Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Announcement
Article
Book Review
Brief Research
Brief Research Article
Case Report
CME
CME/View Point/Book Review
COMMENTARY
Editorial
Letter to Editor
Letter to the Editor
OBITUARY
Organisation News
Orginal Article
OriginaI Article
Original Aeticle
Original Article
Original Article 1
Original Article 2
Original Article 3
Original Article 4
Original Research
Other
Report
Review Article
SHORT ARTICLE
Special Article
Technology Review
View Point
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Announcement
Article
Book Review
Brief Research
Brief Research Article
Case Report
CME
CME/View Point/Book Review
COMMENTARY
Editorial
Letter to Editor
Letter to the Editor
OBITUARY
Organisation News
Orginal Article
OriginaI Article
Original Aeticle
Original Article
Original Article 1
Original Article 2
Original Article 3
Original Article 4
Original Research
Other
Report
Review Article
SHORT ARTICLE
Special Article
Technology Review
View Point
View/Download PDF

Translate this page into:

ORIGINAL ARTICLE
9 (
2
); 75-82
doi:
10.53553/JCH.v09i02.005

Assessment of Infant and Young Child Feeding Practices and its Relation with Nutritional Status of Under Two Children: A Community Based Study at Malda Town, West Bengal

House Physician, Malda Medical College & Hospital
Professor, Department of Community Medicine, Malda Medical College & Hospital
Assistant Professor, Department of Community Medicine, Raiganj Government Medical College & Hospital

CORRESPONDING AUTHOR: Dr Nazrul Mallick, Vill- Nandanpur, Post Office - Jejur, Police Station - Haripal, District- Hooghly, Pin- 712405, West Bengal, India E Mail ID: nazrulmallick83@gmail.com

Licence
This open access article is licensed under Creative Commons Attribution 4.0 International (CC BY 4.0). http://creativecommons.org/licenses/by/4.0

Abstract

Background:

Correct practices of nutrition remains the cornerstone to combat the problem of under nutrition among the children. Most important of them is propriety of breast feeding. Its initiation within an hour of birth is important for both mother and child as the first breast milk (colostrums) is considered to be highly nutritious and has antibodies that protect the new-born from serious diseases. The study was conducted to assess the IYCF practices among the under two children and the relationship between the aforesaid practices and the nutritional status of the study participants of a district town of West Bengal.

Methods:

It was a community based observational study, cross-sectional in design conducted among children aged less than twenty four months in a district town of West Bengal using cluster sampling method among 390 participants.

Results:

The study revealed that less than half (47.9%) of mothers initiated breast feeding within one hour of birth. Exclusive breast feeding rate at 6 months was 68.3% and 84.3%mothers were continuing breast feeding at two years age of the child. Optimal diversity of food was seen among 30.3% eligible children. The proportion of underweight and stunting was 40.7% and 43.6% respectively and were significantly related to initiation of breast feeding in one hour, adequate food diversity, adequate meal frequency, age adjusted minimum acceptable diet and exposure to bottle feeding.

Conclusion:

The study reiterates that appropriate feeding practices in first two years of life are crucial to attain proper growth of the children in their later life.

Keywords

IYCF indicators
Malnutrition
Nutritional status
Stunting

INTRODUCTION

As today‘s children are the citizens of tomorrow‘s world, their survival, protection and development are the prerequisites for the future development of humanity(1). Exclusivity of breast milk without any pre-lacteal feeding till six months, and its continuation till two years along with nutritionally rich complementary feeds of adequate amount and frequency is of equal significance to prevent malnutrition in children. Studies have proved absence of any of these practices leading to adversities in the health of the child(2,3). Considering the above, World Health Organization (WHO) has come up with objective definition of the different specific aspects of these practices, called optimal Infant and Young Child Feeding (IYCF) practices and the various indicators to assess those(4). So it becomes an imperative to find out the association of these practices of an area with the nutritional status of the children there.

National Family Health Survey IV (NFHS IV, 2015 - 2016) has demonstrated a rise in severely undernourished children in West Bengal with reduction in exclusive breastfeeding practice from 58.6 percent to 52.3 percent (NFHS III to IV) among mothers of West Bengal based on youngest child living with the mother, Beside this proportion of breastfeeding and non-breastfeeding children receiving adequate diet was significantly low(5). There has been some improvement regarding some basic indicators of IYCF practices but some studies still indicate that there exists heterogeneity in the finding that these changes are not uniform, neither is their association with the nutritional status of the children there(6).

