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Table of Contents
ARTICLE
Year : 2016  |  Volume : 17  |  Issue : 2  |  Page : 36-40

Impact of feeding practices of mothers on nutritional status of children


1 Lecturer, Shri Guru Ram Dass College of Nursing, Hoshiarpur, India
2 Associate Professor, Shri Guru Ram Dass College of Nursing, Hoshiarpur, India

Date of Web Publication9-Jun-2020

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  Abstract 


Child malnutrition is still a serious health problem in many developing countries including India. Feeding practices of mothers may play a significant role in improvement of nutritional status of children. A descriptive correlational study was conducted to find out correlation between nutritional status of children and feeding practices of mothers. A purposive sampling technique was used to recruit 60 male and female children between the age group of 6 months to 3 years along with their mothers. Nutritional status of children and feeding practices of mothers were assessed through anthropometric assessment and self- reporting feeding practice checklist respectively. The collected data were analyzed using descriptive and inferential statistics. The results according to weight-for-age calculation revealed that 75% of children had normal nutritional status and 18.3% and 6.7% of children had grade 1 and grade 2 malnutrition respectively. According to height-for-age calculations, 83.3% of children had normal height, 10% of children were short for age, and 1.7% children had gigantism. As per levels of feeding practices of mothers, 31.6% had satisfactory, 41.7% had partially satisfactory and 26.7% had unsatisfactory feeding practices. There was a significant moderately positive correlation (r = .64, p = .01) between weight for age and feeding practices and a non significant low positive correlation (r=.29, p =. 14) between height for age and nutritional practices. Hence, there is a need for creating awareness about healthy feeding practices to combat the problem of malnutrition.

Keywords: Nutritional status, children, feeding practices, mothers


How to cite this article:
Kaur J, Singh M. Impact of feeding practices of mothers on nutritional status of children. Indian J Cont Nsg Edn 2016;17:36-40

How to cite this URL:
Kaur J, Singh M. Impact of feeding practices of mothers on nutritional status of children. Indian J Cont Nsg Edn [serial online] 2016 [cited 2021 May 8];17:36-40. Available from: https://www.ijcne.org/text.asp?2016/17/2/36/286297






  Introduction Top


Nutrition is one of the basic requirements of any living organism to grow and sustain life. The quality and quantity of nutrients play an important role in the physical, mental, and emotional development of growing children and in maintenance of good health throughout the life span. Any major deviation in nutrient intake either in quality or in quantity from normal requirement can affect the growth and life of children in a number of ways in the later period (Mishra & Mishra, 2007). Well-nourished children perform better in school, grow into healthy adults and in turn give their children a better start in life whereas, undernourished children have lower resistance to fight against infection so they are more likely to die from common childhood ailments like diarrhoeal diseases and respiratory infections. For those who survive, frequent illnesses sap their nutritional status, locking them into a vicious cycle of recurring sickness and faltering growth. Their dilemma is largely invisible as three quarters of the children who die from causes related to malnutrition are only mildly or moderately undernourished showing no outward sign of their vulnerability (United Nations Children’s Fund [UNICEF], 2006).

Malnutrition is the reason behind more than half of all childhood mortality worldwide. India has the highest number of stunted children in the world. Almost 42% of the children in the country numbering over 61 million are malnourished and stunted according to the hunger and malnutrition report released by the then Prime Minister Dr. Manmohan Singh in2012 (Mahindra&Mahindra, 2012).

The Government of India has released the national and state level fact sheets of the Rapid Survey on Children (RSoC) conducted jointly by the Ministry of Women and Child Development and UNICEF (2006). The survey report revealed that among the children of less than 3 years of age, 9.4% were underweight, 15% were wasted, and 38.7% were stunted. The above figures show an improvement in the child’s nutritional status compared to the National Family Health Survey-3 data, in which the corresponding figures were 40.4% for underweight, 22.9% for wasted and 44.9% for stunted growth (Dasgupta, Sinha, & Yumnam, 2016; National Family Health Survey, 2009). However malnutrition levels remain high and requires attention and action.

The period from birth to two years is widely recognized as the critical period during which children completely depend on mothers for their nutrition. Mother’s knowledge related to feeding of babies and other dietary practices adapted by her have an impact on the nutritional status of the children. Nutritional vulnerability during this period results from poor breastfeeding and complementary feeding practices, coupled with growth faltering, micronutrient deficiencies, and high rates of infectious diseases. Breast-fed infants and children grow normally during the first six months of their life and show slow growth during the transitional period of weaning because they do not get enough nutritious foods (World Health Organization, 2003).

