An Exploratory Study to assess the Infant and Young Child Feeding (IYCF) Practices among Mothers attending Pediatric OPD at selected Health Centers of Punjab.

 

Shivali Sharma¹, Jeen Mexina ², Amiteshwar Kaur³

¹M Sc. Nursing Student, Saraswati Nursing Institute, Dhianpura

²Associate Professor, Saraswati Nursing Institute, Dhianpura

³Lecturer Child Health Nursing, Saraswati Nursing Institute, Dhianpura

 

ABSTRACT:

Infant and young child feeding practices are part of broader child care practices, which is affected by household security and access to food, the availability of safe water and sanitation and access to quality health services. A non-experimental approach is used to assess infant and young child feeding practices among mothers attending pediatric OPD at selected health centres. A sample of 200 subject (mothers) will be selected by convenient sampling technique. Tool used for the present study was Socio-demographic data sheet, knowledge questionnaire to assess the knowledge level and infant and young child feeding assessment for assessing practices among mothers. The data was analyzed by using descriptive and inferential statistics. In descriptive statistics, frequency, percentage, mean, standard deviation were used. In inferential statistics, chi square test was used. The findings shows that 53% of subjects were having good knowledge regarding infant and young child feeding practice 47% of subjects were having average knowledge regarding infant and young child feeding practice. There was significant association between Infant and young child feeding practice with selected demographic variables of children such as weight of the child and initiation of breastfeeding, practice with last week dietary recall of Infant and young child feeding with vegetables.

 

 

 

 

 

 

 

 

INTRODUCTION:

Optimal infant and young child feeding (IYCF) practices are crucial for nutritional status, growth, development and health ultimately the survival of infant and young children (1-3). Worldwide, suboptimal breastfeeding still account for death of 1.4 million children aged less than five year.¹  Feeding practices are determined by various factors including cultural norms, beliefs, mother’s knowledge and previous experience. These factors operate differently across communities and therefore, do affect child health to varying degree. In exclusive breastfeeding where the infant only receives breast milk with no additional foods or drinks has been shown to have short and long term benefits for both mother and child.²

 

Adequate nutrition during infancy and early childhood is essential to ensure the growth, health, and development of children to their full potential. Inappropriate nutrition can also lead to childhood obesity which is an increasing public health problem in many countries. Early nutrition deficits are also linked to long- term impairment in growth and health. Poor breastfeeding and complementary feeding practices are widespread. Worldwide it is estimated that only 34.8% of infants are exclusively breastfed for the first six months of life, the majority receive some other foods or fluid in the early months. Complementary foods are often introduced too early or too late and are often nutritionally inadequate and unsafe.³ Malnutrition is particularly prevalent among children under five year of age. Traditional beliefs and inadequate health and nutrition education have contributed significantly to the current situation. The Infant and young child Nutrition Project was started in 2006, the five year project aims to improve nutrition for mothers, infant and young children.⁴

 

Few children receive adequate nutrition and safe complementary foods; in many countries less than a fourth of infants 6–23 months of age meet the criteria of dietary diversity and feeding frequency that are appropriate for their age. Improving child development and reducing health costs through breastfeeding results in economic gains for individual families as well as at the national level.⁵

 

The key care practices that could impact on child nutrition include care of pregnant and lactating mothers, breast feeding and feeding young children, care of children during illness, psychosocial care of children, food preparation and storage, and hygiene. However, these practices are to a large extent, dependent or modified by availability of resources to the caregiver for its implementation.⁶

 

NEED OF THE STUDY:

Every infant and child has the right to get good nutrition according to the convention on the rights of the child. Under nutrition is associated with 45% of child deaths.⁷

 

Bonding and attachment with the mother will also affect the feeding practices. An effective bond between the mother and neonate that is specific to them, from which both gain security. It is the first social relationship for the infant. Maternal attachment behaviors include gazing at, kissing, fondling, holding the infant in an face position so that their eyes meet on the same plane and talking to the infant in a high- pitched voice than normal.⁸

 

As infants grow, their nutrient needs grow with them. To keep up with these growing demands, WHO recommends that infants begin eating solid, semi-solid or soft foods at 6 months of age to ensure that their nutrient intake is sufficient to Poor nutrition increases the risk of illness, and is responsible, directly or indirectly, for one third of the estimated 9.5 million deaths that occurred in 2006 in children less than five year of age in this world. Inappropriate nutrition can also lead to childhood obesity which is an increasing public health problem in many countries.⁹

 

