Skip to main content
×
×
Home

Systematic review of infant and young child complementary feeding practices in South Asian families: the India perspective

  • Logan Manikam (a1), Ankita Prasad (a2), Abina Dharmaratnam (a3), Christy Moen (a4), Alexandra Robinson (a5), Alexander Light (a2), Sonia Ahmed (a1), Raghu Lingam (a6) and Monica Lakhanpaul (a1)...
Abstract
Objective

Suboptimal nutrition among children remains a problem among South Asian (SA) families. Appropriate complementary feeding (CF) practices can greatly reduce this risk. Thus, we undertook a systematic review of studies assessing CF (timing, dietary diversity, meal frequency and influencing factors) in children aged <2 years in India.

Design

Searches between January 2000 and June 2016 in MEDLINE, EMBASE, Global Health, Web of Science, OVID Maternity & Infant Care, CINAHL, Cochrane Library, BanglaJOL, POPLINE and WHO Global Health Library. Eligibility criteria: primary research on CF practices in SA children aged 0–2 years and/or their families. Search terms: ‘children’, ‘feeding’ and ‘Asians’ and derivatives. Two researchers undertook study selection, data extraction and quality appraisal (EPPI-Centre Weight of Evidence).

Results

From 45 712 abstracts screened, sixty-four cross-sectional, seven cohort, one qualitative and one case–control studies were included. Despite adopting the WHO Infant and Young Child Feeding guidelines, suboptimal CF practices were found in all studies. In twenty-nine of fifty-nine studies, CF was introduced between 6 and 9 months, with eight studies finding minimum dietary diversity was achieved in 6–33 %, and ten of seventeen studies noting minimum meal frequency in only 25–50 % of the study populations. Influencing factors included cultural influences, poor knowledge on appropriate CF practices and parental educational status.

Conclusions

This is the first systematic review to evaluate CF practices in SA in India. Campaigns to change health and nutrition behaviour and revision of nationwide child health nutrition programmes are needed to meet the substantial unmet needs of these children.

