Feeding practices, nutritional status and mortality in pre-school children in rural East Java, Indonesia

During the dry season of 1975 and 1976 two nutrition surveys were carried out in nine regencies of the province of East Java, Indonesia. The objective was to assess the geographical prevalence, magnitude and severity of nutritional deficiencies, especially among mothers and children. In this paper childfeeding practices, nutritional status of pre-school children and child mortality are reported. In the rural areas surveyed breastfeeding is commonly practiced for a prolonged period. In the regencies along the south and north coast of East Java 90%, respectively 94% of children aged 19-24 months were still breastfed; in Sidoarjo, a relative 'surplus' area, the corresponding figure was 73% and on the island of Madura 51%. Even in age-group 25-47 months 34% still were nursed in Blitar-Trenggalek regency, 54% in Tuban-Lamongan, 23% in Sidoarjo and 15% in Madura. The variation in the breastfeeding period between the regencies is a matter of further investigation. In these rural areas the roles as competitor of powdered milk is a minor one. It was intriguing that 9% of the pregnant women still nursed their youngest child. Supplementary food was introduced at a very early age, i.e. in the first week. This was, however, insufficient to maintain adequate growth after the age of six months. According to weight-for-age severe malnutrition was diagnosed in respectively 1%, 4% and 10% of age-groups 0-5 months, 6-11 months and 1-3 years. The anthropometric data suggest that lack of calories is more influential than the deficit in protein. Age-specific mortality, according to age at death was about 21% in the perinatal and 16% in the neonatal period; from 1-11 months (inclusive) it was 31%, from 1.5 years 19% and till 12 years 8%.