Only 42% of newborns are put to the breast within the first hour of birth, and only 2 in 5 infants less than 6 months of age are exclusively breastfed in global reports(7). In India 41.6% mothers starts breastfeeding within 1 hour of birth with exclusivity in 55% cases(2,8). However, a significant decrease in early initiation of breast feeding (34.2%) with exclusivity around 58.7% was found in a study conducted in rural setup of West-Bengal(9). Breastfeeding practices among Indian mothers are almost universal but initiation of breastfeeding is not timely and the valuable colostrums is discarded may be out of ignorance or false notions which is reflective of social-cultural and socio-economic conditions(10). If a child is malnourished in the womb of the mother or before the age of 2 years the damage can be irreparable. Thus malnutrition remains a hidden crisis for the world. To reverse the scenario and to make a difference, it is essential to concentrate on the nutrition of pregnant women, breastfeeding women and children under 2 years(11).

So with these perspectives; the study was conducted to assess the IYCF practices among the under two children and to find out the relationship between the aforesaid practices and the nutritional status of the study subjects of a district town of West Bengal.

MATERIAL & METHODS

It was a Community based observational study, cross-sectional in design conducted among children aged less than twenty four months in the municipal area of English Bazar, Malda town. Data were collected in the study period of 2 months (June- July 2018).

Sample size:

According to National Family Health Survey IV West Bengal (2015 - 2016)(5) the average proportion of three principal IyCf indicators (Children under age 3 years breastfed within one hour of birth, Children under age 6 months exclusively breastfed and Children age 6- 8 months receiving solid or semi-solid food and breast milk) was calculated to be 50.6%. Taking that proportion as the prevalence, considering 95% confidence level and absolute precision of 0.075, the sample size was calculated.

Sample size (n) = Za2 *p*(1-p) /E2 = 171 (Where Za =1.96 at that 95% confidence level, p = assumed prevalence rate (0.506), E= Absolute precision=0.075)

Multiplying by a design effect of 2 for cluster sampling and adding a non-response rate of 10% the sample size was 377. Finally the study was conducted among 390 participants.

Inclusion and exclusion criteria:

Inclusion criteria was children aged less than twenty four months in the municipal area of English Bazar, Maldatown. Exclusion criteria was those who were not given consent.

Sampling Procedure:

The standard procedure of 15-cluster sampling was followed from the selected municipal wards (Clusters) of the English Bazar municipality. The list of population of the individual wards was collected from the municipality and it was used to select the clusters based on population proportional to size (PPS). It meant (390/15=) 26 subjects were collected from each cluster. Study population were children aged less than twenty four months in the municipal area of English Bazar, Malda town.

Strategy of data collection:

Each cluster was divided into two halves based on geographical distribution of the locality. From the midpoint of each half moved towards a direction chosen randomly to collect sample. Starting from the first home of that direction, adjacent homes were visited until required samples were not met. The parents of the child were explained the objectives, procedure and benefits of the study. The assent form was provided to them and once the consent was obtained the interview and anthropometric assessments were conducted. One cluster or ward was visited on a single day, so data was collected by researcher on fifteen visits to cover the study area.

IYCF practices, based on the definitions described by WHO(4)

  1. Early initiation of breastfeeding (IBF) - Proportion of children born in the last 24 months who were put to the breast within one hour of birth

  2. Exclusive breastfeeding (EBF) under 6 months - Proportion of infants 0-5 months of age who are fed exclusively with breast milk.

  3. Continued breastfeeding at 1 year (CBF-1) - Proportion of children 12-15 months of age who are fed breast milk.

  4. Introduction of solid, semi-solid or soft foods or Complementary feeding (CF) - Proportion of infants 6-8 months of age who receive solid, semi-solid or soft foods.

  5. Minimum dietary diversity (MDD) - Proportion of children 6-23 months of age who receive foods from 4 or more food groups.

  6. Minimum meal frequency (MMF) - Proportion of breastfed and non-breastfed children 6-23 months of age who receive solid, semi-solid, or soft foods (but also including milk feeds for non-breastfed children) the minimum number of times or more.

  7. Minimum acceptable diet (MAD) - Proportion of children 6-23 months of age who receive a minimum acceptable diet (apart from breast milk).

