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      Complementary feeding practices and nutritional status of children 6–23 months old: formative study in Aceh, Indonesia

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          Abstract

          BACKGROUND/OBJECTIVES

          The 6–23 months for infants is the longest period in the “first 1,000 days” of life. This period is very important for child development, so complementary feeding (CF) practices should be optimized to maximize children's potential for growth and development. The aim of this study was to analyze the CF practices and nutritional status of children aged 6–23 months.

          SUBJECTS/METHODS

          For this cross-sectional study, 392 children aged 6–23 months were selected using stratified random sampling. Socio-demographic data were collected through interviews. CF practices, collected by interviews and repeated 24-hour food recall method, were the timely introduction of CF, minimum meal frequency, dietary diversity and minimum acceptable diet, consumption food rich in proteins and vitamin A. Nutritional status was assessed using the indicators of underweight, wasting and stunting. To analyze the association between socio-demographic indicators and CF with nutritional status, the chi-square test with a confidence interval of 95% was used.

          RESULTS

          Results showed that 39% were exclusively breastfed, only 61% received prolonged breastfeeding and 50% received timely introduction of CF. Minimum meal frequency was met by 74% of subjects, but dietary diversity and minimum acceptable diet were only realized in 50% and 40% of the children, respectively. The prevalence of underweight, wasting, and stunting were 26%, 23%, and 28%, respectively. Age of the child, birth order, birth weight, parents' education level, family size and incidence of fever and diarrhea during the previous two weeks were associated with underweight, while child's birth order, fathers' education level, mother's age, family size, completion of the age-appropriate vaccination and fish consumption frequency were associated with wasting. Age of the child, incidence of fever and acute respiratory infection, and fortified food consumption were associated with stunting.

          CONCLUSIONS

          Suboptimal CF practices and high prevalence of underweight, wasting and stunting were found among children aged 6–23 months old in Aceh. These results highlight the need to improve CF and nutritional status.

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          Most cited references14

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          Complementary feeding practices: Current global and regional estimates

          Insufficient quantities and inadequate quality of complementary foods, together with poor feeding practices, pose a threat to children's health and nutrition. Interventions to improve complementary feeding are critical to reduce all forms of malnutrition, and access to data to ascertain the status of complementary feeding practices is essential for efforts to improve feeding behaviours. However, sufficient data to generate estimates for the core indicators covering the complementary feeding period only became available recently. The current situation of complementary feeding at the global and regional level is reported here using data contained within the UNICEF global database. Global rates of continued breastfeeding drop from 74.0% at 1 year of age to 46.3% at 2 years of age. Nearly a third of infants 4–5 months old are already fed solid foods, whereas nearly 20% of 10–11 months old had not consumed solid foods during the day prior to their survey. Of particular concern is the low rate (28.2%) of children 6–23 months receiving at least a minimally diverse diet. Although rates for all indicators vary by background characteristics, feeding behaviours are suboptimal even in richest households, suggesting that cultural factors and poor knowledge regarding an adequate diet for young children are important to address. In summary, far too few children are benefitting from minimum complementary feeding practices. Efforts are needed not only to improve children's diets for their survival, growth, and development but also for governments to report on progress against global infant and young child feeding indicators on a regular basis.
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            Minimum dietary diversity and associated factors among children aged 6–23 months in Addis Ababa, Ethiopia

