School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India.
School of Tourism and Hospitality, University of Johannesburg, Johannesburg, South Africa.
J Health Popul Nutr. 2023 Jan 19;42(1):4. doi: 10.1186/s41043-022-00342-6.
Inequalities in child feeding practices are evident in urban slums in developing nations. Our study identified the determinants of complementary feeding (CF) practices in the informal settings of Pune, India, a district close to the business capital of India.
Employing a cross-sectional study design, 1066 mother-children dyads were surveyed. Five indicators defined by the WHO were used to study complementary feeding practices. Determinants of complementary feeding practices were identified using multivariate analyses.
Timely initiation of CF was reported by 42%. Minimum acceptable diet (MAD), minimum meal frequency (MMF), and Diet Diversity Score > 4 were achieved by 14.9%, 76.5%, and 16.4%, respectively. Continued breastfeeding (CBF) at 2 years, and feeding processed foods were practiced by 94% and 50%, respectively. Among the maternal characteristics, a mother's age > 30 years at pregnancy was less likely to achieve DD [AOR: 0.195 (CI 0.047-0.809)] and MAD [AOR: 0.231 (CI 0.056-0.960)]. Mothers with lower education were less likely to meet MMF [AOR: 0.302 (0.113-0.807)], MAD [AOR: 0.505 (CI 0.295-0.867)] and to introduce formula feeds (FF) [AOR: 0.417 (0.193- 0.899)]. Among obstetric characteristics, birth spacing < 33 months was less likely to achieve DD [AOR: 0.594 (CI 0.365-0.965)] and CBF [AOR: 0.562 (CI: 0.322-0.982)]. Receiving IYCF counseling only during postnatal care hindered the timely initiation of CF [AOR: 0.638 (0.415-0.981)]. Very Low Birth Weight increased the odds of achieving DD [AOR: 2.384 (1.007-5.644)] and MAD [AOR: 2.588(CI: 1.054-6.352)], while low birth weight increased the odds of children being introduced to processed foods [AOR: 1.370 (CI: 1.056-1.776)]. Concerning socio-economic status, being above the poverty line increased the odds of achieving MMF, [AOR: 1.851 (1.005-3.407)]. Other backward castes showed higher odds of achieving MAD [AOR: 2.191 (1.208-3.973)] and undisclosed caste in our study setting decreased the odds of FF [AOR: 0.339 (0.170-0.677)]. Bottle feeding interfered with MMF [AOR: 0.440 (0.317-0.611)] and CBF [AOR: 0.153 (0.105-0.224)].
Investing in maternal education and IYCF counseling during both ANC and PNC to provide nutritious complementary foods alongside addressing poverty should be a national priority to prevent the double burden of undernutrition at an early age in informal settings.
在发展中国家的城市贫民窟中，儿童喂养实践方面的不平等现象很明显。我们的研究确定了印度浦那非正式环境中补充喂养（CF）实践的决定因素，浦那是印度商业首都附近的一个区。
采用横断面研究设计，对 1066 对母婴进行了调查。使用世界卫生组织定义的五个指标来研究补充喂养实践。使用多变量分析确定补充喂养实践的决定因素。
报告及时开始 CF 的比例为 42%。最低可接受饮食（MAD）、最低膳食频率（MMF）和饮食多样性评分>4 分别达到 14.9%、76.5%和 16.4%。94%的母亲继续在 2 岁时进行母乳喂养（CBF），50%的母亲食用加工食品。在母亲特征中，妊娠时母亲年龄>30 岁不太可能达到 DD [优势比（AOR）：0.195（CI 0.047-0.809）]和 MAD [AOR：0.231（CI 0.056-0.960）]。受教育程度较低的母亲不太可能达到 MMF [AOR：0.302（0.113-0.807）]、MAD [AOR：0.505（CI 0.295-0.867）]和引入配方奶（FF）[AOR：0.417（0.193-0.899）]。在产科特征中，出生间隔<33 个月不太可能达到 DD [AOR：0.594（CI 0.365-0.965）]和 CBF [AOR：0.562（CI：0.322-0.982）]。仅在产后护理期间接受 IYCF 咨询会阻碍 CF 的及时启动 [AOR：0.638（0.415-0.981）]。极低出生体重增加了达到 DD 的几率 [AOR：2.384（1.007-5.644）]和 MAD [AOR：2.588（CI：1.054-6.352）]，而低出生体重增加了儿童食用加工食品的几率 [AOR：1.370（CI：1.056-1.776）]。关于社会经济地位，高于贫困线增加了达到 MMF 的几率 [AOR：1.851（1.005-3.407）]。在我们的研究环境中，其他落后种姓的人更有可能达到 MAD [AOR：2.191（1.208-3.973）]，而未公开的种姓则降低了 FF 的几率 [AOR：0.339（0.170-0.677）]。奶瓶喂养会干扰 MMF [AOR：0.440（0.317-0.611）]和 CBF [AOR：0.153（0.105-0.224）]。
投资于母亲教育和 ANC 和 PNC 期间的 IYCF 咨询，以提供有营养的补充食品，同时解决贫困问题，应该成为国家的优先事项，以防止在非正式环境中幼儿早期出现营养不良的双重负担。