During the first two years of life, maternal feeding practices are important for the growth, development, and overall health and protection of children against chronic deficiency diseases. Progress in improving infant and young child feeding practices in the developing world has been remarkably slow due to several factors (Avachat, Phalke, & Phalke, 2009).

This study explores the relationship between feeding practices of mothers and nutritional status of children.

The objectives of the study were to

  • assess the feeding practices of mothers
  • assess the nutritional status of children
  • find out the correlation between the nutritional status of children and feeding practices of mothers
  • find out the association of nutritional status of children and feeding practices of mothers with their selected demographic variables



  Methods Top


Design and Sampling

A descriptive correlational research design was adopted. The sample were male and female children of six months to three years of age not suffering with any kind of illness or disability, and their mothers attending the Expanded Programmme on Immunisation (EPI) unit at Civil Hospital, Hoshiarpur, Punjab. Purposive sampling technique was used to select 60 children and their mothers. The sample size was computed through power analysis.

Instruments

The study instrument had three sections, Section I comprised of socio demographic variables of mother and children including age of mother, duration of married life, number of under five children, mother’s education, mother’s occupation, family income, religion, type of family, source of drinking water, source of information regarding feeding practices, residential area, age of child, gender of child, birth weight of child, birth order of child, and dietary pattern. Section II comprised of anthropometric measurements to determine nutritional status of children as per percentage of weight-for-age and percentage of height-for-age. The nutritional status of children as per percentage of weight-forage was classified according to Indian Academy of Paediatrics classification on malnutrition as, normal ( 80% and above), grade 1 malnutrition (70 - 80%), grade 2 malnutrition (60 - 70%), grade 3 malnutrition (50 - 60%), and grade 4 malnutrition (below 50 %). The nutritional status of children as per percentage of height-for-age was classified according to Mc Laren’s classification on malnutrition as, dwarf (< 80%), short (80 - 93%), normal (93 - 105%), and gigantism (> 105%). Section III comprised of self-reported feeding practice checklist to assess feeding practices of mothers. It consisted of 30 statements related to various aspects of feeding practices i.e,. breastfeeding, bottle feeding, weaning, food diversity, food storage and hygiene, feeding style, and meal frequency. If the feeding practice was present a score of’1’ and if absent a score of’0’ was given. The total score (maximum 30) obtained by each participant was interpreted as satisfactory feeding practices (24 to 30), partially satisfactory feeding practices (18 to 23), and unsatisfactory feeding practices (0 to 17).

The tool was translated into Hindi and Punjabi and tested by back translation in to English. Content validity of tool was obtained from six experts in the field of Paediatrics and Paediatric nursing and the content validity index was .94. Reliability of anthropometric assessment tool was tested with inter - observer method and the ICC was found to be 1 (95% CI) whereas the reliability of self-reporting feeding practice checklist was assessed through test retest method. The calculated value of ‘r’ was .9. Hence, both the tools were considered highly reliable.

Data collection

The study was approved by the Postgraduate Students’ Dissertation Committee and written permission was obtained from the Senior Medical Officer of the Civil Hospital, Hoshiarpur. The data were collected after explaining the nature of study and obtaining a written consent from the eligible mothers of children. The socio demographic variables of mother and children were assessed through a self-reporting structured tool. The nutritional status of children as per percentage of weight-for-age and percentage of height-for-age was determined by measuring weight and height. The infants’ weight was measured in supine or sitting position and the older children’s weight was measured in standing position on a standard weighing scale to the nearest 10 grams. The infants’ height was measured in supine position and the older children’s height was measured in standing position through a flexible non stretchable measuring tape to the nearest 0.1 centimetre. The feeding practices of mother’s were assessed through self-reporting structured feeding practices checklist. The total time spent for data collection on each sample was 30-40 minutes.


  Results and Discussion Top


The demographic variables of children showed that majority of children were in the age group of 6 months to 1 year (46.7%), male (68.3%), having birth weight between 2.5 - 3.5 kg (80%), first in birth order (60%), and were vegetarians (70%). Majority of mothers were in the age group of26 - 35 years (55%), married for 1-5 years (65%), having one child (76.7%), literate (96.7%), housewife (95%), having a family income between Rs.10,001 and 20,000 (53.3%), living in joint family (68.3%), residing in urban area (60%), and using tap water for drinking (95%). Fifty three percent of mothers had obtained information regarding feeding practices from health personnel.

