Prevention of Malnutrition among Young Children in Rural Bangladesh by a Food-Health-Care Educational Intervention: A Randomized, Controlled Trial Food supplementation with encouragement to feed it to infants from 4 to 12 months of age has a small impact on weight gain. Nutrition counseling increases weight gain among Brazilian children. An educational intervention to promote appropriate complementary feeding practices and physical growth in infants and young children in rural Haryana, India. A randomized, community-based trial of the effects of improved, centrally processed complementary foods on growth and micronutrient status of Ghanaian infants from 6 to 12 mo of age. Growth and micronutrient status in children receiving a fortified complementary food. Effectiveness of an educational intervention on complementary feeding practices and growth in rural China: a cluster randomised controlled trial. Training in Complementary Feeding Counselling of Healthcare Workers and Its Influence on Maternal Behaviours and Child Growth: A Cluster-randomized Controlled Trial in Lahore, Pakistan The effect of a micronutrient-fortified complementary food on micronutrient status, growth and development of 6- to 12-month-old disadvantaged urban South African infants An Integrated Child Nutrition Intervention Improved Growth of Younger, More Malnourished Children in Northern Viet Nam Effectiveness of an educational intervention delivered through the health services to improve nutrition in young children: a cluster-randomised controlled trial [Impacts of the 10 Steps to Healthy Feeding in Infants: a randomized field trial]. Growth pattern of infants fed with a mixture of extruded malted maize and cowpea. Randomized comparison of 3 types of micronutrient supplements for home fortification of complementary foods in Ghana: effects on growth and motor development. Community-based nutrition education for improving infant growth in rural Karnataka.
Background As a result of inappropriate feeding , poor health and hygiene , and poor caring practice s , the nutritional status of many young infants deteriorates with advancing age . Objective To explore the effectiveness of a nutrition education package to prevent malnutrition among young children . Methods A community-based , r and omized , controlled trial was conducted among 605 normal and mildly malnourished children aged 6 to 9 months in 121 Community Nutrition Centers ( CNCs ) of the Bangladesh Integrated Nutrition Project ( BINP ) in four regions of Bangladesh from 2000 to 2002 . The intervention group received weekly nutrition education based on the nutrition triangle concept of UNICEF for 6 months , whereas the control group received regular BINP services . Both groups were observed for a further 6 months to assess the sustainability of the effects . Information on socio-economic status , feeding patterns , morbidity , and anthropometric features was collected . Results A significant increase in the frequency of complementary feeding was observed in the intervention group as compared with the control group , and the increase was sustained throughout the observation period . The intervention group had a higher weight gain than the control group after the end of the intervention ( 0.86 vs. 0.77 kg , p = 0.053 ) and after the end of the observation period ( 1.81 vs. 1.39 kg , p < .001 ) . The proportion of normal and mildly malnourished children was greater in the intervention group than in the control group after the end of the observations ( 88.9 % vs. 61.5 % , p < .001 ) . Nutrition education successfully prevented malnutrition in all the areas . Variation in the outcome of nutrition education among the regions was observed . Conclusions This culturally appropriate nutrition education package based on the nutrition triangle model effectively prevented growth faltering and malnutrition among young children It is unclear whether a substantial decline in malnutrition among infants in developing countries can be achieved by increasing food availability and nutrition counseling without concurrent morbidity-reducing interventions . The study was design ed to determine whether provision of generous amounts of a micronutrient-fortified food supplement supported by counseling or nutritional counseling alone would significantly improve physical growth between 4 and 12 mo of age . In a controlled trial , 418 infants 4 mo of age were individually r and omized to one of the four groups and followed