Indian Journal of Community Medicine Vol. XXVI, No.3, Jul-Sept, 2001 NUTRITIONAL STATUS AND FEEDING PRACTICES OF CHILDREN ATTENDING MCH CENTRE Rasania SK, Sachdev TR Deptt. of Community Medicine, Lady Hardinge Medical College, New Dethi Abstract: Gescaen question: What isthe effect of feeding practices onthe nutritional status of children? jective Yo ass te muon tau and Sa festng picts among chen aNd To cole the ndings with some pote emit Seay eng: Cros cor SEuNgT Aaland Sd hein one, Metra et Farccpane Mathers and undefve lren atendng union cli Staaten Antvopomcticmeatrenat of hier, brea-feeang Pacts and ote feting pacts, State anal Pofotony, chesque ex e Ret tol of S50 ees we cod in heady, of which 1815289) were le and 1674728) were foal chin 1432 2%) eden tong iterate moter weeny 31(88%) chen belonged Yo educated mater beyond chal eve ‘Anthropometric examination of children revealed mean weight of 6.87+2.47 Kg. and mean height of 64.73+10.13 cms. 71.5% children ttre underelgh au pr welt fr ae we 701 an 2.9% of chen ha ein hg or age aug) and weght or eight (Grasting respectively. Tre mother's eporton breast-feeding revealed that 92.37% children were breast fed. Culdren who were ot beast fader obe gical moe onderwight and tuted Ow otal Sschfenweanng was taeda ene of bua SSyBiealie faunas he ee G45 ie onset ap ee ST) Key words: Anthropometric measurement, Breast feeding practices, Weaning practices, Container for top feeding Introduction: young children, is associated with a web of factors Nutrition and infection are the «wo most important including insufficient food intake, incomect feeding factors that affect growth of the children. Among children, Practices, frequent infections and literacy status of parents ‘malnutrition especially strikes those, who lack auttionally ©", Vaccine preventable diseases and faulty feeding adequate diet, not protected from frequent illnesses and do Practices are associated with profound growth not receive adequate care’. Monitoring of children under Ttardation™". Keeping these aspects of nutrition in view, five years of age, using anthropometric parameters was {his study was undertaken. found to be most effective method of determining health Material and Methods: status and can be used to sereen these children in order to ‘Acinic based observational study was conducted in determine their nutritional status’, Poor nutritional status the month of October 1999, in a Maternal and Child Health can be measured using three types of anthropometric Center, Mehrauli, Delhi and two subcentres under its indicators; each of these indicators gives different supervision, Children not accompanied by their mothers oF {information about the growth and body composition of with some serious or chronic illness were not included in the children”, study. All underfive children attending these centres, on WHO and other international agencies have immunization days were assessed anthropometricaly recommended exclusive breast feeding in the inital four Children were weighed on the portable infant weighing months and to continue breast feeding suppl¢mented by scale, with minimum clothing and to the nearest of 100 gms. ‘other appropriate foods upto second year of life*’, Recumbent length was obtained for younger children. Maloutition, « public health problem among infants and Standing height was measured for older children, to the 145Indian Journal of Community Medicina Vol. XXVI, No, Jul-Sept, 2001 nearest of 0.5 cm. Anthropometric data was clasified as pet Gomez classification for weight for age, Kanawati and McLaren classification for height for age, and Waterlow classification for weight for height. Age and immunization status of child was determined