  8. Consumptionof iron-rich or iron- fortified foods (IF) - Proportion of children 6-23 months of age who receive an iron- rich food or iron-fortified food that is specially designed for infants and young children, or that is fortified in the home.

  9. Children ever breastfed (CEBF) - Proportion of children born in the last 24 months who were ever breastfed.

  10. Continued breastfeeding at 2 years (CBF-2) - Proportion of children 20-23 months of age who are fed breast milk.

  11. Age-appropriate breastfeeding (AABF) - Proportion of children 0-23 months of age who are appropriately breastfed.

  12. Predominant breastfeeding under 6 months (PBF) - Proportions of infants 0-5 months of age who are predominantly breastfed.

  13. Duration of breastfeeding - Median duration of breastfeeding among children 0-35 months of age.

  14. Bottle feeding (BOF) - Proportion of children 0-23 months of age who are fed with a bottle.

  15. Milk feeding frequency for non- breastfed children - Proportion of non-breastfed children 6-23 months of age who receive at least 2 milk feedings.

The indicators of nutritional status of the children were Weight for Age (WFA) and Length for Age (LFA)

Data Analysis:

Data compiled on Microsoft Excel worksheet. Data were analyzed using Statistical Package for Social Science (SPSS) statistical software program version 16 (IBM, Chicago, USA). The categorical variables was analyzed by proportions while the continuous ones by means and standard deviations. Categorical characteristics were compared between groups with the use of Chi-square test. For the entire entire statistical test applied; p value less than 0.05 considered as significant.

Ethical clearance:

Ethical clearance was obtained from the Institutional Ethics Committee of Malda Medical College prior to the initiation of the study.

RESULTS

The study revealed that out of the 390 respondents; six were not initiated breast feeding at all. Among the rest 384 children; breast feeding was initiated within recommended time in 184 (47.9%) subjects [Indicator 1]. (Table 1) Exclusive breast feeding for among children of 0-5 months of age was seen in 41 cases, calculating the rate for Indicator 2 was (41/60*100=) 68.33%. Minimum dietary diversity (Proportion of children 6-23 months of age who receive foods from 4 or more food during the previous day - Indicator 5) was calculated to be (100/330*100=) 30.30%. (Table 2) Indicator 6; Minimum meal frequency (Proportion of breastfed and non-breastfed children 6-23 months of age who receive solid, semi-solid, or soft foods (but also including milk feeds for non-breastfed children) the minimum number of times or more was found to be (270/300*100=) 90% for breast-fed children and 28/30*100= 93.33% for non-breast-fed children. Minimum acceptable diet; Proportion of children 6-23 months of age who receive a minimum acceptable diet (apart from breast milk; Indicator 7; was found to be (90/300*100=) 30% for breast-fed children and (9/30*100=) 30% for non-breast-fed children. Continued breastfeeding at 2 years, Indicator 10, (Proportion of children 20-23 months of age who are currently fed with breast milk) was found to be (58/69*100=) 84.05%. Age-appropriate breastfeeding, Indicator 11; Proportion of children 0-23 months of age who are appropriately breastfed was (41/60*100=) 68.33% for children 0 - 5 months of age and (308/330*100=) 93.3% for children 6-23 months of age. Indicator 13 could not be calculated as it required recruitment of 0 - 36 months children; which was beyond the scope of the study. Proportion of children 0-23 months of age who are fed with a bottle was found to be (147/390*100 =) 37.69% (Indicator 14). Lastly; proportion of non-breastfed children 6-23 months of age who receive at least 2 milk feedings was (12/30*100=) 40% (Indicator 15). Total number of children with normal Weight For Age (WFA) were 233 (59.7%). Numbers of underweight children were 157 (40.3%). Total number of children with normal Length For Age (LFA) were 220 (56.4%). Numbers of stunting children were 170 (43.6%). The details of the relationship between such anthropometric indicators and the different IYCF practices are shown in (Table 3). It was found that Weight for Age was significantly related with early initiation of breast feeding, minimum dietary diversity, minimum meal frequency, minimum acceptable diet, bottle feeding while Length for Age was significantly associated with early initiation of breast feeding only.

