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

  • Amanda Zongrone (a1), Kate Winskell (a2) and Purnima Menon (a3)

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) = 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 = 0·63; P < 0·01) and higher weight-for-age Z-score (WAZ; ES = 0·30; P < 0·05). Higher dietary diversity index (DDI) was associated with higher HAZ (ES = 0·08; P < 0·01 for every 1 point higher DDI) and higher WAZ (ES = 0·04; P < 0·05). Children who achieved minimum diet diversity had higher HAZ (ES = 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.

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Copyright

Corresponding author

*Corresponding author: Email p.menon@cgiar.org

References

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1.Black, RE, Allen, LH, Bhutta, ZA et al. (2008) Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 371, 243260.
2.Victora, CG, de Onis, M, Hallal, PC et al. (2010) Worldwide timing of growth faltering: revisiting implications for interventions. Pediatrics 125, e473e480.
3.Pelletier, D (2002) Toward a Common Understanding of Malnutrition: Assessing the Contributions of the UNICEF Framework. Washington, DC and New York: World Bank and UNICEF.
4.Dewey, KG, Cohen, RJ & Rollins, NC (2004) WHO technical background paper: feeding of nonbreastfed children from 6 to 24 months of age in developing countries. Food Nutr Bull 25, 377402.
5.World Health Organization/Pan American Health Organization (2003) Guiding Principles for Complementary Feeding of the Breastfed Child. Washington, DC: PAHO.
6.World Health Organization (1991) Indicators for Assessing Breastfeeding Practices. Geneva: WHO.
7.Working Group on Infant and Young Child Feeding Indicators (2006) Developing and Validating Simple Indicators of Dietary Quality and Energy Intake of Infants and Young Children in Developing Countries: Summary of Findings from Analysis of 10 Data Sets. Washington, DC: Food and Nutrition Technical Assistance Project, Academy for Educational Development.
8.World Health Organization/UNICEF (2008) Indicators for Assessing Infant and Young Child Feeding Practices: Conclusions of a Consensus Meeting held 6–8 November 2007 in Washington DC, USA. Geneva: WHO.
9.Arimond, M, Daelmans, B & Dewey, K (2008) Indicators for feeding practices in children. Lancet 371, 541542.
10.Ruel, MT & Menon, P (2002) Child feeding practices are associated with child nutritional status in Latin America: innovative uses of the demographic and health surveys. J Nutr 132, 11801187.
11.Ntab, B, Simondon, KB, Milet, J et al. (2005) A young child feeding index is not associated with either height-for-age or height velocity in rural Senegalese children. J Nutr 135, 457464.
12.Sawadogo, PS, Martin-Prevel, Y, Savy, M et al. (2006) An infant and child feeding index is associated with the nutritional status of 6- to 23-month-old children in rural Burkina Faso. J Nutr 136, 656663.
13.Garg, A & Chadha, R (2009) Index for measuring the quality of complementary feeding practices in rural India. J Health Popul Nutr 27, 763771.
14.Moursi, MM, Treche, S, Martin-Prevel, Y et al. (2009) Association of a summary index of child feeding with diet quality and growth of 6–23 months children in urban Madagascar. Eur J Clin Nutr 63, 718724.
15.Zhang, J, Shi, L, Wang, J et al. (2009) An infant and child feeding index is associated with child nutritional status in rural China. Early Hum Dev 85, 247252.
16.Saha, KK, Frongillo, EA, Alam, DS et al. (2008) Appropriate infant feeding practices result in better growth of infants and young children in rural Bangladesh. Am J Clin Nutr 87, 18521859.
17.Giashuddin, MS, Kabir, M, Rahman, A et al. (2003) Exclusive breastfeeding and nutritional status in Bangladesh. Indian J Pediatr 70, 471475.
18.Arifeen, SE, Black, RE, Caulfield, LE et al. (2001) Determinants of infant growth in the slums of Dhaka: size and maturity at birth, breastfeeding and morbidity. Eur J Clin Nutr 55, 167178.
19.Kalanda, BF, Verhoeff, FH & Brabin, BJ (2006) Breast and complementary feeding practices in relation to morbidity and growth in Malawian infants. Eur J Clin Nutr 60, 401407.
20.Victora, CG, Morris, SS, Barros, FC et al. (1998) Breast-feeding and growth in Brazilian infants. Am J Clin Nutr 67, 452458.
21.Spyrides, MH, Struchiner, CJ, Barbosa, MT et al. (2008) Effect of predominant breastfeeding duration on infant growth: a prospective study using nonlinear mixed effect models. J Pediatr (Rio J) 84, 237243.
22.Alvarado, BE, Zunzunegui, MV, Delisle, H et al. (2005) Growth trajectories are influenced by breast-feeding and infant health in an Afro-Colombian community. J Nutr 135, 21712178.
23.Gokcay, G, Turan, JM, Partalci, A et al. (2003) Growth of infants during the first year of life according to feeding regimen in the first 4 months. J Trop Pediatr 49, 612.