Copyright
Corresponding author
* Corresponding author: Email logan.manikam.10@ucl.ac.uk
References
Hide All
1. Black, RE, Victora, CG, Walker, SP et al. (2013) Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 382, 427451.
2. UNICEF (2009) Tracking Progress on Child and Maternal Nutrition: A Survival and Development Priority. New York: UNICEF.
3. World Health Organization (2016) Appropriate complementary feeding. http://www.who.int/elena/titles/complementary_feeding/en/ (accessed October 2016).
4. Davies-Adetugbo, AA & Adetugbo, K (1997) Effect of early complementary feeding on nutritional status in term infants in rural Nigeria. Nutr Health 12, 2531.
5. Semahegn, A, Tesfaye, G & Bogale, A (2014) Complementary feeding practice of mothers and associated factors in Hiwot Fana specialized hospital, eastern Ethiopia. Pan Afr Med J 18, 143.
6. Macharia, CW, Kogi-Makau, W & Muroki, NM (2004) Dietary intake, feeding and care practices of children in Kathonzweni division, Makueni district, Kenya. East Afr Med J 81, 402407.
7. Stewart, CP, Iannotti, L, Dewey, KG et al. (2013) Contextualising complementary feeding in a broader framework for stunting prevention. Matern Child Nutr 9, 2745.
8. Dewey, KG (2016) Reducing stunting by improving maternal, infant and young child nutrition in regions such as South Asia: evidence, challenges and opportunities. Matern Child Nutr 12, 2738.
9. Avula, R, Raykar, N, Menon, P et al. (2016) Reducing stunting in India: what investments are needed? Matern Child Nutr 12, 249252.
10. Ramji, S (2009) Impact of infant & young child feeding & caring practices on nutritional status & health. Indian J Med Res 130, 624626.
11. Engle, PL (2002) Infant feeding styles: barriers and opportunities for good nutrition in India. Nutr Rev 60, 5 Pt 2, S109S114.
12. Senarath, U & Dibley, MJ (2012) Complementary feeding practices in South Asia: analyses of recent national survey data by the South Asia Infant Feeding Research Network. Matern Child Nutr 8, 510.
13. Gragnolati, M, Shekar, M, Das Gupta, M et al. (2005) India’s Undernourished Children: A Call for Reform and Action. Washington, DC: The World Bank.
14. World Health Organization (2010) Indicators for Assessing Infant and Young Child Feeding Practices. Geneva: WHO.
15. Manikam, L, Sharmila, A, Dharmaratnam, A et al. (2017) Systematic review of infant and young child complementary feeding practices in South Asian families: the Pakistan perspective. Public Health Nutr (Epublication ahead of print version, doi:10.1017/S1368980017002956).
16. Manikam, L, Robinson, A, Kuah, JY et al. (2017) A systematic review of complementary feeding practices in South Asian infants and young children: the Bangladesh perspective. BMC Nutr 3, 56.
17. Porta, M (2014) A Dictionary of Epidemiology, 6th ed. New York: Oxford University Press.
18. National Institute of Clinical Excellence (n.d.) NICE Glossary. https://www.nice.org.uk/glossary (accessed November 2016).
19. Centre for Reviews and Dissemination (2009) Systematic Reviews: CRD’s guidance for undertaking reviews in health care. https://www.york.ac.uk/media/crd/Systematic_Reviews.pdf (accessed November 2016).
20. Dixon-Woods, M, Agarwal, S, Jones, D et al. (2005) Synthesising qualitative and quantitative evidence: a review of possible methods. J Health Serv Res Policy 10, 4553.
21. Collins, JA & Fauser, BCJM (2005) Balancing the strengths of systematic and narrative reviews. Hum Reprod Update 11, 103104.
22. Popay, J, Roberts, H, Sowden, A et al. (2006) Guidance on the Conduct of Narrative Synthesis in Systematic Reviews: A Product from the ESRC Methods Programme. http://www.lancaster.ac.uk/shm/research/nssr/research/dissemination/publications/NS_Synthesis_Guidance_v1.pdf (accessed October 2017).
23. Oxford Dictionaries (2017) Definition of barrier in English. https://en.oxforddictionaries.com/definition/barrier (accessed October 2017).
24. Oxford Dictionaries (2017) Definition of promoter in English. https://en.oxforddictionaries.com/definition/promoter (accessed October 2017).
25. Gough, D (2007) Weight of Evidence: a framework for the appraisal of the quality and relevance of evidence. Res Pap Educ 22, 213228.
26. Aruldas, K, Khan, MM, Hazra, A et al. (2010) Increasing appropriate complementary feeding in rural Uttar Pradesh. J Fam Welf 56, 5156.
27. Bentley, A, Das, S, Alcock, G et al. (2015) Malnutrition and infant and young child feeding in informal settlements in Mumbai, India: findings from a census. Food Sci Nutr 3, 257271.
28. Chandwani, H, Prajapati, A, Rana, B et al. (2015) Assessment of infant and young child feeding practices with special emphasis on IYCF indicators in a field practice area of rural health training centre at Dabhoda, Gujarat, India. Int J Med Sci Public Health 4, 14141419.
