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Poor Child Feeding Practices and Malnutrition in Bihar, India
Author(s) -
Young Melissa Fox,
Mehta Rukshan,
Larson Leila,
Kekre Priya,
Verma Pankaj,
Girard Amy Webb,
Ramakrishnan Usha,
Chaudhuri Indrajit,
Srikantiah Sridhar,
Martorell Reynaldo
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.1149.20
Subject(s) - breastfeeding , medicine , malnutrition , socioeconomic status , micronutrient , environmental health , caste , breast feeding , demography , population , pediatrics , public health , linguistics , philosophy , nursing , pathology , sociology
Child malnutrition in Bihar is a public health problem. An improved understanding of the current situation and key determinants is needed to inform policies and programs. We used data that were collected as part of the cross‐sectional baseline survey of an ongoing multiple micronutrient powder program evaluation in West Champaran, Bihar to evaluate child feeding practices and malnutrition among children ages 6–18 months (n=4360). Data were analyzed using SAS; descriptive analyses were used to report socio‐demographic characteristics of the population. Multivariate logistic models were developed to identify determinants of anemia and stunting including key socio‐demographic (child age, sex, parity, early age at marriage (<18 yrs), maternal education, religion, socioeconomic status (SES, from a composite wealth index), household hunger (as measured by the household hunger scale) and child feeding practices (preleacteal feeds, currently breastfeeding, dietary diversity and minimum acceptable diet). The baseline sample was 50% female and the average child was 11 months old. 78% of the households were Hindu and 21% Muslim; 33% were scheduled caste/tribe, 51% were other backward castes and 16% other. 60% of mothers and 36% of fathers were illiterate. 36% of the mothers were married before 18 years. Overall, breastfeeding rates were reported to be high with 99% ever breast fed and 95% currently breastfeeding. However, 61% of infants were given prelacteal feeds. Only 39% of families reported initiating complementary feeding at 6 months, 5% earlier and the majority (56%) reported late initiation of foods. Quality of complementary feeding was a major barrier. Only 20% of households reported adequate dietary diversity and 15% achieved the minimal acceptable diet. Rates of malnutrition were alarming in this population. 72% of children were anemic, 33% stunted, 27% wasted and 42% underweight. Key determinants (odds ratio; 95%CI) for child anemia included: child age (1.04; 1.01–1.07), female sex (0.74; 0.62–0.87), and household hunger (1.4; 1.03–1.96). Key determinants for child stunting included: child age (1.14; 1.11–1.17), female sex (0.74; 0.63–0.87), SES lowest vs highest tertile (1.75; 1.40–2.19), SES mid vs highest tertile (1.56; 1.26–1.94). Overall in Bihar there are high rates of child malnutrition and poor complementary feeding practices. Gender, household hunger and income are key underlying factors contributing to anemia and stunting in children. Support or Funding Information Funding support provided by a BMGF grant through a subcontract with CARE‐India