TABLE 1 DISTRIBUTION OF STUDY PARTICIPANTS ACCORDING TO TIME OF INITIATION OF BREAST FEEDING (N=384)
Age Within 1 hr No (%) 1-6 hrs No (%) 6-24 hrs No (%) >24 hrs No (%) Total Proportion
0 to 5 month 23 (39%) 22 (37.3%) 05 (8.5%) 09 (15.2%) 59 0.15
6-11 months 60 (50%) 37 (30.8%) 07 (5.8%) 16 (13.4%) 120 0.31
12-17 months 56 (52.8%) 33 (31.1%) 05 (4.7%) 12 (11.4%) 106 0.28
18-23 months 48 (48.5%) 35 (35.3%) 05 (5.1%) 11 (11.1%) 99 0.26
Total 187 127 22 48 384*

* 6 children did not breastfed ever

TABLE 2 DISTRIBUTION OF STUDY PARTICIPANTS ACCORDING TO DIFFERENT IYCF PRACTICES (N= 390)
Practices Age Yes No (%) No No (%) Total
Exclusivity of breast feeding 0 to 5 months 41 (68.4%) 19 (31.6%) 60
6-11 months 23 (18.5%) 101 (81.5%) 124
12-17 months 03 (2.8%) 104 (97.2%) 107
18-23 months 01 (1.1%) 98 (98.9%) 99
Total 68 322 390
Still Breastfeeding 0 to 5 months 57 (95%) 03 (5%) 60
6-11 months 116(94%) 08 (6%) 124
12-17 months 99(92.5%) 08 (7.5%) 107
18-23 months 85(85.8%) 14 (14.2%) 99
Total 357 33 390
Introduction of solid, semisolid or soft foods 0 to 5 months 18 (30%) 42 (70%) 60
6-11 months 99 (80%) 25 (20%) 124
12-17 months 103 (96.3%) 04 (3.7%) 107
18-23 months 96 (97%) 03 (3%) 99
Total 316 74 390
Minimum dietary diversity 0 to 5 months 00 (00%) 60 (100%) 60
6-11 months 18 (14.5%) 106 (85.5%) 124
12-17 months 39 (36.4%) 68 (63.6%) 107
18-23 months 43 (43.4%) 56 (56.6%) 99
Total 100 290 390
Consumption of iron-rich or iron-fortified foods 0 to 5 months 00 (00%) 60 (100%) 60
6-11 months 10 (8.1%) 114 (91.9%) 124
12-17 months 25 (23.4%) 82 (76.6%) 107
18-23 months 47 (47.5%) 52 (52.5%) 99
Total 82 308 390
Children ever breastfed 0 to 5 months 59 (98.3%) 01 (1.7%) 60
6-11 months 120 (96.7%) 04 (3.3%) 124
12-17 months 106 (99%) 01 (1%) 107
18-23 months 99 (100%) 00 (00%) 99
Total 384 06 390
Predominant breastfeeding under 6 months 0 to 5 months 42 (70%) 18 (30%) 60
6-11 months 24 (19.4%) 100 (80.6%) 124
12-17 months 04 (3.7%) 103 (96.3%) 107
18-23 months 01 (1%) 98 (99%) 99
Total 71 319 390
Bottle feeding 0 to 5 months 14 (23.3%) 46 (76.7%) 60
6-11 months 50 (40.3%) 74 (59.7%) 124
12-17 months 44 (41.1%) 63 (58.9%) 107
18-23 months 39 (39.4%) 60 (60.6%) 99
Total 147 243 390
TABLE 3 RELATIONSHIP BETWEEN IYCF INDICATORS WITH WEIGHT FOR AGE AND LENGTH FOR AGE
Indicator Practices Weight For Age (WFA) Chi- square Test Length For Age (LFA) Chi- square Test
Normal Grade 1 Grade 2 Normal Grade 1 Grade 2
IBF YES(187) 132 70.6% 34 18.2% 21 11.2 % χ2 =18.21 1 df= 1 P= 0.001 109 58.3% 44 23.5 % 34 18.2 % χ2 =7.147 df= 1 P= 0.028
NO (197) 97 49.2% 60 30.5% 40 20.3 % 107 54.3% 33 16.7 % 57 29%
EBF YES (41) 11 26.8% 12 29.2% 18 44% χ2 =0.949 df= 1 P= 0.621 13 31.7% 06 14.6 % 22 53.7 % χ2=2.33 5 df= 1 P= 0.311
