World Health Organization (WHO) infant and young child feeding indicators: associations with growth measures in 14 low‐income countries

Maternal and Child Nutrition - Tập 8 Số 3 - Trang 354-370 - 2012
Bernadette P. Marriott1, Alan White1, Louise Hadden1, Jayne C. Davies2, John B. Wallingford2
1Abt Associates Inc., Durham, North Carolina, USA
2Pfizer Nutrition, Collegeville, Pennsylvania, USA

Tóm tắt

Abstract

Eight World Health Organization (WHO) feeding indicators (FIs) and Demographic and Health Survey data for children <24 months were used to assess the relationship of child feeding with stunting and underweight in 14 poor countries. Also assessed were the correlations of FI with country gross national income (GNI). Prevalence of underweight and stunting increased with age and ≥50% of 12–23‐month children were stunted. About 66% of babies received solids by sixth to eighth months; 91% were still breastfeeding through months 12–15. Approximately half of the children were fed with complementary foods at the recommended daily frequency, but <25% met food diversity recommendations. GNI was negatively correlated with a breastfeeding index (P < 0.01) but not with other age‐appropriate FI. Regression modelling indicated a significant association between early initiation of breastfeeding and a reduction in risk of underweight (P < 0.05), but a higher risk of underweight for continued breastfeeding at 12–15 months (P < 0.001). For infants 6–8 months, consumption of solid foods was associated with significantly lower risk of both stunting and underweight (P < 0.001), as was meeting WHO guidance for minimum acceptable diet, iron‐rich foods (IRF) and dietary diversity (P < 0.001); desired feeding frequency was only associated with lower risk of underweight (P < 0.05). Timely solid food introduction, dietary diversity and IRF were associated with reduced probability of underweight and stunting that was further associated with maternal education (P < 0.001). These results identify FI associated with growth and reinforce maternal education as a variable to reduce risk of underweight and stunting in poor countries.

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Tài liệu tham khảo

2001, The optimal duration of exclusive breastfeeding: results of a WHO systematic review, Indian Pediatrics, 38, 565

ArimondM.&RuelM.T.(2002)Progress in developing an infant and child feeding index: an example using the Ethiopia demographic and health survey 2000. Discussion Paper – Food Consumption and Nutrition Division International Food Policy Research Institute. International Food Policy Research Institute Washington USA.

10.1093/jn/134.10.2579

10.1093/jn/130.6.1597

10.1016/S0140-6736(03)13779-8

10.1016/S0140-6736(07)61690-0

10.1016/S0140-6736(10)60549-1

Blakely T., 2005, The global distribution of risk factors by poverty level, Bulletin of the World Health Organization, 83, 118

10.1093/ije/25.4.693

10.1111/j.1467-789X.2008.00504.x

10.1093/ajcn/67.1.10

Dewey K.G., 2003, Guiding Principles for Complementary Feeding of the Breastfed Child, 37

Dewey K.G., 2005, Guiding Principles for Feeding Non‐Breastfed Children 6–24 Months of Age

10.1093/ajcn/69.4.679

10.1177/156482650402500407

10.1097/01.mpg.0000304464.60788.bd

10.1093/ajcn/85.2.635S

10.1177/15648265040251S102

10.1093/jn/136.11.2928

Grummer‐Strawn L.M., 1993, Does prolonged breastfeeding impair child growth? A critical review, Pediatrics, 91, 766

10.1016/j.socscimed.2005.06.007

Horta B., 2007, Evidence of the Long‐term Effects of Breastfeeding: Systematic Reviews and Meta‐analysis

10.1016/S0140-6736(03)13811-1

10.1038/sj.ejcn.1600891

10.2471/BLT.09.068791

10.2471/BLT.10.078618

Marriott B.M., 2007, Preliminary data from Demographic and Health Surveys on infant feeding in 20 developing countries, The Journal of Nutrition, 137, 518S, 10.1093/jn/137.2.518S

10.1111/j.1740-8709.2009.00217.x

10.2471/BLT.09.069195

10.1177/15648265040251S103

Peng Y.‐K., 1998, Maternal nutritional status is inversely associated with lactational amenorrhea in Sub‐Saharan Africa: results from Demographic and Health Surveys II and III, The Journal of Nutrition, 128, 1672, 10.1093/jn/128.10.1672

10.1016/S0140-6736(10)60703-9

Rao S., 1992, Prolonged breastfeeding and malnutrition among rural Indian children below 3 years of age, European Journal of Clinical Nutrition, 46, 187

10.1210/jc.2009-0030

10.1093/jn/132.6.1180

Rutstein S.O., 2006, Guide to DHS Statistics

SAS Institute Inc, 2004, SAS/STAT9.1 Users Guide

UN(2000)Millennium development goals.http://www.un.org/millenniumgoals/.

UNICEF(2009)The State of the World's Children: Special Edition: Celebrating 20 Years of the Convention on the Rights of the Child.http://www.unicef.org/rightsite/sowc/pdfs/SOWC_Spec%20Ed_CRC_Main%20Report_EN_090409.pdf 92.

10.2471/BLT.07.044800

10.2471/BLT.08.057901

10.1016/S0140-6736(07)61692-4

10.1016/S0140-6736(03)13917-7

WHO Multicentre Growth Reference Study Group, 2006, WHO Child Growth Standards Length/Height‐for‐age, Weight‐for‐age, Weight‐for‐length, Weight‐for‐height and Body Mass Index‐for‐age Methods and Development

Working Group on Infant and Young Child Feeding Indicators, 2007, WHO Consensus Meeting, 19

World Bank, 2008, Data and Statistics: Country Classifications

World Food Programme, 2006, Ending Childhood Hunger and Undernutrition Initiative: Revised Global Framework for Action