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Grandmothers’ knowledge positively influences maternal knowledge and infant and young child feeding practices

  • Chandni Karmacharya (a1), Kenda Cunningham (a2), Jowel Choufani (a3) and Suneetha Kadiyala (a1)
Abstract Objective

To examine associations between grandmothers’ knowledge and infant and young child feeding (IYCF) practices and to test whether the associations are independent of or operate via maternal knowledge.


Cross-sectional household survey data from households with a child under 5 years (n 4080). We used multivariate regression analyses, adjusted for child, maternal, grandmother and household characteristics, and district-level clustering, to test associations between grandmothers’ knowledge and IYCF practices for children aged 6–24 months living with a grandmother. We used causal mediation to formally test the direct effect of grandmothers’ knowledge on IYCF practices v. maternal knowledge mediating these associations.


Two hundred and forty rural communities, sixteen districts of Nepal.


Children aged 6–24 months (n1399), including those living with grandmothers (n 748).


We found that the odds of optimal breast-feeding practices were higher (early breast-feeding initiation: 2·2 times, P=0·002; colostrum feeding: 4·2 times, P<0·001) in households where grandmothers had correct knowledge v. those with incorrect knowledge. The same pattern was found for correct timing of introduction of water (2·6), milk (2·4), semi-solids (3·2), solids (2·9), eggs (2·6) and meat (2·5 times; all P<0·001). For the two pathways we were able to test, mothers’ correct knowledge mediated these associations between grandmothers’ knowledge and IYCF practices: colostrum feeding (b=10·91, P<0·001) and the introduction of complementary foods (b=5·18, P<0·001).


Grandmothers’ correct knowledge translated into mothers’ correct knowledge and, therefore, optimal IYCF practices. Given grandmothers’ influence in childcare, engagement of grandmothers in health and nutrition interventions could improve mothers’ knowledge and facilitate better child feeding.

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3. D Headey & J Hoddinott (2015) Understanding the rapid reduction of undernutrition in Nepal, 2001–2011. PLoS One 10, e0145738.

5. D Headey , J Hoddinott & S Park (2016) Drivers of nutritional change in four South Asian countries: a dynamic observational analysis. Matern Child Nutr 12, Suppl. 1, 210218.

7. RE Black , LH Allen , ZA Bhutta et al. (2008) Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 371, 243260.

9. CP Stewart , L Iannotti , KG Dewey et al. (2013) Contextualising complementary feeding in a broader framework for stunting prevention. Matern Child Nutr 9, 2745.

12. H Masvie (2006) The role of Tamang mothers-in-law in promoting breast feeding in Makwanpur District, Nepal. Midwifery 22, 2331.

14. LM Locks , PR Pandey , AK Osei et al. (2013) Using formative research to design a context-specific behaviour change strategy to improve infant and young child feeding practices and nutrition in Nepal. Matern Child Nutr 11, 882896.

17. S Pokhrel & R Sauerborn (2004) Household decision-making on child health care in developing countries: the case of Nepal. Health Policy Plan 19, 218233.

18. K Cunningham , GB Ploubidis , P Menon et al. (2015) Women’s empowerment in agriculture and child nutritional status in rural Nepal. Public Health Nutr 18, 31343145.

19. N Joshi , EA Kingsley , MJ Dibley et al. (2012) Determinants of inappropriate complementary feeding practices in young children in Nepal: secondary data analysis of Demographic and Health Survey 2006–2007. Matern Child Nutr 8, Suppl. 1, 6077.

22. M Kaushal , R Aggarwal , A Singal et al. (2005) Breastfeeding practices and health-seeking behavior for neonatal sickness in a rural community. J Trop Pediatr 51, 366376.

23. J Aubel (2012) The role and influence of grandmothers on child nutrition: culturally designated advisors and caregivers. Matern Child Nutr 8, 1935.

26. J Aubel , I Touré & M Diagne (2004) Senegalese grandmothers promote improved maternal and child nutrition practices: the guardians of tradition are not averse to change. Soc Sci Med 59, 945959.

28. B Simkhada , MA Porter & ER van Teijlingen (2010) The role of mothers-in-law in antenatal care decision-making in Nepal: a qualitative study. BMC Pregnancy Childbirth 10, 34.

30. R Li , KS Scanlon & MK Serdula (2005) The validity and reliability of maternal recall of breastfeeding practice. Nutr Rev 63, 103110.

31. R Karkee , AH Lee , V Khanal et al. (2014) Infant feeding information, attitudes and practices: a longitudinal survey in central Nepal. Int Breastfeed J 9, 14.

33. DL Bai , DYT Fong , KYW Lok et al. (2017) Practices, predictors and consequences of expressed breast-milk feeding in healthy full-term infants. Public Health Nutr 20, 492503.

36. H Moestue , S Huttly , L Sarella et al. (2007) ‘The bigger the better’ – mothers’ social networks and child nutrition in Andhra Pradesh. Public Health Nutr 10, 12741282.

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Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
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