until 12 mo of age . The first group received a milk-based cereal and nutritional counseling ; the second group monthly nutritional counseling alone . To control for the effect of twice-weekly home visits for morbidity ascertainment , similar visits were made in one of the control groups ( visitation group ) ; the fourth group received no intervention . The median energy intake from nonbreast milk sources was higher in the food supplementation group than in the visitation group by 1212 kJ at 26 wk ( P < 0.001 ) , 1739 kJ at 38 wk ( P < 0.001 ) and 2257 kJ at 52 wk ( P < 0.001 ) . The food supplementation infants gained 250 g ( 95 % confidence interval : 20 - -480 g ) more weight than did the visitation group . The difference in the mean increment in length during the study was 0.4 cm ( 95 % confidence interval : -0.1 - -0.9 cm ) . The nutritional counseling group had higher energy intakes ranging from 280 to 752 kJ at different ages ( P < 0.05 at all ages ) but no significant benefit on weight and length increments . Methods to enhance the impact of these interventions need to be identified To assess the impact on child growth of the nutrition-counseling component of the Integrated Management of Childhood Illnesses ( IMCI ) strategy , a r and omized trial was implemented . All 28 government health centers in a Southern Brazil city were paired according to baseline nutritional indicators . One center from each pair was r and omly selected and its doctors received 20-h training in nutrition counseling .  Thirty-three doctors were included and 12 - 13 patients < 18 mo of age from each doctor were recruited . The study included testing the knowledge of doctors , observing consultations and visiting the children at home 8 , 45 and 180 d after the initial consultation . Maternal knowledge , practice s and adherence to nutritional recommendations were assessed , and anthropometric measurements were taken . Day-long dietary intake was evaluated on a sub sample of children . Doctors in the intervention group had better knowledge of child nutrition and improved assessment and counseling practice s. Maternal recall of recommendations was higher in the intervention than in the control group , as was satisfaction with the consultation . Reported use of recommended foods was also increased . Daily fat intake was higher in the intervention than in the control group ; mean daily intakes of energy and zinc also tended to improve . Children 12 mo of age or older had improved weight gain and a positive but nonsignificant improvement in length .  Nutrition-counseling training  improved doctors ' performances , maternal practice s and the diets and weight gain of children . The r and omized design with blind outcome evaluation strongly supports a causal link . These results should be replicated in other setting Complementary feeding practice s are often inadequate in developing countries , result ing in a significant nutritional decline between 6 and 18 mo of age . We assessed the effectiveness of an educational intervention to promote adequate complementary feeding practice s that would be feasible to sustain with existing re sources . The study was a cluster r and omized controlled trial in communities in the state of Haryana in India . We developed the intervention through formative research . Eight communities were pair matched on their baseline characteristics ; one of each pair was r and omly assigned to receive the intervention and the other to no specific feeding intervention . Health and nutrition workers in the intervention communities were trained to counsel on locally developed feeding recommendations .  Newborns were enrolled in all of the communities ( 552 in the intervention and 473 in the control ) and followed up every 3 mo to the age of 18 mo . The main outcome measures were weights and lengths at 6 , 9 , 12 , and 18 mo and complementary feeding practice s at 9 and 18 mo . All analyses were by intent to treat . In the overall analyses , there was a small but significant effect on length gain in the intervention group ( difference in means 0.32 cm , 95 % CI , 0.03 , 0.61 ) . The effect was greater in the subgroup of male infants ( difference in mean length gain 0.51 cm , 95 % CI 0.03 , 0.98 ) . Weight gain was not affected . Energy intakes from complementary foods overall were significantly higher in the intervention group children at 9 mo ( mean + /- SD : 1556 + /- 1109 vs. 1025 + /- 866 kJ ; P < 0.001 ) and 18 mo ( 