Improper feeding can lead to malnutrition. There are several factors that contribute to malnutrition. The main contributing factor for under five stunting are sex of child, child age, diarrhea episode, type of food, age of introduction of complementary feeding and method of feeding. Under nutrition is also one of the factor which can affect the feeding practices. Infant who receive too small quantity of food, whether because they refuse food or because food is not offered, are undernourished. These infants fail to gain weight or actually lose weight, are restless, cry excessively and do not sleep well.⁸

 

Though 87.3% of mothers had knowledge about the time of initiation of complementary food, 31.0% of mothers started complementary food within three months of age and 8.9% of mothers did not start complementary feeding even at 6 months of age. Both practices are not only desirable but also harmful to our children but unfortunately, are being still practiced in the developing world.¹⁰

 

While working in clinical and community areas, investigator observed that there is need to assess the mothers feeding practices because most of the mothers had poor knowledge and practices which may leads to further complications like malnutrition, under nutrition, Growth retardation and other nutritional problems. Through extensive literature review and personal experience, the investigator has strong desire to conduct the study to assess the infant and young child feeding practices among mothers.

 

MATERIALS AND METHODS:

The quantitative research approach was used to assess the Infant and young child feeding practices among mothers attending Pediatric OPDs at selected Health centers. The conceptual framework used for present study was based on Health belief model.

 

The research design used for the present study was Descriptive research design. The study was conducted at selected health centers i.e. Civil Hospital of Kurali and Civil Hospital of Roopnagar. Accessible Population is Mothers who were attending Pediatric OPD at selected health centers. Target Population is Mothers of infant and young children. Sample size was 200 mothers and convenient sampling technique was used to select sample.

 

DEVELOPMENT OF TOOLS:

TOOL 1:

This tool included socio-demographic variables of Mother’s and Child’s profile.

TOOL 2:

This tool consisted of 12 items related to Infant and young child feeding practices.

 

TOOL 3:

This tool consists of structured knowledge of 30 questions to assess the knowledge of mother’s regarding infant and young child feeding practices.

Open- ended questions were also included related to last week dietary recall of Infant and Young child feeding practices and water used in child’s food.

 

ETHICAL CONSIDERATION:

1.    Written permission was taken from Institutional ethical committee and from Principal, Saraswati Nursing Institute, V. Dhianpura, Kurali.

2.    Written permission was taken from Senior Medical Officer (SMO) Civil Hospital Kurali, Distt. Mohali.

3.    Written permission was taken from Senior Medical Officer Civil Hospital Distt. Roopnagar.

4.    Informed consent was taken from each subjects.

5.    Confidentiality and anonymity of responses was assured and maintained throughout study.

 

RESULT AND INTERPRETATION:

Table No: 1 Frequency and percentage distribution of subjects as per their socio demographic variables (Mother’s Profile) N=200

Variables		Frequency(f)	Percentage (%)
Age of Mother	20- 25 year	063	31.5
	26- 30 year	111	55.5
	31-35 year	025	12.5
	36-40 year	001	0.5
Religion	Hindu	056	28
	Muslim	007	3.5
	Sikh	137	68.5
Type of Family	Nuclear	033	16.5
	Joint	167	83.5
Place of Residence	Urban	054	27
	Rural	146	73
Educational Status of the Mother	No Formal    Education	006	03
	Primary Education	051	25.5
	Metric Education	084	42
	Higher Secondary Education	042	21
	Graduate and Above	017	8.5
Occupational Status	Homemaker	194	97
	Self- Employed	02	01
	Private- Employed	02	01
	Govt.- Employed	02	01
Family Income/ Month	< 5000/ Month	027	13.5
	5001- 10,000/ Month	145	72.5
	10,001-15000/ Month	15	7.5
	> 15000/ Month	13	6.5
Source of Information	Mass media(radio, TV etc)	13	6.5
	Friends, family or Med. Personnel	186	93
	All of the Above	01	0.5

 

 

 

 

Table No: 2 Frequency and percentage distribution of the children as per their socio demographic variables (Child’s Profile) N= 200

Variables		Frequency(f)	Percentage(%)
Age of the Child	6- 12 month	067	33.5
	13- 24 month	133	66.5
Weight	7- 9 Kg	96	48
	10- 11 Kg	92	46
	12- 13 Kg	12	06
Gender	Male	114	57
	Female	86	43
Birth Order of Child	First	121	60.5
	Second	68	34
	Third	09	4.5
	Fourth	02	01
Number of Sibling in Family	One	00	00
	Two	71	35.5
	More than Two	11	5.5
	No Sibling	118	59
Initiation of Breastfeeding after delivery	Within 2 Hour	113	56.5
	Within 6 Hour	66	33
	Within 12 Hour	01	0.5
	Within 24 Hour	00	00
	After 24 Hour	20	10
Initiation of Complementary Feeding	5- 6 Months	142	71
	7- 8 Months	55	27.5
	9- 10 Months	03	1.5
Any Medical Problem	No	200	100

