Investigating Minimum Acceptable Diet and Infant and Child Feeding Index as indicators of stunting in children aged 6-23 months
Abstract
Background The complementary feeding period of 6-24 months of age is one of the most crucial moments in child growth, in which most of the decline in length-for-age Z-score (LAZ) occurs. The Minimum Acceptable Diet (MAD) and Infant and Child Feeding Index (ICFI) are indicators to assess complementary feeding practices in the children with potential for stunting.
Objective To assess and compare the usefulness of MAD and ICFI scores as indicators of inadequate feeding practice on stunting in children aged 6-23 months.
Methods This case-control study was conducted in South and West Wewewa subdisctricts of Southwest Sumba, East Nusa Tenggara, Indonesia, from February to August 2019. Participants were children aged 6-23 months who had received complementary feeding for a minimum duration of one month. Children with LAZ <-2 were allocated into the case group (stunted) and those with LAZ>-2 into the control group. Both MAD and ICFI scores were assessed in both groups. ICFI was categorized as low, average, and high. The association between complementary feeding practice which depicted by the MAD and ICFI scores and stunting was measured using logistic regression.
Results Of 322 participants, 161 children were allocated into each group. Multivariate analysis revealed that those in low and average ICFI tertile had higher odds of stunting [(OR 2.85; 95%CI 1.35 to 6.00; P<0.01) and (OR 1.95; 95%CI 1.09 to 3.46; P<0.05), respectively]. No association was found between MAD and stunting.
Conclusion Inadequate complementary feeding practice is found to increase the risk of stunting among children aged 6-23 months. Compared to MAD, ICFI is a better indicator in demonstrating an association between complementary feeding practice and stunting.
References
Kementerian Kesehatan Republik Indonesia. Hasil utama riskesdas 2018 [Internet]. Kementerian Kesehatan Republik Indonesia; 2019 [cited 2019 Mar 24]. Available from: www.depkes.go.id/resources/download/info-terkini/materi_rakorpop_2018/Hasil.
Badan Penelitian dan Pengembangan Kesehatan. Riset kesehatan dasar 2013 [Internet]. Indonesia: Kementerian Kesehatan Republik Indonesia; 2013 [cited 2019 Apr 8]. Available from: www.depkes.go.id/resources/download/general/Hasil%2520Riskesdas.
Kementerian Kesehatan Republik Indonesia. Data dan informasi profil kesehatan Indonesia 2017 [Internet]. Kementerian Kesehatan Republik Indonesia; 2018 [cited 2019 Apr 8]. Available from: www.depkes.go.id/resources/download/pusdatin/profil-kesehatan-indonesia/Profil-Kesehatan-Indonesia-tahun-2017.pdf.
Tim Nasional Percepatan Penanggulangan Kemiskinan. 100 Kabupaten / kota prioritas untuk intervensi anak kerdil (stunting). Vol. 2. Jakarta Pusat, Indonesia: Sekretariat Wakil Presiden Republik Indonesia; 2017. p. XXIV.
Lohia N, Udipi S. Infant and child feeding index reflects feeding practices, nutritional status of urban slum children. BMC Pediatr. 2014;14:290. DOI: 10.1186/s12887-014-0290-7.
Stewart C, Iannotti L, Dewey K, Michaelsen K, Onyango A. Contextualising complementary feeding in a broader framework for stunting prevention. Matern Child Nutr. 2013;9(Suppl.2):27–45. DOI: 10.1111/mcn.12088.
White J, Begin F, Kumapley R, Murray C, Krasevec J. Complementary feeding practices: current global and regional estimates. Matern Child Nutr. 2017;13(S2):e12505. DOI: 10.1111/mcn.12505.
Ahmad A, Madanijah S, Dwiriani C, Kolopaking R. Complementary feeding practices and nutritional status of children 6-23 months old: formative study in Aceh, Indonesia. Nutr Res Pract. 2018;12:512–20. DOI: 10.4162/nrp.2018.12.6.512.
