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      Determinants of age‐appropriate breastfeeding, dietary diversity, and consumption of animal source foods among Indonesian children

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          Abstract

          Global child feeding practices remain suboptimal. In this study, we assess the determinants of age‐inappropriate breastfeeding, dietary diversity, and consumption of 3+ types of animal source foods (ASFs) using 11,687 observations from combined data from the Indonesian Demographic Health Survey of 2012 and 2017. We used linear and logistic regression after adjusting for the complex sampling design. Child's age and quality of antenatal care (ANC) were associated with all outcomes. Socio‐economic status and labour force participation were positively associated with higher dietary diversity score, ASF consumption, and age‐inappropriate breastfeeding. More ANC visits and having consultation at ANC were associated with more dietary diversity. Higher women's knowledge level was associated with more dietary diversity and consuming more ASF. Compared with western Indonesia, more children in eastern Indonesia were age‐inappropriately breastfed and had lower dietary diversity. The Indonesian government needs to develop programmes to improve child feeding particularly in eastern Indonesia, focusing on improving dietary diversity and ASF consumption in poorer households and on prolonging breastfeeding in richer households. Women's labour force participation should be encouraged, but programmes for working mothers are also needed to support continued breastfeeding and to express breast milk. ANC and postnatal programmes need improved consultation sessions for child feeding.

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          Associations between women's autonomy and child nutritional status: a review of the literature.

          Around the world, many women continue to experience low levels of autonomy. Recent literature has reported that the health consequences of low maternal autonomy extend beyond mothers and translate into health consequences for their children, and may be an important causal factor in child malnutrition. This review summarises the current knowledge of the relationship between maternal autonomy and children's nutritional status (defined as any measure that reflects the nutritional state of the body, such as birthweight or anthropometric scores) and child-feeding practices. The review also includes both discussion of the limitations found in the literature and directions for future research. A systematic review of the literature was conducted. Results of the studies included in the review strongly suggest that raising maternal autonomy is an important goal for improving children's nutritional status, yet gaps in the current knowledge exist, further confounded by issues with how autonomy is measured and limitations of cross-cultural comparability. A thorough understanding of the consequences of restricting women's autonomy will inform programmes and policy worldwide, and speed progress towards both empowering women and alleviating the global burden of child malnutrition.
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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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              Determinants of inappropriate complementary feeding practices in young children in India: secondary analysis of National Family Health Survey 2005-2006.

              In India, poor feeding practices in early childhood contribute to the burden of malnutrition as well as infant and child mortality. This paper aims to use the newly developed World Health Organization (WHO) infant feeding indicators to determine the prevalence of complementary feeding indicators among children of 6-23 months of age and to identify the determinants of inappropriate complementary feeding practices in India. The study data on 15,028 last-born children aged 6-23 months was obtained from the National Family Health Survey 2005-2006. Inappropriate complementary feeding indicators were examined against a set of child, parental, household, health service and community level characteristics. The prevalence of timely introduction of complementary feeding among infants aged 6-8 months was 55%. Among children aged 6-23 months, minimum dietary diversity rate was 15.2%, minimum meal frequency 41.5% and minimum acceptable diet 9.2%. Children in northern and western geographical regions of India had higher odds for inappropriate complementary feeding indicators than in other geographical regions. Richest households were less likely to delay introduction of complementary foods than other households. Other determinants of not meeting minimum dietary diversity and minimum acceptable diet were: no maternal education, lower maternal Body Mass Index (BMI) (<18.5 kg/m(2)), lower wealth index, less frequent (<7) antenatal clinic visits, lack of post-natal visits and poor exposure to media. A very low proportion of children aged 6-23 months in India received adequate complementary foods as measured by the WHO indicators. © 2011 Blackwell Publishing Ltd.
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                Author and article information

                Contributors
                sksebayang@fkm.unair.ac.id
                Journal
                Matern Child Nutr
                Matern Child Nutr
                10.1111/(ISSN)1740-8709
                MCN
                Maternal & Child Nutrition
                John Wiley and Sons Inc. (Hoboken )
                1740-8695
                1740-8709
                02 October 2019
                January 2020
                : 16
                : 1 ( doiID: 10.1111/mcn.v16.1 )
                : e12889
                Affiliations
                [ 1 ] Department of Biostatistics and Population Studies Universitas Airlangga, Banyuwangi Campus Banyuwangi Indonesia
                [ 2 ] Sydney School of Public Health University of Sydney Sydney New South Wales Australia
                [ 3 ] Department of Epidemiology Universitas Airlangga, Banyuwangi Campus Banyuwangi Indonesia
                [ 4 ] Faculty of Nursing Universitas Airlangga Surabaya Indonesia
                Author notes
                [*] [* ] Correspondence

                Susy K. Sebayang, Research Group for Health and Wellbeing of Women and Children, Department of Biostatistics and Population Studies, Faculty of Public Health, Universitas Airlangga, Banyuwangi Campus, Jl. Ikan Wijinongko No 18, Banyuwangi 68418, East Java Indonesia.

                Email: sksebayang@ 123456fkm.unair.ac.id

                Author information
                https://orcid.org/0000-0003-0470-8308
                https://orcid.org/0000-0002-1554-5180
                https://orcid.org/0000-0001-7988-9196
                https://orcid.org/0000-0002-2371-8950
                Article
                MCN12889 MCN-12-18-OA-3596.R1
                10.1111/mcn.12889
                7038882
                31577064
                e00355fc-0b96-476d-86e2-7e9968548dac
                © 2019 The Authors. Maternal & Child Nutrition published by John Wiley & Sons, Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 April 2019
                : 15 July 2019
                : 20 August 2019
                Page count
                Figures: 1, Tables: 4, Pages: 19, Words: 5125
                Funding
                Funded by: Indonesian Ministry of Research, Technology and Higher Education
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                January 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.5 mode:remove_FC converted:19.02.2020

                breastfeeding,dietary diversity,animal source food,child feeding,indonesia

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