Infant and young child feeding practices and undernutrition in rural El Salvador Open Access

Fox, Garrett Paul (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/dv13zt31f?locale=en
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Abstract

Child undernutrition can result in irreversible developmental impairments and increased susceptibility to illness and mortality. In El Salvador, undernutrition remains a moderate public health problem, with the highest burden among the rural poor. In 2014, only 67% of Salvadoran children were receiving a minimum acceptable diet. No studies as of yet have used 24-hour diet recalls to measure dietary intakes of children 6 to 24 months in El Salvador. This study characterized infant and young child feeding (IYCF) practices among children 6 to 24 months of age, identified risk factors for anemia and stunting, and provided recommendations for government and nongovernmental nutrition programs and policies. A laptop/tablet-based survey was used to collect data on 24 hr dietary recall, IYCF practices, anthropometry, hemoglobin, illness, and use of vitamins/supplements among 138 mother-child pairs living in 47 communities of 4 rural municipalities of La Libertad province. These data were linked to baseline data on household demographics. Multivariate linear and logistic regression models were used to examine the relationship between IYCF practices and height-for-age z-score (HAZ), weight-for-age z-score (WAZ), hemoglobin concentration, stunting, underweight, and anemia. 18% of children were stunted, 9% were underweight, and 58% were anemic. 55% breastfed within 1hr of birth, 62% exclusively breastfed for 6 months, and 59% continued breastfeeding at 2 years. 97% received timely introduction to complementary foods, 75% of children met minimum dietary diversity, and 75% consumed an iron-rich food/fortified foods. 87% consumed a fried food, 79% of children consumed a sugar-sweetened beverage, and 51% consumed a sugary snack in the past day. Sweet bread and thin watery porridge were associated with lower HAZ and WAZ. Older children and those who had stopped breastfeeding before 15 months were associated with stunting and underweight. Dietary diversity, eggs, sweet bread, bananas, and younger age were associated with improved hemoglobin levels. While progress has been made in improving basic child-feeding practices in this population, further efforts are required to promote breastfeeding and improve dietary quality. This study provides detailed recommendations for improvements to nutrition program activities and national level IYCF guidelines including: efforts to increase nutrient density of diets, timely introduction of complementary foods, avoidance of non-nutrient dense foods (thin porridges, broths, coffee, sugar-sweetened beverages, sugary snacks, and fried foods) and increased promotion of locally available nutritious foods (avocados, eggs, and flesh foods).

Table of Contents

Abstract.......................................................4
Table of Contents...........................................7
Chapter I: Introduction....................................8
Chapter II: Literature Review...........................15
Chapter III: Manuscript...................................27
Chapter IV: Conclusions and Recommendations....67
References....................................................70

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