Complementary Feeding Practices and Nutrient Adequacy of Complementary Foods Consumed by Young Children in West Gojam, Ethiopia
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Date
2016-11
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Addis Ababa University
Abstract
Stunting is prevalent in Ethiopia and reaches a peak during the complementary feeding period. The present study investigated the complementary feeding practices and nutritional adequacy of complementary foods consumed by young children (12 to 23 months) in Mecha, district, West Gojam, Ethiopia.
One hundred Health Extension Workers (HEWs) and 226 mother-child dyads participated in the study. Data on the socio-demographic characteristics, educational level of the mothers, and mothers’ andchildren’s anthropometric measurements were collected. Knowledge of mothers and HEWs on optimalInfant and Young Child Feeding (IYCF) was examined using a pre-tested questionnaire. The impact of HEWs knowledge and knowledge sharing effectiveness (KSE) on mothers’ knowledge and child nutritional status was studied. IYCF practices were evaluated and child and caregivers’ feeding behaviorswere characterized using observation and self-report. The association between child food intake and stunting with caregiver feeding style was studied. The adequacy of energy and selected nutrient intakes from the complementary foods were determined using two 24hour recalls, and the intakes were compared with WHO recommendations. The intake of additional nutrients from MNP was simulated and the risks of inadequate and excessive intakes were estimated. Furthermore, breastmilk vitamin A (BMVA) and concentration of pro-vitamin A carotenoids were measured using HPLC and iCheck, and the agreement between the two measurements studied.
Although nutrition education through the HEP did not reach all the caregivers, those that did receive IYCF training had higher knowledge scores and better child feeding practices than untrained ones (P< 0.05). Trained mothers had a lower proportion of stunted children, and KSE of HEWs’ was found associated with child linear growth. Although responsive feeding practices were not widely observed, they were associated with accepted mouthful and child linear growth. Not only low food intake, but also low quality complementary foods were observed in this setting. Iron, zinc, but also calcium intakes were found inadequate; while at the same time excessive iron intakes (8 %) were observed. Our simulation of MNP intervention, showed reductions in the prevalence of inadequate intakes, but was accompanied with iron and zinc excessive intakes beyond acceptable limits (< 2.5%). Low BMVA was prevalent and breastmilk provitaminA concentrations were lower than average composition for women in developing countries. BMVA measurements with iCheck are comparable to those obtained using HPLC.
Stunting in West Gojam is associated with poor IYCF knowledge, KSE of HEW, inadequate feeding style, and inadequate micronutrient intakes from complementary foods (iron, zinc, calcium) and breastmilk (vitamin A and carotenoids). Interdisciplinary interventions targeting both behavioral and food aspects of child feeding are needed in this setting. Such interventions would benefit from rigorous monitoring and evaluation that can be facilitated through novel indicators (KSE) and instruments (iCheck).
Keywords: stunting; micronutrients; child feeding; complementary foods; iron, zinc; vitamin A,breastmilk, responsive feeding
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Keywords
stunting; micronutrients; child feeding; complementary foods; iron, zinc; vitamin A,breastmilk, responsive feeding