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Letters to the Editor Indian Pediatrics 2003; 40:579-580 |
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Infant Feeding Practices in a Relocated Slum - A Pilot Study |
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Thirty-five mothers of infants aged 6-18 months were identified through domiciliary visits, purposively. Data was collected using a pretested interview schedule. Detailed information was gathered from the mother on KAP on current breast-feeding (BF) and complementary feeding (CF) practices. It was found that BF was initiated after 3 days of child-birth (54.3%), colostrum was discarded (77%) considering it ‘dirty’ and ‘unfit’ for the baby, prelacteals like honey, unboiled water, sugar syrup and ‘ghutti’ were given by 80% of mothers considering them as cleansing agents, for discarding colostrum. Conjucteral trends have been reported earlier(1,2). No mother exclusively breast fed her infant for the first six months. It was seen that 25.7% of mothers had not initiated any kind of CF of their infants. Of those who had initiated CF (74.3%), 45% did so only after 8 months. Similar findings have been reported earlier(3). It was seen that of those mothers who were CF their infants (74.3%) 19.4% mothers fed only animal milk in addition to BF and the rest fed CF in deplorable amounts for namesake alone that was severely sub-optimal in terms of food classes, nutrients and consistency. No relation was seen between an increase in quantity of CF with age of the infant as all mothers fed only 1-2 tsp of thin and mashed foods two-three times a day. In between meal feeding was practiced by very few. Due to lack of time available from household chores feeding was under-supervised, hunger cries were satisfied by BF alone and no attempt was made to re-feed the infant after the infant signalled a food reject. Of those mothers who fed commercial milk (7.7%), its composition was highly diluted. Green leafy vegetables and pulses of thick consistency were initiated by all mothers after 9 months only. Mothers (80.8%) fed the child from their hand, in the plate they were eating and were reluctant to feed semi-solid and/or solid food in view that it would choke his/her throat. The knowledge of the mothers regarding the time of initiation of BF and CF, types and frequency of CF to be fed was poor. Similar results have been reported earlier(4,5). Inspite of feeding deplorable amounts of food, 42.8% though not satisfied did not increase the quantity of food fed either due to economic constraints, ignorance of the kinds of foods to be given, perceptions like lack of teeth of the child or waiting for the infant to be an year old. A long list of food fads, especially those pertaining to hot and cold foods restricted the quantity and types of food fed. Hygienic practices were not maintained while feeding the infant especially those feeding milk in a bottle (26.8%), this could be one of the causes of the frequent episodes of diarrhea. Discontinuing CF during child illness (92.3%) and BF in maternal illness was a common practice observed amongst mothers and awareness of the prevention and management of diarrhea and other minor ailments was absent. It can be concluded that delayed initiation of complementary foods and feeding in grossly inadequate quality, quantity and consistency is a common practice in urban slums. Ignorance and blindly following generation old beliefs emerged as barriers to appropriate infant feeding practices. It is an urgent need for nutrition education programs emphasizing small ‘doable’ behaviors that are cost and time effective and that reinforce the message time and again to the mothers/caregivers to improve the infant health in a community. Acknowledgement The help extended by field officers of Deepalaya (Dwarka) and Dr. Siddharth Agarwal, Country Representative, Environ-ment Health Project, USAID (India) are duly acknowledged. V. Sethi, |
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