Infant and Young Child Complementary Feeding in Saudi Arabia: Timely Introduction, Frequency and Diversity
DOI:
https://doi.org/10.3923/pjn.2019.216.225Keywords:
Complementary feeding, minimum dietary diversity, minimum meal frequency, Saudi Arabia, the minimum acceptable dietsAbstract
Background and Objective: Appropriate feeding practice reduces the risk of undernutrition, sickness and mortality rates among infants and young children less than 24 months of age. The objective of this study was to assess the timely introduction, frequency and diversity of complementary feedings given to infants 0-24 months of age in Saudi Arabia. To achieve this objective, there is a need to compute and assess the introduction of complementary feedings, minimum dietary diversity (MDD), minimum meal frequency (MMF) and the minimum acceptable diet (MAD) indicators. Materials and Methods: A descriptive cross-sectional study of 1,700 infant mothers’ ages 19-49 years with infants 0-24 months of age was conducted in Saudi Arabia. Multistage random sampling was used, five regions were selected (Northern, Southern, Middle, Eastern and Western) and from each region 33 primary health care centers were selected from both urban (80%) and rural (20%) sites. From each center, 9-16 respondents were randomly selected. Structured interviewer administered questionnaire was used. Results: The results revealed that in Saudi Arabia, the mean number of the food group consumed is amounted to 3.85 times, which is below the threshold for MDD. The top four food groups consumed were dairy products (95%), grains (83%), flesh foods (65%) and vitamin-A-rich fruits and vegetables (53%). The least consumed food groups were other fruits and vegetables, eggs and legumes and nuts. The majority (83%) of infants were introduced to complementary feeding under six months of age, while, merely 13% of infants were optimally introduced to complementary feedings. One in three Saudi infants ages 6-23 months did not consume from four food groups or more and is at risk of undernutrition, including micronutrient deficiencies. Nearly 42% of children ages 6-23 months were not being fed the minimum number of meals per day during this critical period of growth and development. The prevalence of the MAD was merely 35%, indicating that 65% of the Saudi’s infants and children were deprived from being fed frequently throughout the day and their meals weren’t nutrient-dense or coming from diversified food groups. Early introduction, less frequent and diversified infants’ complementary feedings were the major determinants of optimal complementary feeding practices in KSA. Conclusion: The present study estimates the infant and child complementary feeding indicators, according to World Health Organization (WHO) standardized methodology and a gap existing between the prevailing and recommended levels, thus the formulation and implementation of infant and young child feeding strategy is highly recommended, so as to enhance the appropriateness of complementary feedings practices in Saudi Arabia.
References
WHO., 2008. Indicators for Assessing Infant and Young Child Feeding Practices, Part I: Definition. World Health Organization, Geneva, Switzerland, ISBN: 978 92 4 159666 4, Pages: 19.
WHO., 2016. Infant and young child feeding. World Health Organization, Geneva, Switzerland. http://who.int/mediacentre/factsheets/fs342/en/#.
PAHO., 2003. Guiding principles for complementary feeding of the breastfed child. Pan American Health Organization, Washington DC., USA.
WHO., 2010. Indicators for Assessing Infant and Young Child Feeding Practices Part II: Measurement. World Health Organization, Switzerland, ISBN: 9789241599290.
Black, R.E., L.H. Allen, Z.A. Bhutta, L.E. Caulfield and M. de Onis et al., 2008. Maternal and child undernutrition: Global and regional exposures and health consequences. Lancet, 371: 243-260.
Reinbott, A., 2016. Effectiveness of a nutrition education intervention to improve complementary feeding practices: Randomized controlled trial in Cambodia. Dissertation Submitted to the Faculty of Agriculture, Nutritional Sciences and Environmental Management Justus Liebig University Giessen for the Degree of Dr. Oec. Troph.
Labadarios, D., N.P. Steyn and J. Nel, 2011. How diverse is the diet of adult South Africans? Nutr. J., Vol. 10, No. 1.
Kennedy, G.L., M.R. Pedro, C. Seghieri, G. Nantel and I. Brouwer, 2007. Dietary diversity score is a useful indicator of micronutrient intake in non-breast-feeding Filipino children. J. Nutr., 137: 472-477.
Michael, F., 1996. A guide to qualitative research for improving breastfeeding practices. Wellstart International, Washington, DC., USA. http://pdf.usaid.gov/pdf_docs/PNABZ605.pdf.