from the mother’s literacy status and her occupation. Information was also collected on feeding practices of the child, breast feeding status, initiation and duration of breast feding et. ‘The collected data was analyzed using SPSS software. Categorical data was evaluated by chi square test comparing immunization card, The additional data obtained included normal and malnourished children. Sex Child breastfed Total - Male Female Yes No ‘Weight for age (Under weight) Normal 68(36.4) 3319.8)" —96(29.4)S(IBS)* 1010285) Mild 76(40.6) 80479) 1460446) 1037.0) ——156(44.1) Moderate 21048) 3923.4) 60183) 622.2) 66(18.6) Severe 16(08.6) 1509.0) 251076) -6(22.2) 31(08.8) Height for age (Stunting) Normal 65348) 41246" 10109) 518.5)" ———106(29.9) Mild 90(48.1) 8148.5) 6048.9) 11(40.7) 1748.3) Moderate 23123) 32092) 49(15.0) 622.2) 55(15.5) Severe (048) 130078) 1710.2) 5118.5) 22(06.2) Weight for height (Wasting) Normal 79422) $331.7) 123076) 93.3) 1320373) Mild 78(31.7) 7746.1) 1451843) 1037.0) ——155(43.8) Moderate 2123) 2917.4) 4714.4) 518.5) 52147) Severe 1403.7) 808.8) 1203.7) 311.1) 15(04.2) Figures in parentheses indicate percentages; *significant; **highly significant. A total of 354 children were included inthe study, of which 187(52.8%) were male and 167(47.2%) were female children. Anthropometric examination of these children revealed mean weight of 6.8742.47 Kg. (7.0242.53 for male and 6.6942.39 for female children) and mean height of (64,73410.13 cms. (65.57410.26 for male and 63.7739.85 for female children). 71.5% children were underweight as per weight for age while 70.1% and 62.7% of children had ‘Nutritonal status and fescing practoas 48 deficit in height for age (stunting) and weight for height (wasting) respectively. Female children were significantly more underweight (p<0.001) and stunted (p<0.05). Severe degree of stunting and wasting was observed more in the female children. 327(92.37%) children were breast fed. "Non-breast fed children were found tobe significantly more ‘underweight and stunted (p<0.05). Fasania SK otalIndian Joumal of Community Medicine Vol. XXVI, No, ul-Sept, 2001 ‘Table II: Nutritional status of children according to breast feeding practices. Variables Normal Moderate Severe Total (n=96) (n= 146) (n= 60) (n=25) (0=327) ‘When breast-feeding started** Within 2 hrs 3151.4) 22805) 1216.7), 1.4) n 2-6 hrs 3146.3) 270403) 7110.4) 28.0) 6 6-12hrs 9200) 24(533) 10222) 214.4) 45 12-24 hrs 919.1) 2451.1) 99.4) 500.6) a1 24-48 his 51125) 23575) 820.0) 410.0) 40 >48 hrs 5089) 2646.4) «14(250) —11(19.6) 56 How often breast-fed 1-4 times 16208) 31402) 217.3) 911.7) n 5-8 times 4630.9) 7147.6) 23154) (906.0) 149 9-12 times 275.1) 3342.8) 12086) 506.5) 1 >12 times 7092) 110458) 4(16.7) 28.3) 24 How long breast-fed* 1-6 months 8133.6) 108(42.7)_ 4117.0) 16(6.6) 241 7-12 months 15Q1.4) — 35(50.0)—13(18.6) 7110.0) 70 13-18 months. (0) 5055.6) 333) Na) 9 19-24 months 0(0) 30429) 3042.9) 1014.2 7 Breast-feeding according to Fixed time 3028.0) 4239.3) 2422.4) 11(10.3), 107 ‘On demand 66(30.0) 104473) 36(16.4) 146.3) 220 Any problem in breast feeding* Yes 4118) 13G82) 926.5) 823.5) 34 No 9030.3) 143(44.7) 5717.8) 237.2 320 Figures in parentheses indicate percentages; *significant; **highly significant Only in 72(20.3%) children breast-feeding was initiated within two hours of birth while in $6(15.82%) children it was delayed beyond two days of delivery. These were the children in whom severe degree of malnutrition Nutone! status and feeding practices ‘was observed (p<0.001). The duration of breastfeeding was found to be significantly associated with malnutrition (<0.05), however, the frequency of breast feeding was found to be insignificant. Rasania SK ot al