Improving infant and young child feeding practices through nutrition education with local resources

Full text: Poor nutritional status in early infancy is associated with growth faltering and increased risk for morbidity. Main causes for undernutrition are a diet poor in quality and quantity, feeding practices, and hygiene. Programmes emphasize on affordable ways for improving diets for low-income families. Little is known about the period needed for behaviour changes. Longitudinal studies were conducted in Malawi and Cambodia looking at infant and young child feeding as well as growth of children below two years. At baseline 6-9 months old children and their caregivers participating in a nutrition education(NE) program of FAO were invited. The recruited children were matched by age (days) and sex with children living in an area without NE (control). Baseline data was collected prior the NE carried out by trained volunteers twice a month based on locally adopted teaching materials. The children and their caregivers were visited every three months for a total period of 12 months. At baseline the mean age of the children in Malawi was 227 days, all breastfed (n = 149). In Cambodia the mean age was 230 days and 90% of them were still breastfed (n = 96). The mean HAZ was -1.53 in Malawi and -0.87 in Cambodia. Minimum acceptable diet(MAD) was received by 42% and 34% of the children in the intervention areas of Malawi and Cambodia respectively. After three months MAD was achieved by 88% in Malawi and 45% in Cambodia. The rates in the control area in Malawi increased as well from 22% at baseline to 52% three months later. A similar change could be observed in Cambodia with 28% of the children receiving MAD at baseline and 38% three months later. Hygiene behaviour was one focus of the NE in both countries. In Malawi soap usage before feeding the child increased to 32% (p< 0.001), and before food preparation to 33% (both p < 0.001). Also washing before eating the food increased to 22%. In the control area no significant changes in terms of soap usage could be observed. In Cambodia the prevalence of good hygiene was already at 90%. No further changes could be observed. Regarding an improved porridge, the intervention in Cambodia led to 19% of the caregivers stating to have prepared a special meal for their child during the previous day at baseline and 44% after three months. In the control area this change was smaller with 3% at baseline and 20% three months later. Behaviour change messages can be quickly adopted if they are locally appropriate and affordable. The research was conducted within the IMCF Project of FAO and JLU Giessen, Germany which is funded by the German Federal Ministry of Food, Agriculture and Consumer Protection. (author)