 

Table No: 3 Frequency and percentage distribution of knowledge level regarding Infant and young child feeding practices among mothers N=200

CRITERIA MEASURE OF KNOWLEDGE
Category Score	Frequency	Percentage
Good (21-30)	106	53.0
Average (11-20)	94	47.0
Poor (0-10)	0	0.0

 

The data presented in Table 3 depicts that Majority of subjects i.e. 53 % had good knowledge regarding the Infant and young child feeding practics, whereas only 47% subjects had average knowledge regarding the the Infant and young child feeding practices.

 

 

 

 

Table No: 4 Item wise frequency and percentage distribution of Infant and young child feeding practices N=200

Items	Yes		No
	Frequency (f)	Percentage (%)	Frequency(f)	Percentage (%)
Does your child take breastfeed	171	85.5	029	14.5
Do you breastfeed during the night	171	85.5	29	14.5
Do you give any other milk beside breast milk	162	81	38	19
Do you ever give your child anything to drink in a baby bottle/ cup	163	81.5	37	18.5
Do you give your baby any feeding beside breastfeeding	100	100	00	00
Does the child receive his own serving	105	52.5	95	47.5
Do you encourage your child to finish all the food	90	45	110	55
Do you talk to the child , or sing to the child while feeding	184	92	16	08
Any difficulty with child’s feeding	09	4.5	191	95.5
Do you wash your hand before you feed your child	195	97.5	05	2.5
Do you always use soap	101	50.5	99	49.5
Do you ever feed your young child food that you prepared earlier in the day	021	10.5	179	89.5

 

Table No: 5 Frequency and percentage distribution of last week dietary recall of Infant and young child feeding practices (6- 24 months) N=200

Items	Yes		No
	Frequency(f)	Percentage (%)	Frequency(f)	Percentage (%)
Pulses soup	198	99%	02	01
Vegetables	180	90%	20	10
Egg	49	24.5%	151	75.5
Fruits	183	91.5%	17	8.5

 

Table No: 6 Frequency and percentage distribution of water used in child’s food. N=200

Water used in child’s food	Frequency (f)	Percentage (%)
Boiled Water	78	39
Filter Water	50	25
Tap Water	66	33
Supply Water	06	03

 

Table No: 7 Association of Infant and young child feeding practices with selected demographic variables (mothers) N= 200

Demographic variables		Levels			df	Chi square
		High	Average	Low
Age of mother ( in years)	20- 25	18	44	001	6	5.275
	26- 30	42	68	001
	31-35	12	13	0
	36-40	01	0	0
Religion	Hindu	21	34	001	4	4.800
	Muslim	0	07	0
	Sikh	52	84	001
Type of Family	Nuclear	12	21	0	2	0.404
	Joint	61	104	002
Place of Residence	Urban	20	33	001	2	0.565
	Rural	53	92	001
Educational Status of the Mother	No Formal Education	002	004	0	8	7.641
	Primary Education	17	33	001
	Matric Education	30	54	0
	Higher Secondary Education	19	23	0
	Graduate and Above	005	11	001

 

Table No: 7 (A) Contd Association of Infant and young child feeding practices with selected demographic variables (mothers) N=200

Demographic variables		Levels			df	Chi square
		High	Average	Low
Occupational Status	Homemaker	69	123	002	6	3.893
	Self- Employee	001	001	0
	Private- Employee	2	0	0
	Govt.- Employee	1	1	0
Family Income/ Month	< 5000/ Month	10	17	0	6	5.824
	5001- 10,000/ Month	53	91	001
	10,001-15000/ Month	006	008	001
	> 15000/ Month	004	009	0
Source of Information	Printed source (newspaper etc)	0	0	0	4	0.757
	Mass media(radio, TV etc)	005	008	0
	Friends, family or Med. Personnel	68	116	002
	All of the Above	0	001	0

 * Significant p<0.05

Table No: 8 Association of Infant and young child feeding practices with selected demographic variables (children) N=200

* Significant p<0.05

 

Table No: 9 Association of children feeding practice with last week dietary recall of Infant and young child feeding N=200

Variables		Levels			df	Chi squre
		High	Average	Low
Pulses soup	Yes	71	125	2	2	3.515
	No	2	0	0
Vegetables	Yes	71	108	1	2	9.631*
	No	2	17	1
Egg	Yes	20	29	0	2	1.094
	No	53	96	2
Fruits	Yes	69	113	1	2	5.480
	No	4	12	1
Water used in child’s food	Boiled water	31	47	0	6	7.727
	Filter water	22	27	1
	Tap water	20	45	1
	Supply water	0	6	0

* Significant p<0.05

 

 

 

Table 8 depicts that association of Infant and young child feeding practices with the selected demographic variables (children). There was statistical significant association of Infant and young child feeding practices with weight of the child (0.003)* and initiation of breastfeeding (0.031)* and there was no significant association found in the infant and young child feeding practices with age, gender, birth order of the child, number of siblings in the family, and initiation of complementary feeding.

