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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 15  |  Issue : 2  |  Page : 188-191

Assessment of feeding practices in children of age group 6 months–3 years in Urban Slums of Arvi Naka


Department Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe), Wardha, Maharashtra, India

Date of Submission23-Jan-2020
Date of Decision02-Feb-2020
Date of Acceptance10-Feb-2020
Date of Web Publication21-Dec-2020

Correspondence Address:
Dr. Nikhil Dhande
Department Community Medicine, Jawaharlal Nehru Medical College, Sawangi (Meghe), Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_17_20

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  Abstract 


Aim and Objectives: Assessment of feeding practices in children of age group 6 months–3 years in urban slums of Arvi Naka. The study determines breastfeeding as one of the four strategies for improving child survival and nutrition. Materials and Methods: The study uses various methodologies to determine breastfeeding practices in slum areas of Arvi Naka and uses a lottery method to determine the place of people to be taken; the sample size was 100 individuals, and the study was conducted for 3 months. The study uses various variables and methods to determine the objectives. Data collection was done by making two groups. Results: 2.29% of hospital-delivered children started breastfeeding within 1 h, 43.67% were started within 4 h, 50.57% were started within 8 h, and the remaining 3.47% were started ≥8 h. 30.76% of home-delivered children started breastfeeding within 4 h, 61.53% were started breastfeeding within 8 h, and 7.71% were started breastfeeding ≥8 h. Conclusion: Study reinforces the planning and strategies for building up health education more towards slum areas.

Keywords: Breastfeeding practices, children, urban slum


How to cite this article:
Bhalamwala Y, Raphy JS, Dhande N. Assessment of feeding practices in children of age group 6 months–3 years in Urban Slums of Arvi Naka. J Datta Meghe Inst Med Sci Univ 2020;15:188-91

How to cite this URL:
Bhalamwala Y, Raphy JS, Dhande N. Assessment of feeding practices in children of age group 6 months–3 years in Urban Slums of Arvi Naka. J Datta Meghe Inst Med Sci Univ [serial online] 2020 [cited 2021 Jan 16];15:188-91. Available from: http://www.journaldmims.com/text.asp?2020/15/2/188/304246




  Introduction Top


Breastfeeding is taken into account because the first four strategies are promoted by the UNICEF for improving infant and child survival, as reported by Grant.[1] This may enhance child survival up to 3 years aged even in undernourished children.[2] In 2001, the World Health Assembly resolved that exclusive breastfeeding for 6 months is the most appropriate infant feeding practice.[3],[4] Tribal communities are not the exception. 228 Proceeding of the National Symposium on Tribal Health in consideration of the improper breastfeeding practices, there are several socioeconomic factors affecting the way of breastfeeding practices, including low parental education (Mikiel-Kostyra et al., 2005[5]), poor socioeconomic condition results not only shorter duration of breastfeeding but also those women with higher education have lower duration of breastfeeding, consistent with the findings observed by Giashuddin and Kabir.[6]

Anthropometry is best to assess the growth and nutritional status of a private or population. The three factors, namely malnutrition, poverty, and disease, are interlinked in such a way that each contributes to the presence and permanence of the others. Malnutrition makes its principal impact on young children in developing countries. While malnutrition manifests its diverse forms, protein–energy malnutrition (PEM) ranks foremost in terms of socioeconomic consequences and the enormity of its effects. Numerous criteria have been suggested for the assessment of PEM in a population group. Nutritional anthropometric (body measure) parameters such as weight-for-age, height-for-age, weight-for-height, and mid-upper arm circumference-for-age are commonly used for assessing malnutrition and evaluating the effects of dietary treatment on children.

The present study has been carried out to explore the nutritional status of children of age group 6 months–3 years along with some socioeconomic and demographic factors to assess the association and effect of breastfeeding practices with undernourished children among the urban slum community of Arvi Naka area, Wardha city, Wardha district, Maharashtra.

Objectives

The objectives of this study were to assess the mother's practices on prelacteal feed, colostrums, exclusive breastfeeding, duration of breastfeeding, importance of weaning, and practices of these.


  Materials and Methods Top


Study setting

A community-based cross-sectional study was conducted at Indira Nagar, Adivasi Colony, Arvi Naka, for slum areas in Wardha city.

Study participants

Mothers having children in the age group of 6 months–3 years residing in areas as stated above were included in the study.

Sample size selection

The sample size studied was 100 individuals for slum areas.

Study design

From the list of 17 slum areas of Wardha city, we have selected three slums by a lottery method (simple random sampling method).

Duration of study

The study was conducted between October 18, 2019, and January 13, 2020 (3 months).

Study variables

Age, sex, breastfeeding, and weaning are the study variables.

Data collection (methodology)

We made two groups of two investigators each. A pretested, semi-structured questionnaire was used to collect information by interviewing mothers in local languages, and anthropometric measurements of a child were taken.

Statistical analysis

Statistical analysis was done using bar diagram, pie diagram, and Chi-square test.