3807 + /- 1527 vs. 2577 + /- 1058 kJ ; P < 0.001 ) . Improving complementary feeding practice s through existing services is feasible but the effect on physical growth is limited . Factors that limit physical growth in such setting s must be better understood to plan more effective nutrition programs BACKGROUND Koko , a fermented maize porridge used as the primary complementary food in Ghana , has been implicated in the high prevalence of child malnutrition . Weanimix , a cereal-legume blend developed by the United Nations Children 's Fund and the Ghanaian government , has been promoted as an alternative . OBJECTIVE We evaluated the effect of feeding Weanimix and 3 other locally formulated , central ly processed complementary foods on the nutritional status of 208 breast-fed infants . DESIGN Infants were r and omly assigned to receive 1 of 4 foods from 6 to 12 mo of age : Weanimix ( W ) , Weanimix plus vitamins and minerals ( WM ) , Weanimix plus fish powder ( WF ) , and koko plus fish powder ( KF ) . Dietary and anthropometric data were collected regularly . Blood was collected at 6 and 12 mo of age to assess iron , zinc , vitamin A , and riboflavin status . Before and after the intervention , cross-sectional data on the anthropometric status of infants not included in the intervention ( NI ; n = 464 ) were collected . RESULTS There were no significant differences between intervention groups in weight or length gain or in hemoglobin , hematocrit , transferrin saturation , plasma zinc , or erythrocyte riboflavin values between 6 and 12 mo of age . From 9 to 12 mo of age , z scores were lower in NI infants than in the combined intervention groups [ at 12 mo : -1.71 + /- 0.90 compared with -1.19 + /- 0.93 for weight and -1.27 + /- 1.02 compared with -0.63 + /- 0.84 for length ( P < 0.001 for both ) , respectively ] . The percentage of infants with low ferritin values increased significantly between 6 and 12 mo of age in groups W , WF , and KF but not in group WM . Change in plasma retinol between 6 and 12 mo of age was significantly greater in group WM than in the other 3 groups combined ( 0.14 + /- 0.3 compared with -0.04 + /- 0.3 micromol/L , P = 0 . 003 ) . CONCLUSIONS All 4 foods improved growth relative to the NI group . Infants fed WM had better iron stores and vitamin A status than those fed nonfortified foods Linear growth retardation and anemia are the most prevalent nutritional problems in the world ; effective interventions are urgently needed . We evaluated Ecuador 's National Food Nutrition Program ( PANN 2000 ) that included a micronutrient-fortified complementary food ( FCF ) , Mi Papilla , in poor periurban and rural communities of Ecuador . The program is preventive and targeted to all infants and young children living in poor communities and receiving government health services . We compared dietary intake , micronutrient status , and growth over 11 mo in a cohort of children from the catchment areas of the PANN 2000 with same-age control children in nearby communities eligible to enter the program 1 y later . PANN 2000 children enrolled in the program when they were age 9 - 14 mo and were age 20 - 25 mo at the final survey . They consumed significantly more energy , protein , fat , iron , zinc , vitamin A , and calcium than control children because of their FCF consumption . Anemia , 76 % in both groups at baseline , fell to 27 % in PANN 2000 children but only to 44 % in control children ( P < 0.001 ) . The odds of being anemic were 58 % lower for PANN 2000 children ( P = 0.003 ) . The effects on linear growth and weight were limited to children who were older when the program began ( 12 - 14 mo ) and were significant for weight ( interaction with age , 0.38 kg ; P = 0.029 ) and positive but not significant for length ( 0.66 cm ; P = 0.08 ) . An FCF , including ferrous sulfate , delivered through public health services , is highly effective in improving weight and hemoglobin and reducing anemia OBJECTIVE Inappropriate complementary feeding is one of the major causes of malnutrition in young children in developing countries . We developed an educational intervention , delivered by local health-care providers , aim ed at improving complementary feeding practice s and child nutrition . DESIGN Eight townships in Laishui , a rural area in China , were r and omly assigned to the educational intervention or control group . A total of 599 healthy infants were enrolled at age 2 - 4 months and followed up until 