Saaka M, Wemakor A, Abizari A, Aryee P. How well do WHO complementary feeding indicators relate to nutritional status of children aged 6-23 months in rural Northern Ghana? BMC Public Health. 2015;15:1157. DOI: 10.1186/s12889-015-2494-7.
Reinbott A, Kuchenbecker J, Herrmann J, Jordan I, Muehlhoff E, Kevanna O, et al. A child feeding index is superior to WHO IYCF indicators in explaining length-for-age Z-scores of young children in rural Cambodia. Paediatr Int Child Health. 2015;35:124–34. DOI: 10.1179/2046905514Y.0000000155.
World Health Organization. Indicators for assessing infant and young child feeding practices-part III: country profiles [Internet]. Malta: World Health Organization; 2010 [cited 2019 Apr 8]. Available from: whqlibdoc.who.int/publications/2010/9789241599757_eng.pdf?ua=1.
Marriot B, White A, Hadden L, Davies J, Wallingford J. World Health Organization (WHO) infant and young child feeding indicators: associations with growth measures in 14 low-income countries. Matern Child Nutr. 2012;8:354–70. DOI: 10.1111/j.17408709.2011.00380.x.
Ruel M, Menon P. Child feeding practices are associated with child nutritional status in Latin America: innovative uses of the demographic and health surveys. J Nutr. 2002;132:1180–7. DOI: 10.1093/jn/132.6.1180.
Bork K, Cames C, Barigou S, Cournil A, Diallo A. A summary index of feeding practices is positively associated with height-for-age, but only marginally with linear growth, in rural Senegalese infants and toddlers. J Nutr. 2012;142:1116–22. DOI: 10.3945/jn.112.157602.
Badan Pusat Statistik Kabupaten Sumba Barat Daya. Kecamatan Wewewa Selatan dalam angka [Internet]. Kabupaten Sumba Barat Daya, Indonesia: Badan Pusat Statistik Kabupaten Sumba Barat Daya; 2018 [cited 2020 Mar 1]. Available from: sumbabaratdayakab.bps.go.id/publication/2018/09/27/c7a0b18ff142ac2c8044ee5c/kecamatan-wewewa-selatan-dalam-angka-2018.html.
World Health Organization. Interpreting growth indicators. In: Training course on child growth assessment: WHO child growth standard [Internet]. Geneva: World Health Organization; 2008 [cited 2020 Jul 8]. Available from: www.who.int/childgrowth/training/module_c_interpreting_indicators.pdf.
World Health Organization. Guidelines on sanitation and health [Internet]. Geneva: World Health Organization; 2018 [cited 2020 Jul 8]. Available from: apps.who.int/iris/bitstream/handle/10665/274939/9789241514705-eng.pdf?ua=1.
World Health Organization. Indicators for assessing infant and young child feeding practices-part II: measurement [Internet]. Malta: World Health Organization; 2010 [cited 2019 Apr 8]. Available from: whqlibdoc.who.int/publications/2010/9789241599290_eng.pdf?ua=1.
Sawadogo PS, Martin-Prével Y, Savy M, Kameli Y, Traissac P, Traoré AS, et al. An infant and child feeding index is associated with the nutritional status of 6- to 23-month-old children in rural Burkina Faso. J Nutr. 2006;136:656–63. DOI: 10.1093/jn/136.3.656.
Udoh E, Amodu O. Complementary feeding practices among mothers and nutritional status of infants in Akpabuyo Area, Cross River State Nigeria. SpringerPlus. 2016;5:2073. DOI: 10.1186/s40064-016-3751-7.
Qu P, Mi B, Wang D, Zhang R, Yang J, Liu D, et al. Association between the infant and child feeding index (ICFI) and nutritional status of 6-to 35 month-old children in rural western China. PLoS One. 2017;12:e0171984. DOI: 10.1371/journal.pone.0171984.
Srivastava N, Sandhu A. Infant and child feeding index. Indian J Pediatr. 2006;73:767–70. DOI: 10.1007/BF02790382.
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Accepted 2020-08-27
Published 2020-08-27