 

Table 9 depicts the association of children feeding practice with last week dietary recall of Infant and young child feeding. There was significant association of the children feeding practice with last week dietary recall of Infant and young child feeding with vegetables (0.008)*. There was no significant association found in the last week dietary recall of Infant and young child feeding with pulses soup, egg, fruits and water used in child’s food.

 

DISCUSSION:

The findings of the present study shows that majority of the subjects i.e 53% had good knowledge and 47% of the subjects had average knowledge regarding Infant and young child feeding practices. The findings of the study similar to study of Onah S, Osuorah DI et. al (2014) conducted a cross- sectional and analytical study to describe the feeding practices of infants and determine maternal socio- demographic factors that influences the practices of exclusive breastfeeding among mothers. The results of the study shows that awareness (95.3%) and knowledge (82%) of exclusive breastfeeding was high among surveyed mothers.¹¹

 

The findings of the present study shows that majority 71% of the mothers were initiate complementary feeding at 5-6 months, 28% of the mothers were initiate at 7-8 months and only 2% of mothers were initiate complementary feeding at 9- 10 months. The findings of the study similar to the study of Owais A, Kleinbaum DG et.al (2015) conducted a prospective, cohort study to determine the association between household food security and infant complementary feeding practices in two rural sub- districts. The results revealed that complementary feeding was initiated at age < 4 months for 7% , at 5-6 months for 49% and at 7 month for 44% of infants. The study conclude that improving infant nutritional status need to focus on both complementary food provision and education.¹²

 

CONCLUSION:

The finding of the study indicated majority of the subjects i.e 53% of mothers had good knowledge regarding infant and young child feeding practices. Significant association was only found with demographic variables like weight of the child and initiation of breastfeeding and last week dietary recall of infant and young child feeding with vegetables.

 

REFERENCES:

1        Infants and young child feeding practices Bankura. J Health populNutr. 2010 Jun.28 (3).294-299. Available from- URL:http:/ www.ncbi.nlm.nih.gov>pm2980895

2        Feeding practices and nutritional status of infants. Available from-URL:http:/ www.bioline.org.br>pdf

3        World Health Organization. The global burden of disease: 2004. Geneva:World Health Organization; 2008.Available from- URL: http:/www.ncbi.nlm.nih.gov

4        USAID’s Infant and young child Nutrition Project 2011Jan, IYCN. Ethopia-literature iycn.wpengine.netdna-cdn.com

5        WHO: Infant and young child feeding http://www. WHO. Int/ mediacentri/ factsheet/fs 342/en

6        Impact of infant and young child feeding and caring practices on nutritional status. Icmr.nic.in.>ijmr>November Indian J Med Res 130, 2009 Nov,624-626

7        Impact of infant and young child feeding and caring practices on nutritional status. Icmr.nic.in.>ijmr>November Indian J Med Res 130, 2009 Nov,624-626

8        Marlow R.Dorothy, A test book of pediatric nursing, Fourteen Edition Elsevier publisher.

9        Infant and Young Child Feeding Practices in an urban slums. Available from- URL: https://www. World wide journals.com>file 6(4) June 2014

10      Aggrawalverma S, Feridi MA and chand D. Complementary feeding- Reason for Inappropriateness in timing, Quality and consistency, Indian J Pediatric 2008; 75,49,56

11      Onah S,Osuorah DI, Ebenebe J,Ezechukwu C, Ekwochi U, Ndukwu I. Infant feeding practices and maternal socio- demographic factors that influence practice of exclusive breastfeeding.Int Breastfeed J.2014 may20;9:6.Available from- URL: doi:10.1186/1746-4358-9-

12      Owais A, Kleinbaum DG, Suchdev PS, Faruque A, Das SK, Schwartz B, et. al. Household food security and infant feeding practices. Public Health Nutr. 2015 Nov 13:1-7. www.ncbi.nlm.nih.gov/m/pubmed/ 26563771

 

 

 

 

 

 

Received on 21.08.2017           Modified on 30.10.2017

Accepted on 09.01.2018   © A&V Publications all right reserved

Int. J. Nur. Edu. and Research. 2018; 6(2): 179-184.