and Health Survey (MDHS) were analyzed. Appropriate complementary feeding practices were assessed using the core indicators recommended by the World Health Organization (WHO)/United Nations Children's Fund (UNICEF), and consist of the introduction of complementary feeding, minimum dietary diversity, minimum meal frequency and minimum acceptable diet based on a dietary intake during a most recent 24-h period.Results: The prevalence of stunting (height-for-age z-score < −2 SD) was 31.9% (95% CI: 29.3%, 34.6%), wasting (weight-for-height z-score < −2 SD) 3.5% (95% CI: 2.6%, 4.7%) and underweight (weight-for-age z-score < −2 SD) 9.9% (95% CI: 8.4%, 11.8%). Of the 4,722 children, 7.7% (95% CI: 6.9%, 8.5%) were provided appropriate complementary foods. Appropriate complementary feeding practices were found to result in significant decrease in stunting (OR = 0.7, 95% CI: 0.4, 0.95). They also resulted in the decrease of wasting (OR = 0.4, 95% CI: 0.1, 1.7) and underweight (OR = 0.6, 95% CI: 0.2, 1.7).Conclusion: Appropriate complementary feeding practices resulted in a reduction of stunting, wasting, and underweight among children 6 to 23 months of age in Malawi. We recommend the continued provision of appropriate complementary foods to infants and young children to ensure that the diet has adequate nutritional needs for their healthy growth.

scholarly journals Complementary Feeding: Is It The Forgotten Factor of The First 1000 Days of Life?

2021 ◽  
Author(s):  
Catherine Muthoni Njeru ◽  
Anthony Ngugi ◽  
Caroline Kathomi ◽  
Mary Slessor Limbe
Keyword(s):  
Young Children ◽  
Quantitative Data ◽  
Complementary Feeding ◽  
Tertiary Education ◽  
Feeding Practices ◽  
Urban Setting ◽  
Information Support ◽  
World Health ◽  
Practical Guidelines ◽  
Infants And Young Children

Abstract Background:Appropriate complementary feeding is a practice with great potential for reduction of nutrition-related diseases and mortalities in children. However, uptake of the recommended World Health Organisation (WHO) infant and young child feeding practices in Kenya remains low. Most previous studies have been done in rural or urban poor populations hence the need to provide practical guidelines for the complementary feeding period in a typical middle-class urban setting. This study investigated complementary feeding practices by caregivers of infants and young children on follow up at Aga Khan University Hospital-Nairobi (AKUH-N) well-baby clinic and the factors influencing compliance with the WHO guidelines.Methods:A total of 290 caregivers of infants and young children aged between nine and twenty-four months were interviewed using a questionnaire. Out of these, 21 were purposively sampled to participate in a qualitative study using in-depth interviews. Thematic analysis was used to analyse qualitative data while descriptive statistics, univariate and multivariate regression analysis were used for quantitative data. A convergent parallel design was used to integrate the qualitative and quantitative data.Results:Out of 290 caregivers interviewed, 125 (43.1%) complied with WHO complementary feeding guidelines. Proportions of underweight and stunting were 6.9% and 1.7%, respectively, while that of overweight was 8.6%. Factors that affected complementary feeding practices included education level of the caregiver, access to information, support from healthcare workers and fear of allergic reactions. Conclusions:Full compliance to WHO complementary feeding guidelines remained below 50%. In addition, the proportion of children who were overweight in this study was double the national average, highlighting a growing trend of obesity in childhood. Some of the factors positively associated with compliance with complementary feeding guidelines included access to multiple sources of information, and support from health workers and family members. Lack of tertiary education of the caregiver, absence of specific and practical guidelines, resource constraints and fear of allergies were found to negatively impact compliance with complementary feeding guidelines.

scholarly journals Association Between Appropriate Complementary Feeding and Anthropometric Measures Among Infants and Young Children in Malawi using Cross-Sectional Data: A Propensity Score Matching Approach

2020 ◽  
Author(s):  
Halima Sumayya Twabi ◽  
Samuel O Manda ◽  
Dylan Small
Keyword(s):  
Propensity Score ◽  
Young Children ◽  
Propensity Score Matching ◽  
Complementary Feeding ◽  
Child Growth ◽  
Anthropometric Measures ◽  
Cross Sectional ◽  
Resource Limited ◽  
Mean Differences ◽  
Infants And Young Children

Abstract Background: Inappropriate feeding practices among infants and young children are adversely associated with their growth and development. This study aimed to investigate the causal association between appropriate complementary feeding and child growth among children aged 6 to 23 months in Malawi using propensity score matching.Methods: Data on 4722 children aged 6 to 23 months from the 2015-16 Malawi Demographic and Health Survey (MDHS) were analysed. Distribution of confounder variables on children who were not on appropriate complementary feeding were made similar to those who were on appropriate complementary feeding using a 1:1 nearest neighbour matching within a calliper region of 0.1. Matching was evaluated based on the average standardised absolute mean differences and covariate specific p-values after matching. The effect of appropriate complementary feeding was estimated based on the matched sample. A sensitivity analysis was done to assess the effect of unmeasured confounders on the estimates.Results: The prevalence of stunting was at 28% (95% CI:27%,29%), wasting was at 3.3%(95% CI:2.5%,4.1%) and underweight was at 13.6%(95% CI:12.1%,15%). Of the 4772 children, 16.7% (95% CI:15.6, 17.8) were given appropriate complementary feeding. A majority (81.8%) of the children were initiated to complementary feeding after 6 months of age. Appropriate complementary feeding was associated with reduced stunting (OR=0.5, 95% CI:0.3,0.9) among the children but did not have an effect on wasting and underweight.Conclusion: The study has found that appropriate complementary feeding led to less stunting among children aged 6-23 months in Malawi. The use of statistical techniques such as propensity score matching to balance confounder variables could be useful to reduce bias in the estimation of exposure comparative effectiveness from observational studies. We recommend optimal feeding for young children, especially in resource-limited settings.