Ethical Approval

Ethical approval for this study (DMIMS(DU)/IEC/2019-20/1967) was provided by the Ethical Committee of Datta Meghe Institute of Medical Sciences (Deemed to be University) on 09/02/19.


  Observations and Results Top


The age-wise distribution of patients shows that majority of children, i.e., 48%, were in the age group of 27–36 months, 22% were in the age group of 20–26 months, 18% were in the age group of 13–19 months, and the remaining 12% were in the age group of 6–12 months.

Of total hospital deliveries, 24.13% of children were given colostrums and 75.87% were not given colostrums, and of total home deliveries, 38.46% of children were given colostrums and 61.54% were not given colostrums. Thirty-two percent of children were not given any type of prelacteal feed, 27% were given ghutti, 20% were given top milk, 13% were given honey, and only 9% were given jaggery. 2.29% of hospital-delivered children started breastfeeding within 1 h, 43.67% were started within 4 h, 50.57% were started within 8 h, and the remaining 3.47% were started ≥8 h. 30.76% of home-delivered children started breastfeeding within 4 h, 61.53% were started breastfeeding within 8 h, and 7.71% were started breastfeeding ≥8 h.

Thirty-eight percent of children were started supplementary feeding <6 months, 32% were started supplementary feeding ≥6 months of age, and the remaining 20% started supplementary feeding at 6 months and 10% not yet started supplementary feeding. Thirty-seven percent of children were given breastfeeding along with other foods for a period of ≥6 months, 22% were given for a period of ≥9 months to 1 year, 31% were given for a period of 102 years, and 10% were not yet started supplementary feeding. Of total children, 48% were malnourished; in the age group of 6–12 months, 58.33% were malnourished; in the age group of 13–19 months, 66.66% were malnourished; in the age group of 20–26 months, 63.63% were malnourished; and in the age group of 27–36 months, 31.25% were malnourished [Table 1], [Table 2], [Table 3].
Table 1: Distribution of children according to demographic profile

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Table 2: Distribution of children according to colostrums, prelacteal feed, and initiation of BF

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Table 3: Distribution of children according feeding

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  Discussion Top


The present study reported very high rates of underweight among slum children. According to the WHO, the severity of undernutrition was very high indicating a critical situation. These results implied that their children were under critical nutritional stress. Most studies worldwide have also reported high to very high rates of undernutrition among slum children.

Of total hospital deliveries, 24.13% of children were given colostrums and 75.87% were not given colostrums, and of total home deliveries, 38.46% of children were given colostrums and 61.54% were not given colostrums.

Thirty-two percent of children were not given any type of prelacteal feed, 27% were given ghutti, 20% were given top milk, 13% were given honey, and only 9% were given jaggery.

2.29% of hospital-delivered children started breastfeeding within 1 h, 43.67% were started within 4 h, 50.57% were started within 8 h, and the remaining 3.47% were started ≥8 h. 30.76% of home-delivered children started breastfeeding within 4 h, 61.53% were started breastfeeding within 8 h, and 7.71% were started breastfeeding ≥8 h.

Manju et al.[7] in their study on newborn care practices in an urban slum of Delhi revealed that colostrum was given to the baby in 26 (72.2%) hospital deliveries as against 32 (69.5%) of home deliveries. Nearly one-third (29.3%) of all newborns were not given colostrums. About 27 (32.9%) newborns were given breast milk as the first feed in the present study as compared to 47.5% in a study conducted in Ho Chi Minh City in Vietnam. Although breast milk was the first feed given to higher proportion of babies delivered in the institutions, the practice of prelacteal feeds in the form of ghutti, honey, and jaggery water was still highly prevalent in both home- and institutional-delivered babies. The practice of prelacteal feeds is widely prevalent in India. Such a practice, by delaying initiation of breastfeeding, may adversely affect the establishment of lactation and introduce enteric infections if prelacteal feeds are not given in a hygienic manner. Breastfeeding was initiated within 4 h in only 34.8% of home deliveries (16) as against 44.4% of institutional deliveries (16). The difference was statistically not significant. In case breastfeeding initiated later than 4 h, reasons for this were enquired into. Traditional practices such as baby to be fed on a starlit night or in the presence of a paternal aunt were cited as reasons in 26% of cases. It was Dai's advice who conducted the deliveries in 14% of cases, no milk secretion (18.1%), no knowledge regarding early breastfeeding (16%), mother was tired (10%), postoperative (10%), staff instructions (4%), or baby asleep/did not take feed (2%) were the other reasons cited.[8],[9],[10],[11],[12],[13],[14],[15],[16],[17],[18]


  Conclusions and Recommendations Top


Lack of information and knowledge, cultural practice, elder's false guidance to mothers, other medical illnesses, financial inabilities, and many more such factors have shown their more impact on malpractices regarding breastfeeding and weaning in slum areas. Hence, it reinforces the planning and strategies for building up health education more toward slum areas.

