Age-appropriate feeding practices and their association with undernutrition among children aged 6–23 months in aspirational districts of India: a multinomial analysis

Abstract

‘Health and nutrition’ is one among the five areas covered by the Aspirational District Programme in India, which aims to achieve the Sustainable Development Goals (SDGs). The reduction of undernutrition in under-five children has remained a major focus of the SDGs, especially at the ages of 6–23 months as this affects child development. This study used National Family Health Survey 2015–16 data to examine appropriate feeding practices and their associations with undernutrition among children aged 6–23 months in the 124 aspirational districts of India. Multinomial logistic regression analysis was used to analyse the association between feeding practices and undernutrition, adjusting for covariates. A total of 13,851 children aged 6–23 months were included in the analysis. Child nutritional outcomes, and children receiving the recommended minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD), were poorer in the aspirational compared with non-aspirational districts. However, the proportions of children who continued to breastfed, i.e. currently breastfeeding and the proportion of children who were receiving appropriate breastfeeding, i.e. receiving complementary feeding, in addition to breast milk, were higher in the aspirational districts. Appropriate breastfeeding and MDD were found to be associated negatively with undernutrition. While the continuation of breastfeeding increased the odds of children being undernourished, appropriate breastfeeding lowered the odds. The significant predictors of undernourishment among the study children were the child being male, of higher birth order, older and of smaller than average birth size; mother’s lower educational level, mother’s lower BMI of mothers and being a teenage mother; and poor household drinking water, sanitation facilities and lower economic status. This study suggests that educating mothers, especially illiterate and poor mothers, about appropriate breastfeeding and dietary diversity could help prevent and reduce child undernutrition in the aspirational districts of India.

Assessment of Nutritional Status Using Composite Index of Anthropometric Failure (CIAF) Among Under-Five Children from An Urban Slum of Southern India: A Cross-Sectional Study

“…The determinants of composite index of anthropometric failure among urban slum children in the present study were exclusive breast feeding not being provided for 6 months, fathers being illiterate, Calorie intake being deficient as per RDA and birth weight being <2.5kgs. According to the study's findings, infants who are exclusively breastfed have a lower risk of developing anthropometric failure which coincides with other studies such as Itishree Pradhan et al 20 . The author analyzed the feeding practices and their associations with under nutrition among children aged 6-23 months in the 124 districts of India and stated that appropriate breastfeeding lowered the odds of children being undernourished.…”

Factors associated with minimum dietary diversity failure among Indian children

“…Children of the first birth order had higher odds of having MDDF than the children of the second and third birth order. With the increase in maternal age and maternal education, children were less likely to experience MDDF, whereas the children of mothers with some exposure to mass media (aOR: 0⋅84, 95 % CI 0⋅78, 0⋅91, P < 0⋅001) and with four or more antenatal care (ANC) Recent studies (25,26) also identified that strengthening IYCF programmes would require intensive focused intervention to control MDDF in select districts, especially aspirational districts in high-focus group states in India. The present study presents the association of MDDF with a range of factors, including child, maternal, household and regional characteristics of children, their healthcare exposure and concurrent health status.…”

“…With developed states such as Kerala, Goa and Karnataka reporting an increase in MDDF between 2005–6 and 2015–16, as well as large clusters of districts with high MDDF covering highly populated states in India, poor IYCF practices among children in India seem widespread. Recent studies ( 25 , 26 ) also identified that strengthening IYCF programmes would require intensive focused intervention to control MDDF in select districts, especially aspirational districts in high-focus group states in India. The present study presents the association of MDDF with a range of factors, including child, maternal, household and regional characteristics of children, their healthcare exposure and concurrent health status.…”