Academic journal article Journal of Health Population and Nutrition

Complementary Feeding Practices among Mothers in Selected Slums of Dhaka City: A Descriptive Study

Academic journal article Journal of Health Population and Nutrition

Complementary Feeding Practices among Mothers in Selected Slums of Dhaka City: A Descriptive Study

Article excerpt

INTRODUCTION

Adequate nutrition during infancy and early childhood is essential to ensure the growth, health, and development of children to their full potential. The World Health Organization (WHO) and United Nations Children's Fund (UNICEF) recommend exclusive breastfeeding (EBF) for six months, i.e. 180 days (1) and addition of complementary foods at six months of age with continued breastfeeding till at least two years (2). Globally, optimal breastfeeding could prevent 13% of deaths of children aged less than five years while appropriate complementary feeding (CF) practices might result in an additional 6% reduction in under-five mortality (3), especially in developing countries as ours. Poor feeding practices, coupled with high rates of infectious diseases, are the proximate causes of malnutrition during the first two years of life. The second half of an infant's first year is especially a vulnerable time when breastmilk alone is no longer sufficient to meet his/her nutritional requirements, and CF should be started (4).

During the period of CF, the young child gradually becomes habituated to eating family foods. Complementary foods bridge the gap in energy, vitamin A, and iron intake, which occurs in breast- fed infants at six months of age (2). Too early or too late introduction of CF may lead to nutritional deficiencies of iron, zinc, calcium, and vitamins (2). Therefore, CF needs to be nutritionally adequate and safe and appropriately fed to meet the energy and nutrient needs of the young child.

CF is also influenced by cultural factors, beliefs, and knowledge of parents on appropriate practices (5). Similarly, psychosocial care, safe preparation and proper storage of complementary foods, and hygiene practice are also the important determinants of proper CF practices.

Urbanization is now occurring at a rapid pace, which has significant implications for child survival. Slums in Dhaka are characterized by poor environmental sanitation and livelihood conditions. Generally, the recommended feeding practices are not followed in the urban or rural communities in Bangladesh (6). Moreover, due to limited health services, the recommendations are also not followed in urban slums.

To the best of our knowledge, no studies have been undertaken to gather information on CF practices among slum mothers in Dhaka. In this study, we assessed the CF practices, with reference to the recommendations of WHO, in selected slums of Dhaka city.

MATERIALS AND METHODS

Study site and subjects

This descriptive study was carried out during January-June 2010 in four urban slums (Tejgoan, Rayerbazar, Beribadh, and Jafrabad) in Dhaka city. In total, 120 mother-child pairs were selected conveniently. The mean (standard deviation) age of the children was 14.68±5.55 months. The minimum required sample-size was calculated using the formula: n=Z2pq/d2 where n=required sample-size, p=expected proportion, Z=95% confidence interval, and d=5% error. In Bangladesh, the proportion of CF practices among the mothers of 6-9 months old children is 74% (7). Therefore, p=74% was taken as the expected proportion, i.e. 0.74, and q is (1-p)=0.26. The study included children who were given breastmilk and taking any complementary foods.

Collection of data

Data were collected through face-to-face interviews, using a questionnaire developed following the guidelines of WHO (2) for CF practices. The sociodemographic profiles of mothers of the four slums were similar.

The dietary intake of the children was calculated using 24-hour recall (8). Adequacy of CF practices was assessed according to the recommendation of WHO (4): 6-8 months: 2-3 meals + 1-2 snack(s) (200 kcal) per day; 9-11 months: 3-4 meals + 1-2 snack(s) (300 kcal) per day; and 12-23 months: 3-4 meals + 1-2 snack(s) (550 kcal) per day.

Analysis of data

Data were analyzed using the SPSS software (version 11.5). Frequencies were calculated for descriptive analysis. …

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