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

Abstract

Objective: To determine the association between indicators of infant and young child feeding (IYCF) and anthropometric measures of nutritional status among children aged 0-23 months in a nationally representative data set. Design: Data from the 2007 Bangladesh Demographic and Health Survey were used. Analyses were conducted using multiple linear regression and logistic regression analyses adjusted for the complex survey design of the survey, controlling for child, maternal and household characteristics, and including regional dummy variables. Setting: Bangladesh. Subjects: Pairs (n 2096) of last born infants and their mothers. Results: Exclusive breast-feeding under 6 months of age was associated with higher weight-for-height Z-score (effect size (ES) 5 0?29; P , 0?05). Appropriate complementary feeding in children aged 6-8 months was associated with higher height-for-age Z-score (HAZ; ES 5 0?63; P , 0?01) and higher weight-for-age Z-score (WAZ; ES 5 0?30; P , 0?05). Higher dietary diversity index (DDI) was associated with higher HAZ (ES 5 0?08; P , 0?01 for every 1 point higher DDI) and higher WAZ (ES 5 0?04; P , 0?05). Children who achieved minimum diet diversity had higher HAZ (ES 5 0?20; P , 0?05). Logistic regression models confirmed that exclusive breast-feeding was protective against wasting and DDI was protective against stunting and underweight. Conclusions: Our results highlight the importance of IYCF practices as determinants of child growth outcomes in this context, and reinforce the need for interventions that address the spectrum of IYCF practices, from exclusive breast-feeding to age-appropriate complementary feeding, especially diet diversity, in efforts to improve nutrition of infants and young children. Keywords Infant and young child feeding Exclusive breast-feeding Dietary diversity Nutrition BangladeshGlobally, childhood undernutrition is one of the most important public health challenges. When considering all causes of under-5s mortality worldwide, it is estimated that 35 % of these deaths are attributable to malnutrition (1) . The critical 'window of opportunity' for child growth is in the first 2 years of life; recent analyses have found that the effect of growth faltering during this period is more severe than previously thought (2) . In this critical period for the growth of children under 2 years of age, it is essential to ensure proper nutrition. According to the UNICEF conceptual framework for child nutrition (3) , both dietary intake and health care are critical determinants of child undernutrition.Aspects of infant and young child feeding (IYCF) that are important in the first 2 years of life include: early initiation of breast-feeding; exclusive breast-feeding for the first 6 months of life; adequate, timely and appropriate complementary feeding from 6 to 24 months of age; continued breast-feeding after the introduction of complementary foods; adequate dietary diversity in complementary foods; and adequate frequency of meals. A large body of research was conducted over alm...

Prevalence and determinants of stunting in a conflict-ridden border region in Armenia - a cross-sectional study

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A systematic review of complementary feeding practices in South Asian infants and young children: the Bangladesh perspective

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Magnitude and factors associated with appropriate complementary feeding among children 6–23 months in Northern Ghana

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