            Background Dietary diversity has long been recognized as a key element of high quality diets. Minimum Dietary Diversity (MDD) is the consumption of four or more food groups from the seven food groups. Globally, only few children are receiving nutritionally adequate and diversified foods. More than two-thirds of malnutrition related child deaths are associated with inappropriate feeding practice during the first two years of life. In Ethiopia, only 7 % of children age 6–23 months had received the minimum acceptable diet. Therefore, the main aim of this study was to determine the level of minimum dietary diversity practice and identify the associated factors among children aged 6–23 months in Addis Ababa, Ethiopia. Methods A health facility based cross sectional study was undertaken in the three sub-cities of Addis Ababa from 26th February to 28th April, 2016. A multi-stage sampling technique was used to sample the 352 study participants or mothers who had children aged 6–23 months. Data were collected by using a structured and pretested questionnaire, cleaned and entered into Epi info 7 and analyzed using SPSS 24 software. Logistic regression was fitted and odds ratio with 95% confidence interval (CI) with p-value less than 0.05 was used to identify factors associated with minimum dietary diversity. Result In this study, the overall children with minimum dietary diversity score were found to be 59.9%. Mother’s educational attainment and a higher household monthly income were positively associated with the minimum dietary diversity practice. Similarly, mothers’ knowledge on dietary diversity and child feeding was positively associated with minimum dietary diversity child feeding practice, with an adjusted odds ratio of 1.98 (95% CI: 1.11–3.53). Conclusion In this study, the consumption of minimum dietary diversity was found to be high. In spite of this, more efforts need to be done to achieve the recommended minimum dietary diversity intake for all children aged between 6 and 23 months.
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              Diet quality and risk of stunting among infants and young children in low- and middle-income countries

              Age‐appropriate complementary feeding practices are far from optimal among low‐ and middle‐income countries with available data. The evidence on the association between feeding practices and linear growth is mixed. We sought to systematically examine the association between two indictors of dietary quality—dietary diversity and animal source food (ASF) consumption (WHO, 2008)—and stunting (length‐for‐age z‐score) employing existing data from 39 Demographic and Health Surveys. Data on 74,548 children aged 6–23 months were pooled and multiple logistic regression models, adjusting for child, maternal, and household characteristics, employed to assess the association between dietary quality and stunting. Stratified models by child age and by World Bank country‐income classifications (World Bank, 2015) were also applied. Children aged 6–23 months consuming zero food groups in the previous day had a 1.345 higher odds of being stunted when compared to the reference group (≥5 food groups); those who did not consume any ASF in the previous day had a 1.436 higher odds of being stunted compared to children consuming all three types of ASF (egg, meat, and dairy). We estimated that 2,629 cases of stunting would have been averted (12.6% of those stunted) among the population studied if all children had consumed five or more food groups. Outcomes by country‐income groupings showed larger associations of diet diversity and ASF consumption for upper‐ and lower‐middle income countries compared to low‐income countries. In summary, dietary diversity and ASF consumption were associated with stunting, with associations varying by stratified groups.
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                Author and article information

                Journal
                Nutr Res Pract
                Nutr Res Pract
                NRP
                Nutrition Research and Practice
                The Korean Nutrition Society and the Korean Society of Community Nutrition
                1976-1457
                2005-6168
                December 2018
                26 November 2018
                : 12
                : 6
                : 512-520
                Affiliations
                [1 ]Department of Nutrition, Health Polytechnic, Aceh Health Ministry, Jl. Soekarno Hatta, Darul Imarah Aceh Besar 23231, Indonesia.
                [2 ]Department of Community Nutrition, Bogor Agricultural University, Jl. Lingkar Kampus, Babakan, Dramaga, Bogor, Jawa Barat 16680, Indonesia.
                [3 ]Department of Psychology, Syarif Hidayatullah State Islamic University, Jakarta 15412, Indonesia.
                Author notes
                Corresponding Author: Aripin Ahmad, Tel. 62-651-46121, Fax. 62-651-46129, aripinahmad@ 123456poltekkesaceh.ac.id
                Author information
                https://orcid.org/0000-0001-8663-2751
                https://orcid.org/0000-0002-1228-7665
                https://orcid.org/0000-0003-2245-310X
                https://orcid.org/0000-0003-0969-9295
                Article
                10.4162/nrp.2018.12.6.512
                6277313
                30515279
                18c9f49f-e04e-4215-bb82-d4545b52cb25
                ©2018 The Korean Nutrition Society and the Korean Society of Community Nutrition

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 May 2018
                : 02 July 2018
                : 18 October 2018
                Funding
                Funded by: Indonesian Danone Institute Foundation;
                Award ID: 009/ROG-D/IDIF/X2016
                Categories
                Original Research

                Nutrition & Dietetics
                complementary feeding,breast feeding,nutritional status,stunting,infant
                Nutrition & Dietetics
                complementary feeding, breast feeding, nutritional status, stunting, infant

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