The nutritional status determination based percentage of weight-for-age showed that majority of children (75%) had normal nutritional status, 18.3% of children had erade 1 malnutrition. 6.7% of children had erade 2 malnutrition and none of the children had grade 3 and grade 4 malnutrition (see [Table 1]. The nutritional status determination based on percentage of height-for-age results indicated that most of the children (83.3%) had normal height, few children (10%) were short, and 1.7% had gigantism (see [Table 2]. These findings are consistent with findings of the study done by Benjamin and Zachariah (1993) who reported that 25% of children suffer from malnutrition in the city of Ludhiana, Punjab. The current finding also revealed that there has not been much improvement in the nutritional status of children over the years in the same state. The findings of present study contrast with the study done by Vinod, Swarnakanta, Smita and Pushpa (2011) who have indicated that 52.23 % children suffer from various grades of malnutrition 32.18 % grade 1,16.09 % grade II, 3.46 % grade III, and 0.5 % grade IV malnutrition. The environment also plays an important role in influencing the nutritional status of children. In a recent study done in North India (Gupta & Jindall, 2016) 51% of children under 5 years of age were found to have mild to moderate malnutrition indicating the continuous prevalence of the problems.
Table 1: Distribution of Children as per their Nutritional Status (percentage of weight-for-age)

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Table 2: Distribution of Children as per their Nutritional Status (percentage of height-for-age)

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According to levels of feeding practices of mothers, 31.6% of mothers had satisfactory feeding practices, 41.7% of mothers had partially satisfactory feeding practices, and 26.7% of mothers had unsatisfactory feeding practices (see [Table 3]. These findings are similar to the findings of Rosamma (2009), where majority of mothers had moderately satisfactory feeding practices. The findings of present study are contradictory with the study done by Kuriakose (2010) which reveals that 25.9% mothers follow good feeding practices, and 74.1% mothers follow average feeding practices.
Table 3: Distribution of Mothers according to their Level of Feeding Practices

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The major findings regarding feeding practices of mothers revealed that, 65% mothers had not initiated breast feeding within half hour of birth of baby; 35% of mothers gave colostrum whereas 65% of mothers gave prelacteal feed (honey, jaggery, water, cow’s milk) as first feed to the baby; 65% of mothers practiced bottle feed for the baby; 71.6% of mothers fed the baby on an average of 6 times in a day and 2 times in night; 78.3% of mothers practiced feeding on demand; 83.3% of mothers burped the baby after each feed; 78.3% of mothers continued the breast feed for more than 6 months; 58.3% of mothers initiated the complementary feeding at 6 months of age; 65% of mothers introduced liquid diet (rice water, dalia, khichdi,soup of daal) as first weaning food; 93.3% of mothers gave 5-7 day interval in initiation of two different types of weaning food; 78.3% of mothers used variety of food items (khichdi, dalia, rice water, mashed potato, banana, papaya etc) in the diet of their baby; 90% of mothers prepared fresh food at all times; 95% of mothers washed the fruits and vegetables before serving; 75% of mothers did not get nutritional food from Anganwadi centres; and 51.6% of mothers continued breast feed along with Oral Rehydration Solution (ORS) when the childhad diarrhoea.

There was a significant moderately positive correlation (r = .64, p = .001) between nutritional status of children as per percentage of weight-for-age and feeding practices of mothers (see [Figure 1]. The mean score of nutritional status of children as perpercentage of height-for- age and feeding practices of mothers was 75.27 and 20.80 respectively. There was non-significant low positive correlation (r = .29, p = .14) between nutritional status of children as per percentage of height-for-age and feeding practices of mothers. This positive correlation suggests thai when mothers have satisfactory feeding practices children will have good nutritional status. These findings are consistent with the study findings of Rosamma (2009) who had reported that there was a positive correlation between feeding practices and weight (r = .161) and feeding practices and height(r=. 122) of children.
Figure 1: Correlation between nutritional status of children as per weight for age and feeding practices of mothers

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There was a significant association between nutritional status of children as per percentage of weight-for- age and duration of married life (p = .002), number of under five children (p=.01), and age of children (p=.01). Similarly, there was significant association between nutritional status of children as per percentage of height-for-age and duration of married life (p = .009), number of under-five children (p = .04) and age of children (p =.05). These findings are in line with the study finding of Hien and Kam (2008) who have reported that number of under-five children had significant association with nutritional status of children. The present study findings are consistent with the study done by Kuriakose (2010) who reported that there was no significant association of nutritional status with selected demographic variables like gender, birth order, number of siblings, age of mother, religion, education of mother and socio-economic status. The feeding practices of mothers had no significant association with sociodemographic variables of mother and children.


