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Infant, Young Child Feeding Practices, their Influencers and Barriers in Dibrugarh District, Assam-A Mixed Method
Mridushman Saikia1, Tulika G Mahanta1, Swarnali D Baruah2
1Community Medicine Department, Assam Medical College and Hospital, Dibrugarh, Assam, India.
Insights
Improving Infant and Young Child Feeding (IYCF) practices is crucial for preventing child mortality. This study in Dibrugarh identified cultural beliefs and socioeconomic factors influencing IYCF among diverse communities.
Area of Science:
- Public Health
- Nutrition Science
- Pediatrics
Background:
- Adequate nutrition is a fundamental right for infants and children.
- Improved Infant and Young Child Feeding (IYCF) practices can prevent approximately 20% of deaths in children under five.
- Understanding IYCF practices and their determinants is vital for public health interventions.
Purpose of the Study:
- To determine the prevalence of Infant and Young Child Feeding (IYCF) practices in Dibrugarh district, Assam.
- To identify influencers and barriers to IYCF practices among diverse communities (Missing, Bengali, Muslim, Riverine).
- To provide data for targeted interventions to improve child nutrition outcomes.
Main Methods:
- A mixed-method study involving children aged 0-23 months and their caregivers.
- Sample size of 210 participants calculated with 95% CI and 20% relative precision.
- Data collection through house-to-house visits using UNICEF/WHO schedules and focus group discussions (FGDs) with thematic analysis.
Main Results:
- Exclusive breastfeeding rate was 66.7%; only 36.7% achieved a minimum acceptable diet.
- Bottle feeding was prevalent in 59.5% of children.
- Early complementary feeding was influenced by tradition (e.g., rice beer, sugar water) and necessity, with reliance on traditional healers and rituals observed.
Conclusions:
- Higher socioeconomic status, education, paternal involvement, and avoiding teenage pregnancies are associated with improved IYCF practices.
- Cultural beliefs and financial constraints significantly impact dietary choices and feeding practices.
- Targeted interventions addressing cultural norms and socioeconomic barriers are needed to enhance IYCF in the region.
Background:
Every infant and child possess fundamental right to adequate nutrition. Nearly 1/5th of deaths in children under five could be prevented by proper Infant and Young Child Feeding (IYCF) practices. The current study was conducted to determine the prevalence of IYCF practices in Dibrugarh district and to identify its influencers and barriers among different communities (Missing (tribal), Bengali (linguistic minority), Muslim (religious minority), and Riverine community (hard to reach)) residing in Dibrugarh district, Assam.
Materials And Methods:
This mixed-method study was conducted from March 2023 to February 2024; it included children aged 0-23 months and their primary caregivers. Considering the prevalence of children (6-8 months) receiving solid/semisolid food and breastmilk in Assam as 51.7%, with 20% relative precision, 95% confidence interval (CI), design effect of 2, and 10% nonresponse rate, the sample size became 198, rounded up to 210. Four communities were purposefully selected for FGDs, with two FGDs per community. Data were collected via house-to-house visits using the UNICEF/WHO schedule. FGDs were audio-recorded, transcribed, coded, and thematically analyzed. Chi-square and Fisher's exact tests were applied, and the unadjusted odds ratio (U-OR) was calculated with 95% CI.
Results:
Only 66.7% were exclusively breastfed; while 55.9% children received solid, semisolid or soft foods 6-8 months. Only 36.7% achieved minimum acceptable diet, while bottle feeding 0-23 months occurred in 59.5% of children. Rural, ST children were significantly less likely to have early initiation of breastfeeding. Early introduction of complementary foods is driven by both tradition (tribal community use "Apong" rice beer; Muslim community use sugar water prelacteally) and necessity (Riverine community starts early due to work/financial demands). Reliance on traditional healers and practices-such as Jhar phook (Muslim), Domai (Riverine), and rituals against the "evil eye" (Missing community)-remains a dominant feature.
Conclusion:
Our study shows that higher SES, education, paternal involvement, and avoiding teenage pregnancies improve IYCF practices. Cultural beliefs and financial constraints also impact dietary choices.
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