Effectiveness of an educational intervention to improve child feeding practices and growth in rural China: updated results at 18 months of age

Abstract

Inappropriate complementary feeding practices have led to, in part, significant disparities in growth and nutritional status between rural and urban children in China. A cluster-randomised, controlled trial was implemented in Laishui, China to assess the effectiveness of an educational intervention on caregivers' feeding practices and children's growth. Eight townships were randomly assigned to the intervention or control. Five hundred ninety-nine healthy infants were enrolled at 2-4 months old, and were followed up at ages 6, 9, 12, 15 and 18 months. The intervention group received information on enhanced home-prepared recipes and food preparation and hygiene through group training, counselling and home visit. Key outcomes were children's physical growth, caregivers' knowledge and behaviours on complementary feeding, and the infant and child feeding index (ICFI). Analysis was by intention to treat. The intervention group achieved better knowledge and practices related to complementary feeding, and significantly higher ICFI scores at each follow-up point. Children in the intervention group achieved higher z-scores for weight-for-age (WAZ) and weight-for-height (WHZ) than the control (0.18 vs. 0.01 and 0.49 vs. 0.19, respectively) at 18 months old, and were less likely to have stunted growth (odds ratio = 0.71, 95% confidence interval: 0.53-0.94). Mixed model showed that the intervention group achieved significantly better linear growth over time, including WAZ (P = 0.016), WHZ (P = 0.030) and HAZ (P = 0.078). These results indicated that an educational intervention delivered through local health services can enhance caregivers' knowledge and practices of complementary feeding and ultimately improve children's growth.

The effectiveness of the WHO training course on complementary feeding counseling in a primary care setting, Ismailia, Egypt

“…They provided nutritional counseling without food supplements and reported results similar to ours [15][16][17]. They provided nutritional counseling without food supplements and reported results similar to ours [15][16][17].…”

Scaled-Up Nutrition Education on Pulse-Cereal Complementary Food Practice in Ethiopia: A Cluster-Randomized Trial

“…Almost all mothers in the intervention group had good knowledge about the bene ts of pulses, household food processing techniques, and methods of preparation; they also started preparing complementary food using pulse crops. This current study ndings are similar to other large intervention studies in other counties such as China [30,31] and Kenya [32], which showed improved mothers' knowledge about feeding practices when health service providers were used to provide nutrition education.…”

The impact of a primary health care intervention on infant feeding practices: a cluster randomised controlled trial in Brazil

“…There is evidence that the ICFI score is positively correlated with infant nutritional status in underprivileged population groups . However, the use of the ICFI to measure the impact of an intervention programme on children's eating practices has only been reported by Zhang , with adaptations according to recommendations for Chinese children. Higher ICFI scores were observed for the intervention group at all ages, as evaluated between 6 and 18 months.…”