29. Menon, P, Bamezai, A, Subandoro, A et al. (2015) Age-appropriate infant and young child feeding practices are associated with child nutrition in India: insights from nationally representative data. Matern Child Nutr 11, 7387.
30. Mukhopadhyay, DDK, Sinhababu, A, Saren, AAB et al. (2013) Association of child feeding practices with nutritional status of under-two slum dwelling children: a community-based study from West Bengal, India. Indian J Public Health 57, 169172.
31. Patel, A, Pusdekar, Y, Badhoniya, N et al. (2012) Determinants of inappropriate complementary feeding practices in young children in India: secondary analysis of National Family Health Survey 2005–2006. Matern Child Nutr 8, Suppl. 1, 2844.
32. Senarath, U, Agho, KE, Akram, DES et al. (2012) Comparisons of complementary feeding indicators and associated factors in children aged 6–23 months across five South Asian countries. Matern Child Nutr 8, Suppl. 1, 89106.
33. Khan, AAM, Kayina, P, Agrawal, P et al. (2012) A study on infant and young child feeding practices among mothers attending an urban health center in East Delhi. Indian J Public Health 56, 301304.
34. de Onis, M (2006) Complementary feeding in the WHO Multicentre Growth Reference Study. Acta Paediatr Suppl 450, 2737.
35. D’Alimonte, MR, Deshmukh, D, Jayaraman, A et al. (2016) Using positive deviance to understand the uptake of optimal infant and young child feeding practices by mothers in an urban slum of Mumbai. Matern Child Health J 20, 11331142.
36. Garg, A & Chadha, R (2009) Index for measuring the quality of complementary feeding practices in rural India. J Health Popul Nutr 27, 763771.
37. Katara, PS, Patel, SV, Kantharia, SL et al. (2013) Study on feeding practices among children 6 months to 2 years and its effect on their nutritional status in urban slums. Natl J Community Med 4, 475478.
38. Malhotra, N (2013) Inadequate feeding of infant and young children in India: lack of nutritional information or food affordability? Public Health Nutr 16, 17231731.
39. Lohia, N & Udipi, SA (2014) Infant and child feeding index reflects feeding practices, nutritional status of urban slum children. BMC Pediatr 14, 290.
40. Fazilli, A, Imtiyaz, A, Iqbal, M et al. (2011) Infant feeding practices of multiparous women attending the antenatal clinic in a tertiary care hospital. Int J Med Public Health 1, 4750.
41. Neog, N & Baruah, DK (2012) Prevalent infant feeding practices of infants among the missing tribes of Jorhat district, Assam. Food Sci Res J 3, 913.
42. Meshram, II, Laxmaiah, A, Venkaiah, K et al. (2012) Impact of feeding and breastfeeding practices on the nutritional status of infants in a district of Andhra Pradesh, India. Natl Med J India 25, 201206.
43. Kapur, D, Sharma, S & Agarwal, KN (2005) Dietary intake and growth pattern of children 9–36 months of age in an urban slum in Delhi. Indian Pediatr 42, 351356.
44. Pasricha, S-RR, Shet, ASS, JFF, Black et al. (2011) Vitamin B-12, folate, iron, and vitamin A concentrations in rural Indian children are associated with continued breastfeeding, complementary diet, and maternal nutrition. Am J Clin Nutr 94, 13581370.
45. Rangaswamy, K, Kumar, A & Kumar, HV (2013) Socio-cultural factors influencing infant feeding practices in rural Tumkur. Res J Pharmaceut Biol Chem Sci 4, 204212.
46. Ananda Kumar, TS, Rangaswamy, KB & Viswanatha Kumar, HM (2013) Weaning practices in rural Tumkur. Curr Pediatr Res 17, 115117.
47. Sharan, S, Kumari, SPS & Nagabhushanam, K (2001) Status of sericulture farm women and infant feeding habits. Mysore J Agric Sci 35, 351356.
48. Vyas, S, Kandpal, SD, Semwal, J et al. (2014) Trends in weaning practices among infants and toddlers in a hilly terrain of a newly formed state of India. Int J Prev Med 5, 741748.
49. Bhandari, N, Bahl, R, Taneja, S et al. (2002) Growth performance of affluent Indian children is similar to that in developed countries. Bull World Health Organ 80, 189195.
50. Aguayo, VM, Nair, R, Badgaiyan, N et al. (2016) Determinants of stunting and poor linear growth in children under 2 years of age in India: an in-depth analysis of Maharashtra’s comprehensive nutrition survey. Matern Child Nutr 12, 121140.
51. Samuel, TM, Thomas, T, Bhat, S et al. (2012) Are infants born in baby-friendly hospitals being exclusively breastfed until 6 months of age? Eur J Clin Nutr 66, 459465.
52. Lingam, R, Gupta, P, Zafar, S et al. (2014) Understanding care and feeding practices: building blocks for a sustainable intervention in India and Pakistan. Ann N Y Acad Sci 1308, 204217.