1 year of age . In the intervention group , educational messages and enhanced home-prepared recipes were disseminated to caregivers through group trainings and home visits . Question naire surveys and anthropometric measurements were taken at baseline and ages 6 , 9 and 12 months . Analysis was by intention to treat . RESULTS It was found that food diversity , meal frequency and hygiene practice s were improved in the intervention group . Infants in the intervention group gained 0.22 kg more weight ( 95 % CI 0.003 , 0.45 kg , P = 0.047 ) and gained 0.66 cm more length ( 95 % CI 0.03 , 1.29 cm , P = 0.04 ) than did controls over the study period . CONCLUSIONS Findings from the study suggest that an educational intervention delivered through local health-care providers can lead to substantial behavioural changes of caregivers and improve infant growth Malnutrition is common among children aged 6–24 months in developing countries . It increases the risk of mortality .  Interventions to improve infant-feeding hold the promise of reducing malnutrition among these children . A study in Brazil has shown the success of training in communication and counselling skills among health workers in improving the nutritional status of young children . Questions were raised whether the method used in the study in Brazil would also be effective when applied in other countries . The aim of the present study was to reduce growth faltering in young children through proper nutrition-promotion techniques . The objective of the study was to determine the efficacy of training health workers in nutrition counselling in enhancing their communication skills and performance , improving feeding practice s , and reducing  growth faltering in children aged 6–24 months . A cluster-r and omized controlled trial was carried out . The method used in this study was a replica of the method in a similar study in Pelotas , Brazil . Forty health centres were paired , and one centre of each pair was r and omly allocated to the intervention group , and the other to the control group . The Integrated Management of Childhood Illness ( IMCI ) module—‘Counsel the mother'—was used for training health workers in the health centres in the intervention group . Data from 36 paired health centres and 375 mothers and their children aged 6–24 months recruited from these health centres following consultation with health workers were included in analysis . Independent observers , masked to the intervention status , examined the performance of health workers within the first month after training . Mother-child pairs were visited at home within two weeks , 45 days , and 180 days after recruitment . Information was recorded on the feeding practice s , recall of the recommendations of health workers , and sociodemographic variables at these home-visits . Weight and length of the child were measured at each contact . The communication skills and consultation performance of health workers were significantly better in the intervention group than in the control group . The mothers ' recall of the recommendation of health workers and reported infant-feeding practice s were also significantly better in the intervention group than in the control group , even 180 days after the recruitment consultation . Growth faltering was less in the intervention group , with the largest effect observed among children in the age-group of 12 + months . These results indicate that training in IMCI feeding counselling can enhance the communication skills and performance of health workers . Improved feeding practice s of counselled mothers can , in turn , reduce growth faltering in their children The study was conducted to look at the effectiveness of a multimicronutrient-fortified complementary food on the micronutrient status , linear growth and psychomotor development of 6- to 12-month-old infants from a black urban disadvantaged community in the Western Cape , South Africa . The study was design ed as an intervention study . In both the experimental and control groups , serum retinol concentration showed a decline over the intervention period of 6 months . The decline was less pronounced in the experimental group . This result ed in a significantly ( P<005 ) higher serum retinol concentration at 12 months in the experimental group ( 26.8±5.8 μg/dl ) compared with the control group ( 21.4±5 μg/dl ) . Serum iron concentration also declined over the intervention period . The decline was less pronounced