Household food security and infant feeding practices in rural Bangladesh

Abstract

Objective: To determine the association between household food security and infant complementary feeding practices in rural Bangladesh. Design: Prospective, cohort study using structured home interviews during pregnancy and 3 and 9 months after delivery. We used two indicators of household food security at 3-months' follow-up: maternal Food Composition Score (FCS), calculated via the World Food Programme method, and an HHFS index created from an eleven-item food security questionnaire. Infant feeding practices were characterized using WHO definitions. Setting: Two rural sub-districts of Kishoreganj, Bangladesh. Subjects: Mother-child dyads (n 2073) who completed the 9-months' follow-up. Results: Complementary feeding was initiated at age ≤4 months for 7 %, at 5-6 months for 49 % and at ≥7 months for 44 % of infants. Based on 24 h dietary recall, 98 % of infants were still breast-feeding at age 9 months, and 16 % received ≥4 food groups and ≥4 meals (minimally acceptable diet) in addition to breast milk. Mothers' diet was more diverse than infants'. The odds of receiving a minimally acceptable diet for infants living in most food-secure households were three times those for infants living in least food-secure households (adjusted OR = 3·0; 95 % CI 2·1, 4·3). Socio-economic status, maternal age, literacy, parity and infant sex were not associated with infant diet. Conclusions: HHFS and maternal FCS were significant predictors of subsequent infant feeding practices. Nevertheless, even the more food-secure households had poor infant diet. Interventions aimed at improving infant nutritional status need to focus on both complementary food provision and education.

A systematic review of complementary feeding practices in South Asian infants and young children: the Bangladesh perspective

“…Their data suggests a declining trend in MDD achievement between 2007 and 2011, with current attainment around 25%. Diversity of maternal diet was positively associated with child MDD, and mothers tend to consume a larger range of food groups than their children [15,16].…”

“…Dietary diversity was explored in 11 studies [6,8,[13][14][15][16][17][18][19][20][21], with 4 using the seven WHO IYCF food groups to quantify MDD [14][15][16]19]. Their data suggests a declining trend in MDD achievement between 2007 and 2011, with current attainment around 25%.…”

“…In the 2011 BDHS the reported rate had fallen to 25% [19]. A large cohort study conducted in rural subdistricts in 2011 provides an even lower number; Owais et al (Weight of Evidence = High (WOE = H)) interviewed 2073 mother-child pairs over 9 months, and found that just 16% of children received the necessary four food groups per day to satisfy MDD [15]. [16].…”

“…Even among those that did, use was frequently low; Owais et al reported that neither the mother nor the child ate eggs in 79% of the 2073 pairs they interviewed [15]. Similarly, dairy products were reported to be used by 23 studies [6, 8, 15-17, 20, 22-32, 35-39], but by less than 40% of mothers in studies by Owais et al [15], Khatoon et al [17], and Burhanuddin et al [20].…”

“…Complementary feeding with fruit and vegetables (groups V and A) was identified in 23 studies [6, 8, 13-18, 20, 22-31, 33, 35, 36, 38, 39], and reported use varied widely -Sultana et al (WOE = M) reported that only 1.4% of infants consumed leafy green vegetables daily, whereas Owais et al reported that 43% of infants consumed non-Vitamin A rich fruit and vegetables [15,39]. Flesh foods (e.g.…”