Quantifying responsive feeding of infants and young children: An analysis from three countries: Peru, Nicaragua and Indonesia
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Rebecca C. Robert, PhD, Assistant Professor, Conway School of Nursing, The Catholic University of America, Washington DC, robert@cua.edu
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Introduction: Responsive feeding, the age and developmentally appropriate interactions between caregivers and infants and young children (IYC) 6-23 months, represents a critical component of complementary feeding to promote optimal healthy growth and development. A quantitative indicator to measure responsive feeding at a population level is lacking and its development remains urgent. Towards this goal, we examined data on responsive feeding from caregivers of IYC in poor regions of Peru, Nicaragua, and Indonesia where malnutrition remains prevalent. Four dimensions were included to score: 1) opportunities for child self-feeding, 2) talking positively with the child during meal time, 3) encouraging a child who has not eaten enough, and 4) an appropriate response to child refusal. We hypothesized that sufficient variability would exist in responsive feeding scores, that higher scores would be associated with the WHO indicator minimum acceptable diet (MAD). Methods: Cross-sectional surveys were administered to a random sample of households with IYC 6-23 months by trained field workers as part of a program evaluation. Topics included socio-demographics, feeding practices, morbidity and responsive feeding questions--based on previous qualitative research and a validation study. Analysis by country included descriptive statistics, generation of a responsive feeding score and multivariate generalized linear modeling. Results and Discussion: A total of 2273 children were analyzed. Results demonstrated good variability in the responsive feeding scores (-1 to +4) in all three countries. The majority of informants demonstrated low responsive feeding, and patterns among the dimensions indicated potential areas for intervention. Importantly, self-feeding was not associated with increased diarrheal morbidity. Results from multivariate models demonstrated an association between responsive feeding and MAD in Indonesia, but not in Peru or Nicaragua. In conclusion, this research provides evidence that responsive feeding can be quantified for survey research and supports the use of these dimensions and algorithm for future studies.
Dr. Robert is a 2018/2019 Sigma Small Grant recipient.
The Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the Sigma grant. No further peer-review has taken place upon the completion of the Sigma grant final report and its appearance in this repository.
Type | Report |
Acquisition | Self-submission |
Review Type | None: Sigma Grant Recipient Report |
Format | Text-based Document |
Evidence Level | Cross-Sectional |
Research Approach | Quantitative Research |
Keywords | Responsive Feeding; Infant and Young Child Feeding; Peru; Nicaragua; Indonesia |
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