in the experimental group . No difference was observed in haemoglobin levels between the groups at 12 months . Serum zinc concentration did not differ significantly between the two groups at follow up . Weight gain over the 6 months period did not differ significantly between the experimental ( 2.1±0.9 kg ) and control groups ( 2.1±1.2 kg ) . There was no difference in linear growth between the experimental ( 10.0±1.5 cm ) and control group ( 10.1±2.1 cm ) at the end of the follow-up period . Weight and length at 6 months significantly predicted weight and length at 12 months . No difference was observed in psychomotor developmental scores between the two groups after 6 months of intervention . Introducing a multimicronutrient-fortified complementary food into the diet of 6- to 12-month-old infants seemed to have an arresting effect on declining serum retinol and iron concentration in the experimental group . No benefit was observed in serum zinc concentration , linear growth and psychomotor development Integrated nutrition programs are widely used to prevent and /or reverse childhood malnutrition , but rarely rigorously evaluated . The impact of such a program on the physical growth of young rural Vietnamese children was measured . We r and omized six communes to receive an integrated nutrition program implemented by Save the Children .  We matched six communes to serve as controls . Our sample consisted of 238 children ( n = 119 per group ) who were 5 to 30 months old on entry . Between December 1999 and December 2000 , we measured weight and height monthly for six months and again at month 12 . Principle outcomes were weight-for-age Z score ( WAZ ) , height-for-age Z score ( HAZ ) , and weight-for-height Z score ( WHZ ) , and the changes among these measures . As expected , anthropometric indicators relative to international references worsened as the children aged . Overall , children in the intervention communes who were exposed to the integrated nutrition program did not show statistically significant better growth than comparison children . Intervention children who were younger ( 15 months or less ) and more malnourished ( less than −2 Z ) at baseline , however , deteriorated significantly less than their comparable counterparts . Between baseline and month four , for example , intervention children who were malnourished and less than 15 months old at entry lost on average 0.05 WAZ while similar comparison children lost 0.25 WAZ ( p = .02 ) . Lack of overall impact on growth may be due to a lower than expected prevalence of malnutrition at baseline and /or deworming of comparison children . Targeting nutrition interventions at very young children will have the maximum impact on growth BACKGROUND Malnutrition is the underlying cause of half of child mortality . Many programmes attempt to remedy this issue but there is a lack of evidence on effective ways to decrease child malnutrition . METHODS We did a cluster-r and omised trial of an educational intervention in a poor periurban area ( ie , shanty town ) of Peru . Guided by formative research , the intervention aim ed to enhance the quality and coverage of existing nutrition education and to introduce an accreditation system in six government health facilities compared with six control facilities . The primary outcome measure was growth that was measured by weight , length , and Z scores for weight-for-age and length-for-age at age 18 months . Main secondary outcomes were the percentage of children receiving recommended feeding practice s and the 24-h dietary intake of energy , iron , and zinc from complementary food at ages 6 , 9 , 12 , and 18 months . Analysis was by intention to treat . FINDINGS We enrolled a birth cohort of 187 infants from the catchment areas of intervention centres and 190 from control areas . Caregivers in intervention areas were more likely to report receiving nutrition advice from the health service than were caregivers in control health facilities ( 16 [ 52 % ] of 31 vs 9 [ 24 % ] of 37 , p=0.02 ) . At 6 months more babies in intervention areas were fed nutrient-dense thick foods at lunch ( a recommended complementary feeding practice ) than were controls ( 48 [ 31 % ] of 157 vs 29 [ 20 % ] of 147 ; difference between groups 19 [ 11 % ] , p=0.03 ) . Fewer children in intervention areas failed to meet dietary requirements for energy ( 8 months : 30 [ 18 % ] of 170 vs 45 [ 27 % ] of 167 , p=0.04 ; 12 months : 64 [ 38 % ] of 168 