Inadequate feeding of infant and young children in India: lack of nutritional information or food affordability?

Abstract

Objective: Despite a rapidly growing economy and rising income levels in India, improvements in child malnutrition have lagged. Data from the most recent National Family Health Survey reveal that the infant and young child feeding (IYCF) practices recommended by the WHO and the Indian Government, including the timely introduction of solid food, are not being followed by a majority of mothers in India. It is puzzling that even among rich households children are not being fed adequately. The present study analyses the socioeconomic factors that contribute to this phenomenon, including the role of nutritional information. Design: IYCF practices from the latest National Family Health Survey (2005)(2006) were analysed. Multivariate logistic regression analyses were performed to establish the determinants of poor feeding practices. The indicators recommended by the WHO were used to assess the IYCF practices. Setting: India. Subjects: Children (n 9241) aged 6-18 months. Results: Wealth was shown to have only a small effect on feeding practices. For children aged 6-8 months, the mother's wealth status was not found to be a significant determinant of sound feeding practices. Strikingly, nutritional advice on infant feeding practices provided by health professionals (including anganwadi workers) was strongly correlated with improved practices across all age groups. Exposure to the media was also found to be a significant determinant. Conclusions: Providing appropriate information may be a crucial determinant of sound feeding practices. Efforts to eradicate malnutrition should include the broader goals of improving knowledge related to childhood nutrition and IYCF practices. In India, an alarming 43 % of children less than 3 years of age are stunted, 48 % are underweight and 17 % are wasted, according to the latest National Family Health Survey (NFHS; (1) Keywords

Dietary diversity and associated factors among children 6-23 months of age in Gorche district, Southern Ethiopia: Cross-sectional study

“…A secondary data analysis of Ethiopian DHS and another study from Northwest Ethiopia supports the study [22, 29]. A study in India also identified media exposure as a significant determinant of IYCF practice [30]. Media is usually considered as a credible source of health and nutrition information hence such messages are likely to be adopted.…”

Age‐appropriate infant and young child feeding practices are associated with child nutrition in India: insights from nationally representative data

“…Analyses of the NFHS-3 data set to understand determinants of appropriate IYCF practices indicate that maternal education, and access and exposure to media and to health workers are significant contributors to positive practices (Patel et al 2010(Patel et al , 2012Malhotra 2012). Indeed, in India and in other contexts, intervention research (mostly through smallscale studies) shows that behaviour change interventions can be effective in improving IYCF practices, especially if interventions are based on a solid understanding of the local context, and tailored to address multiple barriers to IYCF practices (Bhandari et al 2004(Bhandari et al , 2005Bhutta et al 2008).…”

Systematic review of infant and young child complementary feeding practices in South Asian families: the India perspective

“…Delhi (33,43,47,57,58,70,81,87,100,105) Madhya (69,106) Mangalore (80,102) Haryana (75,86) Rajasthan (52) Gujarat (28,64) Kashmir (38) Ludhiana (53) Himachal (82) Uttarakhand (48,61,77) Uttar Pradesh (36,60,71,98,103) Assam (41,104) Bihar (55,83) West Bengal (30,56,84) Odisha (Orissa) (76,78) Andhra Pradesh (42,74) Maharashtra (27,35,39,50,(66)(67)(68)101) Karnataka (44,(45...…”

“…Meal frequency was explored in twenty-one studies (26,27,30,31,33,34,(36)(37)(38)(39)42,46,50,51,(55)(56)(57)(58)(59)(60)(61) . In ten studies, MMF was attained by between 25 and 50 % of the study population (27,31,33,37,38,46,(57)(58)(59)61) . In contrast, between 50 and 96 % of the population achieved MMF in seven studies (26,30,36,39,42,50,60) .…”

“…Twenty-seven studies described advice providers for CFP, of which nine had overall WOE = H and eighteen had overall WOE = M. The commonest source of feeding advice were health-care professionals, including doctors, auxillary nurse midwives, lady health visitors and anganwadi health workers, usually at antenatal visits or during immunizations (twenty-one studies (26,35,38,45,46,50,51,(53)(54)(55)(56)(57)60,61,64,66,68,(77)(78)(79)(80) ). The next most common source of advice was a family member, usually the grandmother or mother-in-law (eleven studies (26,35,45,46,48,52,54,55,60,67,81) ), with nine further studies specifically mentioning elders (35,40,42,45,51,61,66,77,79) .…”