Student Dissertation

Agency : Feeding Practices, Age Appropriate Complementary Feeding, Minimal Dietary Diversity

Objective : To identify the existing IYCF practices among mothers of infant and young children below two years in Bareilly and Shahjahnpur districts of Uttar Pradesh.

Background : Optimal infant and young child feeding practices are crucial for nutritional status, growth, development, health and ultimately survival of infant and young children. Timely introduction of complementary feeding can prevent almost six percent of under-five mortality. The poor complementary feeding practices mean that many children continue to be vulnerable to irreversible outcomes of stunting, poor cognitive development, and significant increased risk of infectious disease such as diarrhoea and pneumonia. The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life with early initiation and continuation of breastfeeding for two years or more together with nutritionally-adequate, safe, age-appropriate complementary feeding starting at six months. WHO and UNICEF have articulated a global strategy for infant, young, child feeding. Based on these guiding principles, government of India has collaborated with international agencies to adopt the culturally acceptable IYCF guidelines which are in incorporated in Reproductive maternal neonatal and child health + adolescent program (RMNCH+A).

Methodology : Community Based Cross sectional study was conducted in 8 blocks of two Districts of Uttar Pradesh i.e. Bareilly and Shahjahanpur. Out of the total blocks in the district, four blocks were selected randomly from each of the two districts from each block, eight anganwadis were selected randomly. A list of children who have been delivered in the past two years were obtained from the selected anganwadi. From each anganwadi, six infants and young children below two years were selected randomly. A sample of 384 children was selected randomly to conduct the survey. A structured questionnaire for face to face interview was used to collect the data. The data collection formats were adapted from UNICEF guidelines for assessment of infant and young child feeding.

Findings : The study findings revealed that majority of children did not received minimal dietary diversity (90%). Both breast fed infants and non-breastfed children did not achieve standards for minimum acceptable diet. Initiation of breastfeeding within an hour was practiced by only (50%) of mothers. Only 40% babies were exclusively breastfed till six months. The most recurrent reason for withdrawal of breast feeding was – dearth of milk for breast feeding and weakness/illness of mother which could be due to wrong perceptions or beliefs leading to faulty practices.

Recommendations : The study reveals that there is an urgent need to improve IYCF practices in Uttar Pradesh and focus should be more on exclusive breast feeding and complementary feeding. The study finds out that although majority of infants and children (both breast fed and non- breast fed) achieve standards for minimum food frequency but they fail to achieve standards for minimum food diversity because of age inappropriate complementary food practices. Less than half of the mothers of infants aged 6-9 months (42 percent) introduced timely complementary foods which shows lack of awareness about the right age of introduction of complementary feeding. .57 percent of mother of infants aged 0-6 months gave their child plain water before six months, which may be due to lack of awareness about exclusive breast feeding. The study throws light on prevalence of inappropriate complementary feeding practices and intends to prioritize on interventions based on these areas through effective communication and counselling.