vs 82 [ 49 % ] of 167 , p=0.043 ) , iron ( 8 months : 155 [ 91 % ] of 170 vs 161 [ 96 % ] of 167 , 9 months : 152 [ 93 % ] of 163 vs 165 [ 99 % ] of 166 , p=0.047 ) , and zinc ( 9 months : 125 [ 77 % ] of 163 vs 145 [ 87 % ] of 166 , p=0.012 ) than did controls . Children in control areas were more likely to have stunted growth ( ie , length for age less than 2 SD below the reference population median ) at 18 months than children in intervention groups ( 26 [ 16 % ] of 165 vs 8 [ 5 % ] of 171 ; adjusted odds ratio 3.04 [ 95 % CI 1.21 - 7.64 ] ) . Adjusted mean changes in weight gain , length gain , and Z scores were all significantly better in the intervention area than in the control area . INTERPRETATION Improvement of nutrition education delivered through health services can decrease the prevalence of stunted growth in childhood in areas where access to food is not a limiting factor This study assesses the impact of an intervention known as the Ten Steps to Healthy Feeding : A Nutritional Guide for Children under Two on nutritional conditions and infant health in low-income families . Two hundred newborns were r and omized to the intervention group and three hundred to the control group . Parents of the intervention group received nutritional orientation during the child 's first year of life . Both groups received visits at 6 and 12 months and routine follow-up by their pediatricians . The results ( n = 397 ) showed that the intervention was associated with a higher proportion of exclusive breastfeeding at 4 months ( RR = 1.58 ; 95%CI : 1.21 - 2.06 ) and 6 months ( RR = 2.34 ; 95%CI : 1.37 - 3.99 ) and breastfeeding at 12 months ( RR = 1.26 ; 95%CI : 1.02 - 1.55 ) and a lower proportion of children with diarrhea ( RR = 0.68 ; 95%CI : 0.51 - 0.90 ) , respiratory problems ( RR = 0.63 ; 95%CI : 0.46 - 0.85 ) , use of medication ( RR = 0.56 ; 95%CI : 0.34 - 0.91 ) , and dental caries ( RR = 0.56 ; 95%CI : 0.32 - 0.96 ) in the 12 - 16 month bracket . The intervention had no effect on the occurrence of anemia , hospitalization , or nutritional status . The results suggest that the nutritional orientation program led to positive changes in infant feeding practice s and health conditions , but that it was insufficient to prevent iron deficiency anemia OBJECTIVE Breast milk alone is insufficient to support normal growth during the second half of infancy , so I investigated supplementary feeding for infants ' successful transition to solid food . METHODS The nutrition status of 30 infants from a low socioeconomic background weaned onto an extruded formulated complementary diet from maize and cowpea ( L(1)A(1 ) ) were compared with 30 infants with a similar socioeconomic background ( L(2)N , control group ) and 30 infants from an above-average socioeconomic background ( HN , reference group ) without the supplementary diet .  Infants within the control and reference groups were weaned onto different foods of the mothers ' choice . The formulated diet was analyzed for nutrient composition . RESULTS The results showed similarity in the estimated annual family income of the L(1)A(1 ) and L(2)N groups , which ranged from N 25 000 to 74 000 ( US $ 208.30 to 616.70 ) , whereas the estimated family income for the HN group was above N 225 000 ( US $ 1875.00 ) annually . The formulated blend contained 17.3 % protein , 5.0 % fat , and 2106 kJ of energy . Mean weight at birth and 4 mo before the feeding intervention in HN infants was statistically ( P < 0.05 ) higher than in L(1)A(1 ) and L(2)N infants . At the end of the study , L(1)A(1 ) and HN infants had a mean length within -1 st and ard deviation of the st and ard length for age . The mean length of L(2)N infants was within -3 st and ard deviations of the st and ard length for age . The effectiveness of the formulated diet  was expressed in terms of similarity in anthropometric measurements of L(1)A(1 ) ) and HN infants . CONCLUSIONS Based on similarities in socioeconomic background and weight at birth and 4 mo in the L(1)A(1 ) and L(2)N infants , the better nutrition status of the L(1)A(1 ) is attributed to the formulated complementary diet . The contribution of this mixture to total nutrient intake seemed substantial enough to meet the infants ' nutritional requirements . The use of a cheaply available plant protein will go a long way in reducing protein-energy malnutrition among children in developing countries . However , because of the low purchasing power of the low-income