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      Timely Initiation of Complementary Feeding and Associated Factors among Mothers of Children Aged 6–24 Months in Dessie Referral Hospital, Northeast Ethiopia, 2019

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          Abstract

          Background

          Timely, appropriate, safe, adequate, and frequent feeding is essential during the transition period for optimal growth and development as well as vulnerability of the child. The age of initiation of complementary feeding needs to be strongly addressed. Thus, the aim of this study was to determine timely initiation of complementary feeding and associated factors among mothers of children aged 6–24 months in Dessie Referral Hospital.

          Methods

          Institutional-based cross-sectional study was conducted among 280 mothers of children aged 6–24 months. A systematic random sampling technique was employed for selection of study participants by considering the 1st comer as a starting point and then at every 5th interval till the sample size was saturated at exit time. Data were collected using pretested and validated structured interviewer-administered questionnaire. Data were entered to Epi data version 3.1 and exported to SPSS version 20.0 software for analysis. Descriptive statistics and binary logistic regression model were used.

          Results

          Overall response rate was 98.2%. Among 275 mothers with children aged 6–24 months, 36 (13.1%), 179 (65.1%), and 60 (21.8%) mothers started giving complementary feeding for their children early (before six months), timely (at six months), and late (after six months), respectively. Mothers' educational status of grade 9–12 and college and above [AOR = 3.03; 95% CI (1.13–8.14), and AOR = 3.74; 95% CI (1.19–11.70), respectively], getting counsel [AOR = 2.83; 95% CI (1.54–5.21)], and poor knowledge [AOR = 0.37; 95% CI (0.19–0.72)] were found to be independent predictors.

          Conclusions

          Prevalence of timely initiation of complementary feeding was high as compared to the national prevalence. Mothers' educational status, getting counsel about complementary feeding, and knowledge were factors associated with timely initiation of complementary feeding. Therefore, awareness creation, counseling, and health education should be done on society by concerned bodies to improve timely introduction of complementary feeding level more than this result.

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          Most cited references28

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          Effect of breastfeeding promotion interventions on breastfeeding rates, with special focus on developing countries

          Background Given the recognized benefits of breastfeeding for the health of the mother and infants, the World Health Organization (WHO) recommends exclusive breastfeeding (EBF) for the first six months of life. However, the prevalence of EBF is low globally in many of the developing and developed countries around the world. There is much interest in the effectiveness of breastfeeding promotion interventions on breastfeeding rates in early infancy. Methods A systematic literature was conducted to identify all studies that evaluated the impact of breastfeeding promotional strategies on any breastfeeding and EBF rates at 4-6 weeks and at 6 months. Data were abstracted into a standard excel sheet by two authors. Meta-analyses were performed with different sub-group analyses. The overall evidence were graded according to the Child Health Epidemiology Reference Group (CHERG) rules using the adapted Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria and recommendations made from developing country studies for inclusion into the Live Saved Tool (LiST) model. Results After reviewing 968 abstracts, 268 studies were selected for potential inclusion, of which 53 randomized and quasi-randomized controlled trials were selected for full abstraction. Thirty two studies gave the outcome of EBF at 4-6 weeks postpartum. There was a statistically significant 43% increase in this outcome, with 89% and 20% significant increases in developing and developed countries respectively. Fifteen studies reported EBF outcomes at 6 months. There was an overall 137% increase, with a significant 6 times increase in EBF in developing countries, compared to 1.3 folds increase in developed country studies. Further sub-group analyses proved that prenatal counseling had a significant impact on breastfeeding outcomes at 4-6 weeks, while both prenatal and postnatal counseling were important for EBF at 6 months. Conclusion Breastfeeding promotion interventions increased exclusive and any breastfeeding rates at 4-6 weeks and at 6 months. A relatively greater impact of these interventions was seen in developing countries with 1.89 and 6 folds increase in EBF rates at 4-6 weeks and at 6 months respectively.
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            Study of complementary feeding practices among mothers of children aged six months to two years - A study from coastal south India.

            Infants and young children are at an increased risk of malnutrition from six months of age onwards, when breast milk alone is no longer sufficient to meet all their nutritional requirements and complementary feeding should be started. Hence this study was undertaken to assess the practices of complementary feeding.
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              Designing appropriate complementary feeding recommendations: tools for programmatic action.

              Suboptimal complementary feeding practices contribute to a rapid increase in the prevalence of stunting in young children from age 6 months. The design of effective programmes to improve infant and young child feeding requires a sound understanding of the local situation and a systematic process for prioritizing interventions, integrating them into existing delivery platforms and monitoring their implementation and impact. The identification of adequate food-based feeding recommendations that respect locally available foods and address gaps in nutrient availability is particularly challenging. We describe two tools that are now available to strengthen infant and young child-feeding programming at national and subnational levels. ProPAN is a set of research tools that guide users through a step-by-step process for identifying problems related to young child nutrition; defining the context in which these problems occur; formulating, testing, and selecting behaviour-change recommendations and nutritional recipes; developing the interventions to promote them; and designing a monitoring and evaluation system to measure progress towards intervention goals. Optifood is a computer-based platform based on linear programming analysis to develop nutrient-adequate feeding recommendations at lowest cost, based on locally available foods with the addition of fortified products or supplements when needed, or best recommendations when the latter are not available. The tools complement each other and a case study from Peru illustrates how they have been used. The readiness of both instruments will enable partners to invest in capacity development for their use in countries and strengthen programmes to address infant and young child feeding and prevent malnutrition.
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                Author and article information

                Contributors
                Journal
                J Nutr Metab
                J Nutr Metab
                jnme
                Journal of Nutrition and Metabolism
                Hindawi
                2090-0724
                2090-0732
                2020
                29 October 2020
                : 2020
                : 6756202
                Affiliations
                1Department of Nursing, School of Nursing and Midwifery, Wollo University, Dessie, Ethiopia
                2Department of Emergency and Ophthalmic Health, School of Nursing and Midwifery, Wollo University, Dessie, Ethiopia
                3Department of Reproductive Health, School of Public Health, Wollo University, Dessie, Ethiopia
                Author notes

                Academic Editor: C. S. Johnston

                Author information
                https://orcid.org/0000-0002-7291-5782
                https://orcid.org/0000-0002-8990-2646
                Article
                10.1155/2020/6756202
                7803225
                7f0ae326-c55d-45d1-ba4a-3cacc5ef3b5c
                Copyright © 2020 Atsedemariam Andualem et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 4 January 2020
                : 23 July 2020
                : 20 October 2020
                Funding
                Funded by: Wollo University
                Categories
                Research Article

                Nutrition & Dietetics
                Nutrition & Dietetics

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