  Conclusion Top


There is improvement in the nutritional status of children but malnutrition is still a major problem in our country. Majority of mothers do not follow satisfactory feeding practices. The feeding practices of mothers moderately affect weight gain and minimally affect the height gain among children. Every endeavour should be made to combat this problem through multi-faceted approach like growth monitoring, nutritional supplementation, nutritional rehabilitation and last, but not the least, nutritional education.

Conflicts of interest: The authors have declared no conflicts of interest.



 
  References Top

1.
Avachat, S. S., Phalke, V. D„ & Phalke, D. B. (2009). Epidemiological study of malnutrition (under nutrition) among under five children in a section of rural area. Pravara Medical Review, 4(2), 20-2. Retrieved from https://doaj.org/article/cealc436f7314393903749e0327 bae99  Back to cited text no. 1
    
2.
Benjamin, A. I., & Zachariah, P. (1993). Nutritional status and feeding practices in under-3 years old children in a rural community in Ludhiana, Punjab. Health and Population-Perspectives and Issues, 16 (1&2), 3-21.  Back to cited text no. 2
    
3.
Dasgupta, R., Sinha, D., & Yumnam, V. (2016). Rapid survey of wasting and stunting in children: What’s new, what’s old and what’s the buzz?. Indian Pediatrics, 55(1), 47-49.  Back to cited text no. 3
    
4.
Gupta, M., & Jindal, R. (2016). Assessment of nutritional status of under five children attending outpatient department at a tertiary care hospital: A study from North India. International Journal of Scientific Research and Education, 4(05).  Back to cited text no. 4
    
5.
Hien, N. N., & Kam, S. (2008). Nutritional status and the characteristics related to malnutrition in children under five years of age in Nghean, Vietnam. Journal of Preventive Medicine and Public Health, 41(4), 232-40. Retrieved from http://www.researchgate.net/ publication/23135306  Back to cited text no. 5
    
6.
Kuriakose, J. R. (2010). Nutritional status and feeding practices of infants. Nursing Journal of India, I (8), 28- 32. Retrieved from www.scribd.com/doc/35395961  Back to cited text no. 6
    
7.
Mahindra & Mahindra (2012, January 11). 42 percent of Indian children are underweight. The Hindu, 4. Retrieved from http://www.thehindu.com/news/national/42-per- cent-of-indi an-children-are-underweight/ article2789902.ece  Back to cited text no. 7
    
8.
Mishra, B., & Mishra, S. (2007). Nutritional anthropometry and preschool child feeding practices in working mothers of Central Orissa. Studies of Home Community Science, 1(2), 139-144. Retrieved from http://www.krepublishers.com  Back to cited text no. 8
    
9.
National Family and Health Survey. (2009). National family and health survey - 3. Retrieved from http://rchiips.org/nfhs/nfhs3 .shtml  Back to cited text no. 9
    
10.
Rosamma, K. J. (2007). A study to correlatefeeding practices of mothers and nutritional status of their children in a selected area, Bangalore (Unpublished master’s thesis). Rajiv Gandhi University of Health Science, Bangalore, Karnataka.  Back to cited text no. 10
    
11.
UNICEF. (2006). A report card on nutrition: progress for children. Retrieved from www.unicef.org/progress for children  Back to cited text no. 11
    
12.
Vinod, N, Swarnakanta, L., Smita, P., & Pushpa, D. (2011). Nutritional status and dietary pattern of underfive children in urban slum area. National Journal of Community Medicine, 2(1), 143-48.  Back to cited text no. 12
    
13.
World Health Organization. (2003). Guiding principles for complementary feeding of the breastfed child. Retrieved from http://www.who.int/nutrition.  Back to cited text no. 13
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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