family , the costs of this product should be studied BACKGROUND The low micronutrient content of complementary foods is associated with growth faltering in many population s. A potential low-cost solution is the home fortification of complementary foods with Sprinkles ( SP ) powder , crushable Nutritabs ( NT ) tablets , or energy-dense ( 108 kcal/d ) , fat-based Nutributter ( NB ) . OBJECTIVE The objective was to test the hypothesis that multiple micronutrients added to home-prepared complementary foods would increase growth and that the effect would be greatest in the presence of added energy from fat . DESIGN We r and omly assigned 313 Ghanaian infants to receive SP , NT , or NB containing 6 , 16 , and 19 vitamins and minerals , respectively , daily from 6 to 12 mo of age . We assessed anthropometric status at 6 , 9 , and 12 mo ; micronutrient status at 6 and 12 mo ; motor development at 12 mo ; and morbidity weekly . Infants ( n = 96 ) not r and omly selected for the intervention ( nonintervention ; NI ) were assessed at 12 mo . RESULTS The groups did not differ significantly at baseline , except that the NB group had a higher proportion of boys and weighed slightly more . The dropout rate ( 15/313 ) was low . At 12 mo , after control for initial size , the NB group had a significantly greater weight-for-age z score ( WAZ ) ( -0.49 + /- 0.54 ) and length-for-age z score ( LAZ ) ( -0.20 + /- 0.54 ) than did the NT group ( WAZ : -0.67 + /- 0.54 ; LAZ : -0.39 + /- 0.54 ) and the NT and SP groups combined ( WAZ : -0.65 + /- 0.54 ; LAZ : -0.38 + /- 0.54 ) ; the difference with the NI group ( WAZ : -0.74 + /- 1.1 ; LAZ : -0.40 + /- 1.0 ) was not significant . A lower percentage of the NI infants ( 25 % ) than of the intervention groups ( SP : 39 % ; NT : 36 % ; NB : 49 % ) could walk independently by 12 mo . CONCLUSION All 3 supplements had positive effects on motor milestone acquisition by 12 mo compared with no intervention , but only NB affected growth OBJECTIVE To evaluate a nutrition education intervention design ed to improve infant growth and feeding practice s. DESIGN An intervention study using monthly nutrition education delivered by locally trained counsellors targeted at caregivers of infants aged 5 - 11 months . Comparison of outcomes for 2 groups -- one non-intervention group of infants enrolled in 1997 that did not receive the intervention in the first year of life , and an intervention group of infants enrolled 1998 - 1999 that received the nutrition education .  SETTING 11 r and omly selected and 2 purposively selected villages of south Karnataka . SUBJECTS 138 Infants ( n = 69 intervention ) aged 5 - 11 months . METHODS Families were administered a monthly question naire on feeding and child care behavior , and study infants were weighed at this time , using the SECA solar scales , developed for UNICEF . Logistic regression was used to examine differences between intervention and non-intervention infants in infant feeding behavior outcomes . RESULTS Statistically significant improvement was found in weight velocity for female infants in the intervention group . These infants were also more likely to exhibit at least four positive feeding behaviors -- intervention infants had a higher mean daily feeding frequency ( more likely to be fed solids at least four times a day ( OR = 4.35 , 95 % CI = 1.96 , 10.00 ) , higher dietary diversity ( more likely to receive a more diverse diet OR = 3.23 , 95 % CI = 1.28 , 7.69 ) , and were more likely to be fed foods suggested by the counsellors such as bananas ( OR = 10.00 , 95 % = 2.78 , 33.3 ) compared to non-intervention infants . CONCLUSION Nutrition education and counselling was significantly associated with increased weight velocity among girls and improved feeding behavior among both boys and girls . These results provide further evidence that community-based nutrition programs that emphasise appropriate feeding and care behavior can be used to prevent and address early childhood malnutrition in poor households
Background About one third of deaths in children less than 5 years of age are due to underlying undernutrition .
According to an estimate , 19.4 % of children < 5 years of age in developing countries were underweight ( weight-for-age Z score < -2 ) and about 29.9 % were stunted in the year 2011 ( height-for-age Z score < -2 ) .
It is well recognized that the period of 6 - 24 months of age is one of the most critical time for the growth of the infant .