NO (19) 07 37% 06 31.5% 06 31.5 % 05 26.3% 06 31.6 % 08 42.1 %
CBF-1 YES (55) 40 72.8% 10 18.2% 05 9% χ2 =1.657 df= 1 P= 0.436 32 58.2% 12 21.8 % 11 20% χ2 =2.091 df= 1 P= 0.351
NO (04) 03 75% 00 00% 01 25% 02 50% 02 50% 00 00%
CF YES (49) 31 63.3% 12 24.5% 06 12.2 % χ2 =2.282 df= 1 P= 0.319 38 77.5% 07 14.3 % 04 8.2% χ2 =0.236 df= 1 P= 0.888
NO (19) 09 47.4% 05 26.3% 05 26.3 % 15 79% 02 10.5 % 02 10.5 %
MDD YES (100) 92 92% 04 4% 04 4% χ2 =45.89 5 df= 1 P= 0.001 60 60% 23 23% 17 17% χ2 =1.157 df= 1 P= 0.561
NO (230) 123 53.5% 73 31.7% 34 14.8 % 142 61.7% 42 18.3 % 46 20%
MMF YES (298) 201 67.4% 67 22.5% 30 10.1 % χ2 =9.038 df= 1 P= 0.010 180 60.4% 60 20.1 % 58 19.5 % χ2=0.85 0 df= 1 P= 0.653
NO (32) 14 43.8% 10 31.2% 08 25% 22 68.8% 05 15.6 % 05 15.6 %
MAD YES (99) 91 92% 04 4% 04 4% χ2 =36.94 3 df= 1 P= 0.000 59 59.6% 23 23.2 % 17 17.2 % χ2 =0.822 df= 1 P= 0.662
NO (31) 13 42% 10 32.2% 08 25.8 % 21 67.8% 05 16.1 % 05 16.1 %
IF YES (82) 62 75.6% 14 17.1% 06 7.3% χ2 =5.334 df= 1 p= 0.069 44 53.7% 18 21.9% 20 24.4% χ2=2.90 3 df= 1 p= 0.234
NO (248) 153 61.7% 63 25.4% 32 12.9% 158 63.7% 47 19% 43 17.3%
CEBF YES (384) 229 59.6% 94 24.5% 61 15.9% χ2 =0.199 df= 1 p= 0.905 216 56.3% 77 20% 91 23.7% χ2 =1.546 df= 1 p= 0.461
NO (06) 04 66.6% 01 16.7% 01 16.7% 04 66.7% 00 00% 02 33.3%
CBF-2 YES (58) 37 63.8% 15 25.9% 06 10.3% χ2 =0.348 df= 1 p= 0.833 27 46.6% 13 22.4% 18 31% χ2=0.24 2 df= 1 p= 0.885
NO (11) 08 72.7% 02 18.2% 01 9.1% 06 54.5% 02 18.2% 03 27.3%
AABF YES (41) 11 26.8% 12 29.3% 18 43.9% χ2 =0.948 df= 1 p= 0.621 13 31.7% 06 14.6% 22 53.7% χ2 =2.336 df= 1 p= 0.310
NO (19) 07 36.8% 06 31.6% 06 31.6% 05 26.3% 06 31.6% 08 42.1%
PBF YES (42) 12 28.6% 12 28.6% 18 42.8% χ2 =0.476 df= 1 p= 0.788 14 33.3% 06 14.3% 22 52.4% χ2 =2.963 df= 1 p= 0.227
NO (18) 06 33.3% 06 33.3% 06 33.3% 04 22.2% 06 33.3% 08 44.5%
BOF YES (147) 72 (49%) 46 (31.3%) 29 19.7%) χ2 =11.90 9 df= 1 p= 0.003 78 (53%) 27 (18.4%) 42 (28.6%) χ2 =2.904 df= 1 p= 0.234
NO (243) 161 (66.2%) 49 (20.2%) 33 (13.6%) 142 (58.4%) 50 (20.6%) 51 (21%)

DISCUSSION

The nutritional status of children under two years of age is proportional with IYCF practices affecting immensely the child morbidity and mortality. Thus the present study was conducted to scrutinize the IYCF practices in a town which is the headquarters of a district havind divergent nature of population.

Initiation of breast feeding was done within 1 hour in 47.95% of the study population. According to The world breastfeeding trend initiative (WBTi-2012) 40.5% and NFHS-4 (2015-2016), 48.8% (Urban), 47.3% (Rural) Indian mothers were engaged in early initiation of breastfeeding(5,12).