24.Simondon, KB, Simondon, F, Costes, R et al. (2001) Breast-feeding is associated with improved growth in length, but not weight, in rural Senegalese toddlers. Am J Clin Nutr 73, 959967.
25.Eckhardt, CL, Rivera, J, Adair, LS et al. (2001) Full breast-feeding for at least four months has differential effects on growth before and after six months of age among children in a Mexican community. J Nutr 131, 23042309.
26.Villalpando, S & Lopez-Alarcon, M (2000) Growth faltering is prevented by breast-feeding in underprivileged infants from Mexico City. J Nutr 130, 546552.
27.Espo, M, Kulmala, T, Maleta, K et al. (2002) Determinants of linear growth and predictors of severe stunting during infancy in rural Malawi. Acta Paediatr 91, 13641370.
28.Hop, LT, Gross, R, Giay, T et al. (2000) Premature complementary feeding is associated with poorer growth of Vietnamese children. J Nutr 130, 26832690.
29.Galler, JR, Ramsey, FC, Harrison, RH et al. (1998) Infant feeding practices in Barbados predict later growth. J Nutr 128, 13281335.
30.Simondon, KB & Simondon, F (1997) Age at introduction of complementary food and physical growth from 2 to 9 months in rural Senegal. Eur J Clin Nutr 51, 703707.
31.Kant, AK (1996) Indexes of overall diet quality: a review. J Am Diet Assoc 96, 785791.
32.Kant, AK (2004) Dietary patterns and health outcomes. J Am Diet Assoc 104, 615635.
33.Ruel, MT (2003) Operationalizing dietary diversity: a review of measurement issues and research priorities. J Nutr 133, 11 Suppl. 2, 3911S3926S.
34.Hatloy, A, Torheim, LE & Oshaug, A (1998) Food variety – a good indicator of nutritional adequacy of the diet? A case study from an urban area in Mali, West Africa. Eur J Clin Nutr 52, 891898.
35.Onyango, AW (2003) Dietary diversity, child nutrition and health in contemporary African communities. Comp Biochem Physiol A Mol Integr Physiol 136, 6169.
36.Hoddinott, J & Yisehac, Y (2002) Dietary Diversity as a Household Food Security Indicator. Washington, DC: Food and Nutrition Technical Assistance Project, Academy for Educational Development.
37.Arimond, M & Ruel, MT (2004) Dietary diversity is associated with child nutritional status: evidence from 11 demographic and health surveys. J Nutr 134, 25792585.
38.Rah, JH, Akhter, N, Semba, RD et al. (2010) Low dietary diversity is a predictor of child stunting in rural Bangladesh. Eur J Clin Nutr 64, 13931398.
39.Onyango, A, Koski, KG & Tucker, KL (1998) Food diversity versus breastfeeding choice in determining anthropometric status in rural Kenyan toddlers. Int J Epidemiol 27, 484489.
40.Allen, L, Black, A, Backstrand, J et al. (1991) An analytical approach for exploring the importance of dietary quality versus quantity in the growth of Mexican children. Food Nutr Bull 13, 95104.
41.Hatloy, A, Hallund, J, Diarra, MM et al. (2000) Food variety, socioeconomic status and nutritional status in urban and rural areas in Koutiala (Mali). Public Health Nutr 3, 5765.
42.National Institute of Population Research and Training, Mitra and Associates & Macro International (2009) Bangladesh Demographic and Health Survey 2007. Dhaka and Calverton, MD: National Institute of Population Research and Training/Mitra and Associates and Macro International.
43.World Health Organization (2010) The WHO Child Growth Standards. Geneva: WHO.
44.Measure DHS (2010) Demographic and Health Surveys. Methodology: The Wealth Index. http://www.measuredhs.com/topics/Wealth-and-Socioeconomics.cfm (accessed November 2011).
45.Arifeen, S, Black, RE, Antelman, G et al. (2001) Exclusive breastfeeding reduces acute respiratory infection and diarrhea deaths among infants in Dhaka slums. Pediatrics 108, E67.
46.Kramer, MS & Kakuma, R (2004) The optimal duration of exclusive breastfeeding: a systematic review. Adv Exp Med Biol 554, 6377.
47.World Health Organization (1998) Complementary Feeding of Young Children In Developing Countries: A Review of Current Scientific Knowledge. WHO/NUT/981. Geneva: WHO.
48.Arnold, F, Parasuraman, S, Arokiasamy, P et al. (2009) Nutrition in India. National Family Health Survey (NFHS-3), India, 2005–06. Mumbai and Calverton, MD: International Institute for Population Sciences and ICF Macro.
49.Menon, P & Stoltzfus, RJ (2012) Building convergence in science, programs and policy actions on child undernutrition: symposium rationale and overview. Adv Nutr 3, 224226.
50.Caulfield, L, Huffman, S & Piwoz, E (1999) Interventions to improve intake of complementary foods by infants 6 to 12 months of age in developing countries: impact on growth and on the prevalence of malnutrition and potential contribution to child survival. Food Nutr Bull 20, 183200.
51.Bhutta, ZA, Darmstadt, GL, Hasan, BS et al. (2005) Community-based interventions for improving perinatal and neonatal health outcomes in developing countries: a review of the evidence. Pediatrics 115, 519617.

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