Child Feeding Practices Are Associated with Child Nutritional Status in Latin America: Innovative Uses of the Demographic and Health Surveys

Abstract

Data from the Demographic and Health Surveys (DHS) for 5 Latin American countries (7 data sets) were used to explore the feasibility of creating a composite feeding index and to examine the association between feeding practices and child height-for-age Z-scores (HAZ). The variables used for the index were as follows: current breast-feeding, use of complementary foods and liquids in the past 24 h, frequency of use over the past week and feeding frequency. The index was made age specific for 6- to 9-, 9- to 12- and 12- to 36-mo-old age groups, and age-specific feeding terciles were created. Bivariate analyses showed that feeding practices were strongly and significantly associated with child HAZ in all 7 data sets, especially after 12 mo of age. Differences in HAZ between child feeding terciles remained significant after controlling for potentially confounding influences, for all countries except Bolivia. Multiple regression analyses also revealed that better feeding practices were more important for children of lower, compared with higher socioeconomic status (in Colombia 1995 and Nicaragua 1998); among children of Ladino (Spanish speaking) compared with indigenous origin (in Guatemala 1995); and among children whose mothers had primary schooling compared with mothers with no schooling, or mothers with higher than primary school level (Peru 1996). The data available in DHS data sets can thus be used effectively to create a composite child feeding index and to identify vulnerable groups that could be targeted by nutrition education and behavior change interventions.

Feeding practice among younger Tibetan children living at high altitudes

“…As, on the one hand, our survey found a high malnutrition prevalence of 39.0% for stunting and 23.7% for underweight among Tibetan children and rapid increase of malnutrition after 3 months old (Dang et al, 2004). On the other hand, some studies from China and Latin American also confirmed that feeding practices were strongly and significantly associated with child growth (Prentice, 1994, Fu et al, 2000 and better feeding practices were more important for children of lower socioeconomic status (Ruel & Menon, 2002).…”

Infant and young child feeding practices and child undernutrition in Bangladesh: insights from nationally representative data

“…Our findings suggested adequate dietary diversity to be the indicator most strongly associated with better nutrition outcomes during this period. Other studies that have used a variety of indicators aimed at capturing food variety or dietary diversity have come to similar conclusions about the importance of the diversity of young children's diets (10,12,35,37,(39)(40)(41) . Building on these previous studies, and using nationally representative data, our analysis also showed a clear association between dietary diversity and , did not achieve MDD; , achieved MDD) among children aged 6-23 months, 2007 Bangladesh Demographic and Health Survey.…”

The production diversity of subsistence farms in the Bolivian Andes is associated with the quality of child feeding practices as measured by a validated summary feeding index

“…Infant and child feeding index An ICFI was constructed based on previously published summary feeding indices (17,18) . Formative research indicated that the diversity of child diets and frequency with which meals and snacks were fed to children in northern Potosí were frequently not meeting recommendations.…”

“…Therefore, measuring the quality of IYCF practices is challenging. While the set of IYCF indicators developed by the WHO (15) is incredibly valuable for describing IYCF practices globally and advocating for increased attention to child feeding, these indicators may lack sensitivity and specificity and may not be the best tools for all uses (16) .One previous tool used to assess IYCF practices, a child feeding index, derives separate scores for distinct child feeding behaviours and combines these scores into a single, age-specific summary index (17) . If positive child nutrition outcomes are associated with some minimum number of proper child feeding and care practices, a summary index would be more likely to detect these associations than would a measure of any single practice (18) .…”

“…Ninety-one per cent of eligible families participated. All but one of the households that did not participate in the survey were engaged in temporary wage or reciprocatory labour outside their communities and were not available for interview.Infant and child feeding index An ICFI was constructed based on previously published summary feeding indices (17,18) . Formative research indicated that the diversity of child diets and frequency with which meals and snacks were fed to children in northern Potosí were frequently not meeting recommendations.…”