53. Chhabra, R, Subhashini, V & Verma, S (2010) Existing infant feeding and weaning practices in an urban setup. Asian J Home Sci 5, 250254.
54. Narayanappa, R, Ranganath, T & Gowda, K (2015) Infant feeding practices in rural field practice area of Medical College in Karnataka: a cross-sectional descriptive study. Natl J Community Med 6, 508512.
55. Collison, DK, Kekre, P, Verma, P et al. (2015) Acceptability and utility of an innovative feeding toolkit to improve maternal and child dietary practices in Bihar, India. Food Nutr Bull 36, 2432.
56. Roy, S, Dasgupta, A & Pal, B (2009) Feeding practices of children in an urban slum of Kolkata. Indian J Community Med 34, 362363.
57. Aggarwal, A, Verma, S, Faridi, M et al. (2008) Complementary feeding – reasons for inappropriateness in timing, quantity and consistency. Indian J Pediatr 75, 4953.
58. Rasania, S & Sachdev, T (2001) Nutritional status and feeding practices of children attending MCH Centre. Indian J Community Med 26, 145150.
59. Kuriakose, JJR (2010) Nutritional status and feeding practices of infants. Nurs J India 101, 184186.
60. Yasmin, H (2008) Weaning practices of rural women in Chandauli District, Uttar Pradesh, India. Nurture 2, 2429.
61. Saxena, V & Kumar, P (2014) Complementary feeding practices in rural community: a study from block Doiwala district Dehradun. Indian J Basic Appl Med Res 3, 358363.
62. Padmadas, SSS, Hutter, I & Willekens, F (2002) Weaning initiation patterns and subsequent linear growth progression among children aged 2–4 years in India. Int J Epidemiol 31, 855863.
63. Caleyachetty, A, Krishnaveni, GV, Veena, SR et al. (2013) Breastfeeding duration, age of starting solids and high BMI risk and adiposity in Indian children. Matern Child Nutr 9, 199216.
64. Bhanderi, D & Choudhary, S (2011) A community based study of feeding and weaning practices in under five children in semi urban community of Gujarat. Natl J Community Med 2, 277283.
65. Sreedhara, MS & Banapurmath, CR (2014) A study of nutritional status of infants in relation to their complementary feeding practices. Curr Pediatr Res 18, 3941.
66. Bagul, AS & Supare, MS (2012) The infant feeding practices in an urban slum of Nagpur, India. J Clin Diagnostic Res 6, 15251527.
67. Jayant, DD, Purushottam, AG, Deepak, BP et al. (2010) Socio-cultural practices in relation to breastfeeding, weaning and child rearing among Indian mothers and assessment of nutritional status of children under five in rural India. Australas Med J 3, 618624.
68. Farzani, F & Devi, R (2011) A study of feeding practices of infants in Parbhani district. Food Sci Res J 2, 13.
69. Meshram, II, Kodavanti, MR, Chitty, GR et al. (2013) Influence of feeding practices and associated factors on the nutritional status of infants in rural areas of Madhya Pradesh State, India. Asia Pac J Public Health 27, NP1345NP1361.
70. Sanjeev, D & Anuradha, D (2012) Women literacy and infant feeding practices in rural integrated child development scheme (ICDS) block of Delhi. Natl J Community Med 3, 385390.
71. Verma, R & Gupta, P (2015) Impact of breast feeding and weaning practices associated with morbidity in rural area of Ghaziabad, Uttar Pradesh, India: a community based longitudinal study. Natl J Community Med 6, 618621.
72. Damayanthi, M, Jayanth Kumar, K & Sridevi, (2013) Breast feeding practices in rural field practice area of RRMCH, Bangalore. Med Inn 2, issue 1, 58.
73. Pathi, S, Das, BC, Rasania, SK et al. (2003) Feeding practices versus nutritional status of infants in a rural ICDS block of Orissa. Health Popul Perspect Issues 26, 116120.
74. Shroff, MR, Griffiths, PL, Suchindran, C et al. (2011) Does maternal autonomy influence feeding practices and infant growth in rural India? Soc Sci Med 73, 447455.
75. Tyagi, R & Bhan, C (2009) Knowledge of rural mothers regarding recommended child rearing practices. Ann Agric Biol Res 14, 169173.
76. Goswami, M, Dash, B & Dash, NC (2012) Maternal care and childrearing practices: a micro level study among the Bhumija tribe of Northern Orissa, India. South Asian Anthropol 12, 5159.
77. Saxena, V & Kumari, R (2014) Infant and young child feeding – knowledge and practices of ASHA workers of Doiwala block, Dehradun district. Indian J Community Health 26, 6875.
78. Padhy, K & Choudhury, RKR (2004) Practices and attitude of mothers in initiation of infant feeding. South Asian Anthropol 4, 157160.
79. Mayuri, M, Garg, V, Mukherji, C et al. (2012) Bovine milk usage and feeding practices for infants in India. Indian J Public Health 56, 7581.
80. Rao, S, Swathi, P, Unnikrishnan, B et al. (2011) Study of complementary feeding practices among mothers of children aged six months to two years – a study from coastal south India. Australas Med J 4, 252257.
