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
About this Master's Thesis
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