Exclusivity of breast milk as a food 64.8% exclusivity in District Level Household and Facility Survey (DLHS-IV; 2012-2013) and 52.3% in National Family Health Survey (NFHS- IV; 2015-2016) data(5,13) which is very much in accordance with our study. India belongs to Yellow Zone constituting 46.8% Exclusive breast feeding prevalence in WBTi-2012(12).

Proportion of children 6-23 months of age who received foods from four or more food groups were 30.30% in our study as compared to 32.6% in a similar study in Delhi(14). According to NFHS IV Breast feeding and non-breast feeding children having minimum dietary diversity were 19.1% and 25.7% respectively(5). In a similar study conducted in a rural area of west Bengal 87.5% study populations showed minimum dietary diversity(9).

Minimum meal frequency among breastfed and non-breastfed children of 6-23 months of age in our research were 90% and 93.3% respectively which Is very similar to a study conducted in Malaysia where 69.3% of breastfed and 95.2% of non-breastfed children received solid, semi-solid or soft foods including milk feeds the minimum number of times or more(15).

There was no difference between the breastfed (30%) and non-breastfed (30%) children receiving minimum acceptable diet (MAD) which has a higher frequency in our study as compared to 16% found in NFHS- IV(5). In an institution based study lower proportion of minimum acceptable diet, among breastfed (7.5%) and non-breastfed (8.5%) children was found almost in equal proportions. Lack of postnatal counseling by health workers as well as infrequent antenatal health clinics, maternal illiteracy were found to be significant for not meeting Minimum dietary diversity (MDD) and Minimum acceptable diet (MAD) criteria(16).

Bottle feeding among children less than 2 years of age should not be encouraged as a part of post natal care(9). In our study 147 (37.7%) individuals were found who practiced bottle feeding where as 28.1% was found in a study conducted in rural setup of West-Bengal(9). 51% and 47% of them were suffering from malnutrition and stunting. Out of 243 individuals who were not practiced bottle feeding, 161 (66.2%) and 58.4%) children were found to be normal. The effect of bottle feeding on WFA was found to be significant.

This study conducted among children revealed that the different IYCF indicators were as poor as elsewhere in India(5,9,13,14) (e.g. initiation of breast feeding in one hour: 47.9%, Exclusive breast feeding 68.3%, Optimal diversity of food: 30.3%). The proportion of underweight and stunting was 40.7% and 43.6% respectively and were significantly related to initiation of breast feeding in one hour, adequate food diversity, adequate meal frequency, age adjusted minimum acceptable diet and exposure to bottle feeding.

Mukhopadhyay et al. in their study asserted that poor IYCF practices were associated with undernourishment in West Bengal, India.(6) At the same time; as Jones A D et al. found in their synthesis from the studies on the various communities; there has been great inconsistency in respect of the association of such indicators with the anthropometric findings of the children.(17) Like in this study; initiation of breast feeding within one hour of birth was positively related with Height for Age in Bangladesh, Ethiopia and Zambia.(17) In addition; in the current study IBF was more significantly associated with Weight for Age. Studies from Banglaesh and Pakistan reported a significant association between Exclusivity of Breast Feeding and indicators like Weight for Height; but the current study did not reveal any association with either weight for age or length for age.(18,19) There was no significant association between height for age and IBF and EBF in Nepal as well.(20) Studies elsewhere obtained significant association between indicators related to complimentary feeding with both height and weight; which could not be upheld here.(18,20) In this study, minimum dietary diversity, minimum food frequency and minimum adequate diet - all three were significantly associated with weight for age of the children; a finding corroborated in many other studies.(18-20) A significant negative association was found in this study between bottle feeding and weight for age, a finding not similar to other studies. But in Nepal, a weak negative relationship between bottle feeding and height for age was seen.(20)

CONCLUSION

It should be mentioned here that this was a cross sectional study and so the temporal cause and effect relationship could not be established beyond doubt. However; this kind of heterogeneity in the relationship between the different IYCF indicators and the anthropometric indicators of growth of children has been indicated by other authors as well; indicating the importance of various other unknown confounding factors in play.(17,20) Hence, more studies with justifiable methodologies are required for final conclusion about such relationships.

AUTHORS CONTRIBUTION

All authors contributed equally in conducting the study and preparing the manuscript.