81. Subbiah, N & Jeganathan, A (2012) Socio-cultural beliefs influencing breastfeeding practices among primi postnatal mothers residing in urban slum area of Delhi. Health Popul Perspect Issues 35, 6173.
82. Sharma, M & Sharma, S (2003) Infant feeding practices in rural women of Kangra district of HP. Himachal J Agric Res 29, 7983.
83. Sinha, A & Pandey, H (2000) Weaning practices of ‘Ho’ mothers in Bihar. Indian J Nutr Diet 37, 338340.
84. Sinhababu, A, Mukhopadhyay, DK, Panja, TK et al. (2010) Infant- and young child-feeding practices in Bankura district, West Bengal, India. J Health Popul Nutr 28, 294299.
85. Yousafzai, AK, Pagedar, S, Wirz, S et al. (2003) Beliefs about feeding practices and nutrition for children with disabilities among families in Dharavi, Mumbai. Int J Rehabil Res 26, 3341.
86. Dahiya, S & Sehgal, S (2002) Infant feeding practices of working and non-working urban mothers. Indian J Nutr Diet 39, 367372.
87. Chhabra, P & Gupta, A (2015) Infant and young child feeding practices and its determinants in an urbanized village of Delhi. Int J Med Public Health 5, 228231.
88. Veena, SR, Krishnaveni, G V, Srinivasan, K et al. (2010) Infant feeding practice and childhood cognitive performance in South India. Arch Dis Child 95, 347354.
89. Erdman, J (1981) Bioavailability of trace minerals from cereals and legumes. Cereal Chem 58, 2126.
90. Shi, L & Zhang, J (2011) Recent evidence of the effectiveness of educational interventions for improving complementary feeding practices in developing countries. J Trop Pediatr 57, 9198.
91. Dibley, MJJ, Roy, SKK, Senarath, U et al. (2010) Across-country comparisons of selected infant and young child feeding indicators and associated factors in four South Asian countries. Food Nutr Bull 31, 366375.
92. Ministry of Women and Child Development (2016) Draft National Policy for Women 2016: Articulating a Vision for Empowerment of Women. New Delhi: Government of India.
93. Dewey, KG & Brown, KH (2003) Update on technical issues concerning complementary feeding of young children in developing countries and implications for intervention programs. Food Nutr Bull 24, 528.
94. Rogers, P (2014) Theory of Change. Methodological Briefs – Impact Evaluation no. 2. Florence: UNICEF Office of Research – Innocenti.
95. Bhandari, N, Mazumder, S, Bahl, R et al. (2004) An educational intervention to promote appropriate complementary feeding practices and physical growth in infants and young children in rural Haryana, India. J Nutr 134, 23422348.
96. Vazir, S, Engle, P, Balakrishna, N et al. (2013) Cluster-randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth and development among rural Indian toddlers. Matern Child Nutr 9, 99117.
97. Bhutta, ZA, Ahmed, T, Black, RE et al. (2008) What works? Interventions for maternal and child undernutrition and survival. Lancet 371, 417440.
98. Bahuguna, R, Younis Khan, S & Jain, A (2013) Influence of feeding practices on dental caries. A case–control study. Eur J Paediatr Dent 14, 5558.
99. Dakshayani, B & Gangadhar, MR (2008) Breast feeding practices among the Hakkipikkis: a tribal population of Mysore District, Karnataka. Ethno-Med 2, 127129.
100. Fall, CHHD, Borja, JBB, Osmond, C et al. (2010) Infant-feeding patterns and cardiovascular risk factors in young adulthood: data from five cohorts in low- and middle-income countries. Int J Epidemiol 40, 4762.
101. Holambe, VMV & Thakur, NAN (2014) Factors affecting late introduction of complementary food: a Kaplan Meier analysis. Natl J Community Med 5, 140143.
102. Jindal, A (2009) Weaning practices among mothers in selected hospitals in Mangalore. Nurs J India 42, 351356.
103. Kumar, D, Goel, NKK, Mittal, PCC et al. (2006) Influence of infant-feeding practices on nutritional status of under-five children. Indian J Pediatr 73, 417421.
104. Passi, GR & Shad, R (2004) Breastfeeding, weaning practices and nutritional status of infants of tea garden workers of Assam. Indian Pediatr 41, 12771279.
105. Shahrawat, R & Joon, V (2013) Role of inter personal communication in infant and young child feeding practices in an urban slum: an overview based on case studies. Indian J Pediatr 80, 10411046.
106. Singh, A & Vaidya, M (2015) Traditional weaning foods and practices in Jabalpur district with reference to prevalence of malnutrition. Asian J Dairy Food Res 34, 32.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Full text views

Total number of HTML views: 15
Total number of PDF views: 137 *
Loading metrics...

Abstract views

Total abstract views: 693 *
Loading metrics...

* Views captured on Cambridge Core between 23rd November 2017 - 24th June 2018. This data will be updated every 24 hours.