The results of this study reinforce the importance of health education more in slum areas. There is an immediate need to create awareness among socioeconomically disadvantaged mothers, especially in the slum areas, about appropriate supplementary feeding. Informal discussions and demonstration-cum-teaching methods may be adapted to train mothers about preparation of low-cost, high-nutrient-density weaning foods for children.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Grant JP. The State of the World's Children. Oxford: Oxford University Press; 1984.  Back to cited text no. 1
    
2.
Briend A, Wojtyniak B, Rowland MG. Breastfeeding, nutritional state and child survival in rural Bangladesh. BMJ 1988;296:879-82.  Back to cited text no. 2
    
3.
World Health Organization. Infant and Young Child Nutrition Resolution 54.2 of the World Health Assembly. Resolution and Decisions of the 54th World Health Assembly; 14-22 May, 2001.  Back to cited text no. 3
    
4.
Ramachandran P. Breast-feeding practices in South Asia. Indian J Med Res 2004;119:xiii-xv.  Back to cited text no. 4
    
5.
Mikiel-Kostyra K, Mazur J, Wojdan-Godek E. Factors affecting exclusive breastfeeding in Poland: Cross- sectional survey of population based samples. Soz Praventivmed 2005;50:52-9.  Back to cited text no. 5
    
6.
Giashuddin MS, Kabir M. Duration of breast feeding in Bangladesh. Indian J Med Res 2004;119:267-72.  Back to cited text no. 6
    
7.
Rahi M, Taneja DK, Misra A, Mathur NB, Badhan S. Newborn care practices in an urban slum of Delhi. Indian J Med Sci 2006;60:506-13.  Back to cited text no. 7
[PUBMED]  [Full text]  
8.
Chakrabarty S, Ghosh R, Bharati P. Breastfeeding Practices and Nutritional Status of Preschool Children among the Shabar Tribal Community in Orissa, India, Research Gate, 2006.  Back to cited text no. 8
    
9.
Kumar D, Goel N, Mittal PC, Misra P. Influence of infant-feeding practices on nutritional status of underfive children. Indian J Pediatr 2006;73:417-21.  Back to cited text no. 9
    
10.
Tewari P, Shekhawat N, Choudhary S. Use of nutritional anthropometry and clinical examination in the assessment of nutritional status of children. Man India 2005;85:49-60.  Back to cited text no. 10
    
11.
World Health Organization. WHO Child Growth Standards. Methods and Development. Geneva: WHO; 2006.  Back to cited text no. 11
    
12.
De Onis M, Monteiro C, Akre J, Clugston G. The worldwide magnitude of protein- energy malnutrition: An overview from the WHO Global Database on child growth. Bull World Health Organization 1993;71:703-12.  Back to cited text no. 12
    
13.
Mishra RN, Mishra CP, Sen P, Singh TB. Nutritional status and dietary intage of preschool children in urban slums of Varanasi. Indian J Community Med 2001;26:90-3.  Back to cited text no. 13
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14.
Priti K, Gaidhane A, Choudhari S, Khatib MN, Kawalkar U, Gaidhane S, et al. Socio-Cultural Determinants of Infant and Young Child Feeding Practices in Rural India. Med Sci 2019;23:1015-22.  Back to cited text no. 14
    
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Seema P, Fernandez S, Puranik A, Anand D, Gaidhane A, Syed ZQ, et al. Policy Content and Stakeholder Network Analysis for Infant and Young Child Feeding in India. BMC Public Health 2017;17:16-25. Available from: https://doi.org/10.1186/s12889-017-4339-z. [Last accessed on 2020 Jan 18].  Back to cited text no. 15
    
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Marie TA, Karn S, Devkota MD, Rasheed S, Roy SK, et al. Opportunities for Strengthening Infant and Young Child Feeding Policies in South Asia: Insights from the SAIFRN Policy Analysis Project. BMC Public Health 2017;17:16-25. Available from: https://doi.org/10.1186/s12889-017-4336-2. [Last accessed on 2020 Jan 18].  Back to cited text no. 16
    
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Uddin S, Mahmood H, Senarath U, Zahiruddin Q, Karn S, Rasheed S, Dibley M. Analysis of Stakeholders Networks of Infant and Young Child Nutrition Programmes in Sri Lanka, India, Nepal, Bangladesh and Pakistan. BMC Public Health 2017;17:16-25. Available from: https://doi.org/10.1186/s12889-017-4337-1. [Last accessed on 2020 Jan 18].  Back to cited text no. 17
    
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Vani M, Jagzape T, Sachdeva P. Care Seeking Behaviour of Families for Their Sick Infants and Factors Impeding to Their Early Care Seeking in Rural Part of Central India. J Clin Diagn Res 2018;12:SC8-12. Available from: https://doi.org/10.7860/JCDR/2018/28130.11401. [Last accessed on 2020 Jan 18].  Back to cited text no. 18
    



 
 
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  [Table 1], [Table 2], [Table 3]



 

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