ACKNOWLEDGEMENT

Indian Council of Medical research (ICMR), Short Term Studentship (STS)

REFERENCES

  1. , , , , . An assessment of nutritional status of the children of government urdu higher primary schools of Azad Nagar and its surrounding areas of Bangalore. Scholars Research Library, Archives of Applied Science Research. 2011;3(3):167-76.
    [Google Scholar]
  2. National Family Health Survey 4 (NFHS-4) Available from: rchiips.org/nfhs/pdf/NFHS4/India.pdf (accessed )
    [Google Scholar]
  3. , , , , , , , , , , , , . What works? Interventions for maternal and child undernutrition and survival. Lancet. 2008;371:417-40.
    [CrossRef] [PubMed] [Google Scholar]
  4. . Indicators for assessing infant and young child feeding practices: Part-1: Definition: Conclusions of a consensus meeting held 6- 8 November 2007 in Washington DC, USA. Geneva, Switzerland: World Health Organization 2008:4-11.
    [Google Scholar]
  5. National Family Health Survey -IV (2015-2016)- State fact sheet West Bengal. Available from: http://rchiips.org/nfhs/pdf/NFHS4/WB_FactSheet.pdf (accessed )
    [Google Scholar]
  6. , , , , , , . Association of child feeding practices with nutritional status of under-two slum dwelling children: A community-based study from West Bengal, India. Indian J Public Health. 2013;57:169-72.
    [CrossRef] [PubMed] [Google Scholar]
  7. UNICEF global databases, 2018, based on MICS, DHS and other nationally representative sources, 2013-2018. Available from: https://data.unicef.org/topic/nutrition/infant-and-young-child-feeding/ (accessed )
    [Google Scholar]
  8. . Early Childhood Nutrition. Available from: http://unicef.in/Whatwedo/7/Infant-and-Young-Child-Feeding (accessed )
    [Google Scholar]
  9. , , , , , , . Infant and Young Child Feeding Perceptions and Practices among Mothers in a Rural Area of West Bengal, India. Ann Med Health Sci Res. 2013;3(3):370-37.
    [CrossRef] [PubMed] [Google Scholar]
  10. . Breast feeding and weaning practices in India. Asia Pac Popul J. 1990;5(1):71-88.
    [CrossRef] [PubMed] [Google Scholar]
  11. Early detection and referral of children with malnutrition. Available from: http://motherchildnutrition.org/malnutrition/index.html (accessed )
    [Google Scholar]
  12. . Are our babies falling through the gaps? Available from: http://bpni.org/report/51-country-report.pdf (accessed )
    [Google Scholar]
  13. District Level Household and Facility Survey (DLHS-IV) Available from: http://rchiips.org/pdf/dlhs4/report/WB.pdf
    [Google Scholar]
  14. , , , , , , , , . A study on infant and young child feeding practicesamong mothers attending an urban health center in East Delhi. Indian J Public Health. 2012;56(4):301-304.
    [CrossRef] [PubMed] [Google Scholar]
  15. , , , , , , , , . Compliance with WHO IYCF Indicators and Dietary Intake Adequacy in a Sample of Malaysian Infants Aged 6-23 Months. Nutrients. 2016;8(12):778.
    [CrossRef] [PubMed] [Google Scholar]
  16. , , , , . Assessment of nutritional status in children using WHO IYCF indicators: an institution based study. Int J ContempPediatr. 2018;5(3):783-790.
    [CrossRef] [Google Scholar]
  17. , , , , , , , , , , , , . World Health Organization infant and young child feeding indicators and their associations within child anthropometry: a synthesis of recent findings. Maternal and Child Nutrition. 2014;10:1-17.
    [CrossRef] [PubMed] [Google Scholar]
  18. , , , , . Infant and young child feeding practices and child undernutrition in Bangladesh: insights from nationally representative data. Public Health Nutrition. 2012;15(9):1697-1704.
    [CrossRef] [PubMed] [Google Scholar]
  19. , , . Association of Infant and young child feeding practices with linear growth of children under 24 months in Asia and Africa. Pak J Nutr. 2019;18:665-670.
    [CrossRef] [Google Scholar]
  20. , , , , , , , , . Infant and young child feeding practicesand child linear growth in Nepal: Regression- decompositionanalysis of national survey data, 1996-2016. MaternChildNutr 2020:e12911. https://doi.org/10.1111/mcn.12911
    [CrossRef] [PubMed] [Google Scholar]
Show Sections