scholarly journals Nutrient intakes from complementary foods consumed by young children (aged 12–23 months) from North Wollo, northern Ethiopia: the need for agro-ecologically adapted interventions

2012 ◽  
Vol 16 (10) ◽  
pp. 1741-1750 ◽  
Author(s):  
Kaleab Baye ◽  
Jean-Pierre Guyot ◽  
Christèle Icard-Vernière ◽  
Claire Mouquet-Rivier
Keyword(s):  
Young Children ◽  
Vitamin A ◽  
Vitamin C ◽  
Complementary Feeding ◽  
Feeding Practices ◽  
Grass Pea ◽  
Nutrient Intakes ◽  
Complementary Foods ◽  
Broad Beans ◽  
North Wollo

AbstractObjectiveTo characterize current feeding practices and to evaluate the adequacy of energy and nutrient intakes of young children in subsistence farming rural households in North Wollo, Ethiopia.DesignA cross-sectional study examining sociodemographic status, anthropometry, breast-feeding and complementary feeding practices using two in-home non-consecutive 24 h recalls.SettingsTwo rural villages in the highlands and lowlands of Gobalafto district, North Wollo.SubjectsSeventy-six young children aged 12–23 months, thirty-nine from the lowlands and thirty-seven from the highlands.ResultsAbout 33 % of the children, ∼46 % in the highlands and 24 % in the lowlands (P = 0·05), were stunted. Complementary diets were low in animal products, fruits and vegetables. Cereals and legumes were the major sources of energy, protein, Ca, Fe, Zn and vitamin A. Legumes with potentially toxic components (grass pea, broad beans) and low nutrient-dense beverages such as tea were frequently consumed. Intakes of energy, Ca, Zn, vitamin A and vitamin C from complementary foods were below WHO recommendations assuming average breast-milk intakes. In contrast, Fe and protein intakes and densities met WHO recommendations. Although vitamin C intakes and densities were higher (P < 0·05) for the lowlands, they remained far below WHO recommendations.ConclusionsInterventions promoting the WHO guiding principles for complementary feeding practices and behaviours that take the agro-ecological contexts into account are needed here. Furthermore, specific recommendations should be formulated to discourage the consumption of grass pea, broad beans and low nutrient-dense beverages such as tea.

scholarly journals Complementary Feeding Practices and Associated Factors Among Infants and Young Children 6–23 Months in Fort Portal Kabarole District Uganda (P11-049-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sharon Bagaaya ◽  
Henry Wamani ◽  
Richard Kajura
Keyword(s):  
Young Children ◽  
Low Income ◽  
Associated Factors ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Feeding Practices ◽  
Cross Sectional Study ◽  
Child Feeding ◽  
Cross Sectional ◽  
Infants And Young Children

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

scholarly journals Visual information on labels in commercial baby foods on Bulgarian market

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Rangelova ◽  
A Partzova
Keyword(s):  
Young Children ◽  
Visual Information ◽  
Child Nutrition ◽  
Health Claims ◽  
World Health ◽  
Complementary Foods ◽  
Regional Office ◽  
Baby Foods ◽  
Infants And Young Children ◽  
Nutrition And Health Claims

Abstract Background Production and sale of commercial baby foods in Bulgaria has grown in the last years. The evidence suggests that inappropriate promotion and advertising of commercial complementary foods can affect unfavourably child nutrition. The World Health Assembly has urged all Member States to “end inappropriate promotion of foods for infants and young children”. Methods The survey is part of WHO Regional Office for Europe project: Commercial foods for infants and young children in the WHO European Region. The data was collected in November 2017 in two districts in Sofia, Bulgaria using the mobile questionnaire, developed by WHO. The presence on various types of visual information on the package was recorded for 771 products on the market. Results The results reviled that 94.4% of the labels of baby foods on the market in the capital of Bulgaria - Sofia, use the pictures of ingredients and 52.9% - the cartoon images. The use of images of infants and young children presented in 8.7 % of the products and 6.9% of them marketed as suitable for babies under six months old, in violation of the International Code of Marketing of Breastmilk Substitutes. 0.4 % of baby foods use images of mothers in the labels. The “other” visual information related to various claims including “quality”, “bio” (i.e. organic) and various other nutrition and health claims. Conclusions There is inappropriate promotion of commercial complementary foods on Bulgarian market. Key messages Special measures, including legislative to limit inappropriate practices for the advertising of foods for infants and young children, are needed. Raising the parents’ awareness of the criteria for selecting commercial complementary foods is necessary.

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