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The impact of a primary health care intervention on infant feeding practices: a cluster randomised controlled trial
V R Ferreira1,2, C N Sangalli1,2, P S Leffa1,2
1Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil.
Insights
A primary health care intervention improved infant feeding practices in low-income families. Health worker training enhanced the quality of infant diets and delayed the introduction of unhealthy foods.
Area of Science:
- Public Health
- Pediatrics
- Nutrition Science
Background:
- Proper infant feeding is crucial for child development.
- Low-income families often face challenges in providing optimal nutrition.
- Early life feeding practices significantly impact long-term health outcomes.
Purpose of the Study:
- To assess the impact of a primary health care intervention on infant feeding practices.
- To evaluate feeding quality and the introduction of non-recommended foods in young children from low-income backgrounds.
- To determine the effectiveness of health worker training on infant nutrition.
Main Methods:
- A cluster randomized controlled trial was conducted in Porto Alegre, Brazil.
- Healthcare centers were assigned to intervention or control groups, with health workers in intervention sites receiving training.
- Infant feeding practices were assessed at 6 and 12 months using the Infant and Child Feeding Index (ICFI) and evaluation of non-recommended food introduction.
Main Results:
- The intervention group showed higher mean ICFI scores at 6 and 12 months.
- Improved prevalence of meat introduction at 6 months and dietary diversity/meal frequency at 12 months in the intervention group.
- Delayed introduction of added sugars, tea, jelly, and filled cookies in the intervention group, particularly for children with frequent follow-ups.
Conclusions:
- Health worker training effectively improved infant feeding practices.
- The intervention demonstrated positive effects on the quality and timing of food introduction.
- Primary health care interventions can be a valuable tool for promoting optimal infant nutrition in vulnerable populations.
Background:
Proper feeding practices in early life can enhance the full human potential development of children. We aimed to evaluate the impact of a primary health care intervention on infant feeding practices among children from low-income families.
Methods:
A cluster randomised controlled trial was conducted in Porto Alegre, Brazil. Healthcare centres were randomised into intervention (n = 9) and control (n = 11) groups. In intervention sites, health workers were trained in accordance with the national guidelines. Infant feeding practices were assessed in children at 6 months (n = 617) and 12 months (n = 516) of age. Feeding practice quality was assessed using the Infant and Child Feeding Index (ICFI). Additionally, we evaluated the introduction of nonrecommended foods.
Results:
At 6 months, the mean ICFI score was higher in the intervention group [MD = 0.22; 95% confidence interval (CI) = 0.24-1.11]. The prevalence of infants who met the recommendation for meat into the food-frequency score was higher in the intervention than the control group [relative risk (RR) = 1.63; 95% CI = 1.26-2.11]. At 12 months of age, the ICFI mean (MD = 0.23; 95% CI = 0.35-0.56) and the prevalence of children who met the recommendation for dietary diversity (RR = 1.11; 95% CI = 1.01-1.22) and meal frequency (RR = 4.68; 95% CI = 1.34-16.36) were higher in the intervention group, although only among children who had more than seven follow-up appointments during the first year of life. The children from intervention group had a significant delay for added sugar (MD = 0.51; 95% CI = 0.13-0.89), tea (mean = 0.47; 95% CI = 0.13-0.82), jelly (MD = 0.35; 95% CI = 0.11-0.58) and filled cookies (MD = 0.29; 95% CI = 0.06-0.52) compared to the control group.
Conclusions:
The health workers' training was effective with respect to improving infant feeding practices.
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