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.

[1]  I. Meshram,et al.  Influence of Feeding Practices and Associated Factors on the Nutritional Status of Infants in Rural Areas of Madhya Pradesh State, India , 2015, Asia-Pacific journal of public health.

[2]  E. Epel,et al.  Food insecurity is inversely associated with diet quality of lower-income adults. , 2014, Journal of the Academy of Nutrition and Dietetics.

[3]  P. Veugelers,et al.  Food security status among grade 5 students in Nova Scotia, Canada and its association with health outcomes , 2014, Public Health Nutrition.

[4]  A. Stein,et al.  Maternal prenatal attitudes and postnatal breast-feeding behaviours in rural Bangladesh , 2014, Public Health Nutrition.

[5]  F. Ram,et al.  Household Food Insecurity and Nutritional Status of Children and Women in Nepal , 2014, Food and nutrition bulletin.

[6]  Jai K. Das,et al.  Impact of education and provision of complementary feeding on growth and morbidity in children less than 2 years of age in developing countries: a systematic review , 2013, BMC Public Health.

[7]  R. Martorell,et al.  Maternal and child undernutrition and overweight in low-income and middle-income countries , 2013, The Lancet.

[8]  P. Nguyen,et al.  Maternal and child dietary diversity are associated in Bangladesh, Vietnam, and Ethiopia. , 2013, The Journal of nutrition.

[9]  E. Smith-Greenaway.  Maternal Reading Skills and Child Mortality in Nigeria: A Reassessment of Why Education Matters , 2013, Demography.

[10]  Robert E Black,et al.  Global burden of childhood pneumonia and diarrhoea , 2013, The Lancet.

[11]  Rehana A. Salam,et al.  Global Nutrition Epidemiology and Trends , 2013, Annals of Nutrition and Metabolism.

[12]  T. Wardlaw,et al.  Global trends in exclusive breastfeeding , 2012, International Breastfeeding Journal.

[13]  Chowdhury Jalal,et al.  Why Does Nutrition Deteriorate Rapidly among Children under 2 Years of Age? Using Qualitative Methods to Understand Community Perspectives on Complementary Feeding Practices in Bangladesh , 2011, Food and nutrition bulletin.

[14]  Robert A. Levine,et al.  Literacy and Mothering: How Women's Schooling Changes the Lives of the World's Children , 2011 .

[15]  Ivana Bjelic,et al.  Risk factors for childhood malnutrition in Roma settlements in Serbia , 2010, BMC public health.

[16]  S. Arifeen,et al.  Household food security is associated with infant feeding practices in rural Bangladesh. , 2008, The Journal of nutrition.

[17]  J. Bryce,et al.  Maternal and child undernutrition: effective action at national level , 2008, The Lancet.

[18]  Robert E Black,et al.  What works? Interventions for maternal and child undernutrition and survival , 2008, The Lancet.

[19]  C. Mathers,et al.  Maternal and child undernutrition: global and regional exposures and health consequences , 2008, The Lancet.

[20]  B. Rogers,et al.  Commonalities in the experience of household food insecurity across cultures: what are measures missing? , 2006, The Journal of nutrition.

[21]  P. Casey,et al.  Household food insecurity is associated with adult health status. , 2004, The Journal of nutrition.

[22]  E. Frongillo,et al.  Understanding the experience of household food insecurity in rural Bangladesh leads to a measure different from that used in other countries. , 2003, The Journal of nutrition.

[23]  L. Pritchett,et al.  Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India* , 2001, Demography.

[24]  A. Stein,et al.  Maternal Knowledge, Attitudes and Self-efficacy in Relation to Intention to Exclusively Breastfeed Among Pregnant Women in Rural Bangladesh , 2014, Maternal and Child Health Journal.

[25]  M. Dibley,et al.  Determinants of inappropriate complementary feeding practices in infant and young children in Bangladesh: secondary data analysis of Demographic Health Survey 2007. , 2012, Maternal & child nutrition.

[26]  N. Vozoris,et al.  Household food insufficiency is associated with poorer health. , 2003, The Journal of nutrition.

[27]  M. Saadeh,et al.  A new global strategy for infant and young child feeding. , 2003, Forum of nutrition.