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Levels and determinants of complementary feeding based on meal frequency among children of 6 to 23 months in Bangladesh

View Article: PubMed Central - PubMed

ABSTRACT

Background: Information concerning complementary feeding (CF) practice during infancy and early childhood is still scarce in Bangladesh. Therefore, this study aimed to estimate the level of CF among children of 6–23 months and identify individual, household and community level determinants in Bangladesh.

Methods: Secondary data from the Bangladesh Demographic Health Survey (BDHS) 2011 was used. A total of 2,373 children aged 6–23 months were selected. A simplified index called “dimension index” was used to estimate the level of CF. The score of this index was used either as continuous or categorical dependent variables. The highest score based on dimension index is associated to an adequate CF. Statistical analyses and tests were guided by types of variables. Finally, multivariable logistic regression (binary and multinomial) analyses were performed to identify the significant determinants of CF.

Results: The overall level of CF among children of 6–23 months was low. More than 90 % of children experienced either no (2.9 %) or inadequate CF (92.7 %). According to bivariable analyses, mean levels of CF as well as percentages of no/inadequate CF were significantly lower among children of the youngest age group, uneducated parents, unemployed/laborer fathers, socio-economically poor families, food insecure families and rural areas. No weekly exposure to mass media (namely watching TV and reading newspapers/magazines) also revealed significant associations with CF. However, only few variables remained significant for adequate CF in the multivariable logistic regression analysis. For example, the likelihood of experiencing adequate CF was significantly lower among children of 6–11 months (OR: 0.22, 95 % CI: 0.10–0.47), children of illiterate fathers (OR: 0.32, 95 % CI: 0.11–0.95) and socio-economically middle-class families (OR: 0.28, 95 % CI: 0.09–0.86) as compared to their reference categories.

Conclusion: A high level of inadequate CF leading to malnutrition may cause serious health problems among children of 6–23 months in Bangladesh. Vulnerable groups of children (e.g., the children aged 6 to 11 months and children of illiterate fathers), who received low levels of adequate CF, should be targeted by government and other stakeholders while developing strategies and interventions in order to improve overall situation of CF in Bangladesh.

No MeSH data available.


Schematic presentation of sample size selection
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Fig1: Schematic presentation of sample size selection

Mentions: All children, born after January 2006 or later, were eligible for anthropometric (height and weight) measurements. All types of logistic supports were provided by the United Nations Children’s Emergency Fund (UNICEF). Several exclusion and inclusion criteria were used to get required sample. First, some criteria based on the World Health Organization (WHO) 2006 standards flag limits of z-scores were applied to measure implausible values of stunting, wasting and underweight. Generally a child is stunted, wasted, and underweight if the height-for-age z-scores (HAZ), weight-for-height z-scores (WHZ), and weight-for-age z-scores (WAZ) were less than 2 standard deviations (SDs) below the respective median of the WHO reference population, respectively [28]. For stunting, implausible values were defined as values of HAZ below −6 or above +6. Implausible values of wasting were defined as values of WHZ below −5 or above +5. Similarly, implausible values of underweight were the values of WAZ either below −6 or above +5. Second, from a total of 8,761 children below 5 years of age who were eligible for anthropometric measurements, completed data on height, weight and age were available only for 7,647 children. Third, all under-five children outside the range of 6–23 months were excluded from present analysis. Lastly, from a total of 2,405 children aged 6–23 months, 32 children were again excluded due to missing information (see Fig. 1). Therefore, our final sample for analysis was 2,373 children aged 6–23 months. Among them 37.9 % were stunted, 15.2 % were wasted and 31.7 % were underweight. The mean age, weight, height and hemoglobin level of the children were 14.19 (± 5.17) months, 8.30 (± 1.51) kg, 72.72 (± 6.51) cm, and 10.20 (± 1.24) g/dl, respectively.Fig. 1


Levels and determinants of complementary feeding based on meal frequency among children of 6 to 23 months in Bangladesh
Schematic presentation of sample size selection
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5015334&req=5

Fig1: Schematic presentation of sample size selection
Mentions: All children, born after January 2006 or later, were eligible for anthropometric (height and weight) measurements. All types of logistic supports were provided by the United Nations Children’s Emergency Fund (UNICEF). Several exclusion and inclusion criteria were used to get required sample. First, some criteria based on the World Health Organization (WHO) 2006 standards flag limits of z-scores were applied to measure implausible values of stunting, wasting and underweight. Generally a child is stunted, wasted, and underweight if the height-for-age z-scores (HAZ), weight-for-height z-scores (WHZ), and weight-for-age z-scores (WAZ) were less than 2 standard deviations (SDs) below the respective median of the WHO reference population, respectively [28]. For stunting, implausible values were defined as values of HAZ below −6 or above +6. Implausible values of wasting were defined as values of WHZ below −5 or above +5. Similarly, implausible values of underweight were the values of WAZ either below −6 or above +5. Second, from a total of 8,761 children below 5 years of age who were eligible for anthropometric measurements, completed data on height, weight and age were available only for 7,647 children. Third, all under-five children outside the range of 6–23 months were excluded from present analysis. Lastly, from a total of 2,405 children aged 6–23 months, 32 children were again excluded due to missing information (see Fig. 1). Therefore, our final sample for analysis was 2,373 children aged 6–23 months. Among them 37.9 % were stunted, 15.2 % were wasted and 31.7 % were underweight. The mean age, weight, height and hemoglobin level of the children were 14.19 (± 5.17) months, 8.30 (± 1.51) kg, 72.72 (± 6.51) cm, and 10.20 (± 1.24) g/dl, respectively.Fig. 1

View Article: PubMed Central - PubMed

ABSTRACT

Background: Information concerning complementary feeding (CF) practice during infancy and early childhood is still scarce in Bangladesh. Therefore, this study aimed to estimate the level of CF among children of 6–23 months and identify individual, household and community level determinants in Bangladesh.

Methods: Secondary data from the Bangladesh Demographic Health Survey (BDHS) 2011 was used. A total of 2,373 children aged 6–23 months were selected. A simplified index called “dimension index” was used to estimate the level of CF. The score of this index was used either as continuous or categorical dependent variables. The highest score based on dimension index is associated to an adequate CF. Statistical analyses and tests were guided by types of variables. Finally, multivariable logistic regression (binary and multinomial) analyses were performed to identify the significant determinants of CF.

Results: The overall level of CF among children of 6–23 months was low. More than 90 % of children experienced either no (2.9 %) or inadequate CF (92.7 %). According to bivariable analyses, mean levels of CF as well as percentages of no/inadequate CF were significantly lower among children of the youngest age group, uneducated parents, unemployed/laborer fathers, socio-economically poor families, food insecure families and rural areas. No weekly exposure to mass media (namely watching TV and reading newspapers/magazines) also revealed significant associations with CF. However, only few variables remained significant for adequate CF in the multivariable logistic regression analysis. For example, the likelihood of experiencing adequate CF was significantly lower among children of 6–11 months (OR: 0.22, 95 % CI: 0.10–0.47), children of illiterate fathers (OR: 0.32, 95 % CI: 0.11–0.95) and socio-economically middle-class families (OR: 0.28, 95 % CI: 0.09–0.86) as compared to their reference categories.

Conclusion: A high level of inadequate CF leading to malnutrition may cause serious health problems among children of 6–23 months in Bangladesh. Vulnerable groups of children (e.g., the children aged 6 to 11 months and children of illiterate fathers), who received low levels of adequate CF, should be targeted by government and other stakeholders while developing strategies and interventions in order to improve overall situation of CF in Bangladesh.

No MeSH data available.