Complementary Feeding Practices for South Asian Young Children Living in High-Income Countries: A Systematic Review

Abstract

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.

Cultural Influences on Complementary Feeding Beliefs amongst New Chinese Immigrant Mothers in England: A Mixed Methods Study

“…The theoretical framework of this study was underpinned by the socio-ecological model, which considers that any health behavior has many levels of influence and interplay between several factors, with a focus on the social and/or community environment [ 23 , 24 ]. This study is an extension of the Nurture Early for Optimal Nutrition (NEON) project, which aims to support optimal IYCF in ethnic minority families living in the UK, since feeding practices, food practices, and behaviors during early experiences can carry over into later childhood and adulthood, in an effort to prevent the development of cardiovascular diseases and co-morbidities [ 25 , 26 , 27 ].…”

Nurture Early for Optimal Nutrition (NEON) programme: qualitative study of drivers of infant feeding and care practices in a British-Bangladeshi population

“…topic guides Topic guides followed a consistent structure but were tailored to the participant to encourage a progressive depth of information discussed. The literature [28][29][30][31][32] informed community and key informant and health professional interview tool guides. 'Family' topic guides were modified based on findings from these prior phases and tailored to family members (e.g.…”

“…NEON 1 follows a sequential design for evidence generation, beginning with a systematic review series of the literature on infant feeding and care practices in Bangladeshi and other SA families living in: India, Pakistan, Bangladesh and high-income setting. [28][29][30][31][32] This paper presents the results of the subsequent qualitative formative study phase, with participants from 'community', 'key informant', 'health professional' and 'family' groups (across generations), as informed by the multiple levels of the socioecological framework. 33 Evidence from the literature and qualitative study informed an adapted PLA group approach 34 to optimise infant feeding and care practices among Bangladeshi infants aged 6-23 months and will be described elsewhere.…”

“…43 We add to emerging evidence from TH that identifies a myriad of factors, including family and friends as influencers of infant feeding and care practices in TH 44 and a systematic review that recognises the value of heritage, tradition and culture on infant feeding and care practices within SA families living in highincome settings. 31 strengths and limitations Culturally acceptable interventions to promote optimal infant feeding and care among minority populations have been relatively under-researched to date. Existing literature does not adequately capture the cultural and social determinants of infant feeding and care.…”

Feeding practices of pre‐school children and associated factors in Kathmandu, Nepal

“…Imdad, Yakoob & Bhutta reported that educated mothers place high emphasis on feeding nutrient‐rich animal source foods as a diet diversification. Obviously, this might vary again according to ethnicity, residence region and cultural aspects .…”