Appropriate Complmentary Feeding Strategies in Infants
Appropriate Complementary Feeding Strategies in Infants: An Evaluation of Various Strategies to Assess the Growth and Health of the Infants.
The purpose of this study has been to understand the prevalence of under nutrition and
develop effective interventions for improving growth and micronutrient status of infants
receiving complementary foods.
In this community based randomized clinical trial, the nutrition education package
implemented aimed to improve hematological parameters including the micronutrient status and
to see effect on growth indicators.
Transition from exclusive breast feeding to complementary feeding poses many challenges as
the demand for nutrients necessary for optimum growth and development increases steadily.
Malnutrition and micronutrient malnutrition can be inter-generational and affect pregnant
mothers and consequently the baby may be born with deficient micronutrient stores,
especially those of iron. This deficiency can be further exacerbated by sub-optimal
practices of breast feeding. Globally, iron deficiency is the most common cause of anemia
estimated to affect nearly 2 billion people especially preschool children. In Pakistan, 56 %
of children under the age of five years are estimated to have iron deficiency anemia and 13
% are also severely malnourished. These deficiencies affect not only physical growth but
also mental development with significant impact on immunity and increased burden of
infections. It is uncertain what the most appropriate intervention strategy is and a wide
range of options are mentioned including dietary diversification through nutrition
education, provision of fortified foods, iron supplementation and home-based fortification
of complementary foods with micronutrient powders such as Sprinkles.
In an effort to understand the prevalence of under nutrition and develop effective
interventions for improving growth and micronutrient status of infants receiving
complementary foods, I undertook a prospective community-based randomized controlled
efficacy trial in a representative urban population of Karachi. Infants and mothers were
identified after birth and enrolled in the study to receive one of the interventions through
community health workers at the age of six months. The enrolled infants were placed in three
groups - defined as Nutr Education (Nutr Edu), Oral iron supplementation (OIS) and Multiple
micronutrient fortification (MMF). Nutrition education component was common to all the
groups. Through nutritional education sessions held in the community, dietary
diversification along with continuation of breast feeding was stressed to enhance the intake
of diet, rich in iron, and other micronutrients. A cohort of 451 infants (177 in group Nutr
Edu, 141 in group OIS and 133 in MMF) were followed for three months (till the end of
treatments) for growth, micronutrient status, and morbidity rate and thereafter followed for
another three months to evaluate anthropometric parameters.
Anemia, Growth, Infants, Focus of the study is to assess the level of anemia and growth indicators among the infants
Aga Khan University
Aga Khan University, The Hospital for Sick Children, European Union