UNICEF., 2016. From the First Hour of Life: Making the Case for Improved Infant and Young Child Feeding Everywhere. UNICEF., New York, USA., ISBN: 978-92-806-4852-2.
WHO., 2009. Infant and Young Child Feeding: Model Chapter for Textbooks for Medical Students and Allied Health Professionals. World Health Organization, Geneva, Switzerland, ISBN-13: ISBN: 9789241597494, Pages: 99.
Onyango, A.W., E. Borghi, M. de Onis, M.D.C. Casanovas and C. Garza, 2014. Complementary feeding and attained linear growth among 6-23-month-old children. Public Health Nutr., 17: 1975-1983.
WHO., 1998. Complementary Feeding of Young Children in Developing Countries: A Review of Current Scientific Knowledge. World Health Organization, Geneva.
Autret, M. and S. Miladi, 1979. Report on the state of food and nutrition in the United Arab Emirates. Part II. UNICEF, 1979.
Radwan, H., 2013. Patterns and determinants of breastfeeding and complementary feeding practices of Emirati Mothers in the United Arab Emirates. BMC Public Health, Vol. 13, No. 1.
Wijndaele, K., R. Lakshman, J.R. Landsbaugh, K.K. Ong and D. Ogilvie, 2009. Determinants of early weaning and use of unmodified cow's milk in infants: A systematic review. J. Am. Diet. Assoc., 109: 2017-2028.
Fegan, S., E. Bassett, Y. Peng and K.S. O'Connor, 2016. Adherence to complementary feeding recommendations for infants and implications for public health. Public Health Nutr., 19: 638-649.
Kronborg, H., E. Foverskov and M. Vaeth, 2014. Predictors for early introduction of solid food among Danish mothers and infants: An observational study. BMC Pediatr., Vol. 14, No. 1.
Armstrong, J., E.C. Abraham, M. Squair, Y. Brogan and A. Merewood, 2014. Exclusive breastfeeding, complementary feeding and food choices in UK infants. J. Hum. Lactat., 30: 201-208.
Doub, A.E., K.J. Moding and C.A. Stifter, 2015. Infant and maternal predictors of early life feeding decisions. The timing of solid food introduction. Appetite, 92: 261-268.
Tanash, H.A., 2014. Breastfeeding knowledge, practice, attitudes and influencing factors: Findings from a selected sample of breastfeeding mothers in Bemidji, Minnesota. Master’s Theses, Minnesota State University, Mankato, Minnesota.
Solomon, D., Z. Aderaw and T.K. Tegegne, 2017. Minimum dietary diversity and associated factors among children aged 6-23 months in Addis Ababa, Ethiopia. Int. J. Equity Health, Vol. 16, No. 1.
WHO., 2016. Infant and young child feeding 2016. Fact Sheet. World Health Organization. http://www.who.int/mediacentre/factsheets/fs342/en/.
Senarath, U., S.S. Godakandage, H. Jayawickrama, I. Siriwardena and M.J. Dibley, 2012. Determinants of inappropriate complementary feeding practices in young children in Sri Lanka: Secondary data analysis of demographic and health survey 2006-2007. Mater. Child Nutr., 8: 60-77.
Aemro, M., M. Mesele, Z. Birhanu and A. Atenafu, 2013. Dietary diversity and meal frequency practices among infant and young children aged 6-23 months in Ethiopia: A secondary analysis of Ethiopian demographic and health survey 2011. J. Nutr. Metab., Vol. 2013.
Dangura, D. and S. Gebremedhin, 2017. Dietary diversity and associated factors among children 6-23 months of age in Gorche district, Southern Ethiopia: Cross-sectional study. BMC Pediatr., Vol. 17, No. 1.
Beyene, M., A.G. Worku and M.M. Wassie, 2015. Dietary diversity, meal frequency and associated factors among infant and young children in Northwest Ethiopia: A cross-sectional study. BMC Public Health, Vol. 15, No. 1.
Mekbib, E., A. Shumey, S. Ferede and F. Haile, 2014. Magnitude and factors associated with appropriate complementary feeding among mothers having children 6-23 months-of-age in Northern Ethiopia; A community-based cross-sectional study. J. Food Nutr. Sci., 2: 36-42.
Saaka, M., A. Larbi, S. Mutaru and I. Hoeschle-Zeledon, 2016. Magnitude and factors associated with appropriate complementary feeding among children 6-23 months in Northern Ghana. BMC Nutr., Vol. No. 1.
Khan, A.M., P. Kayina, P. Agrawal, A. Gupta and A.T. Kannan, 2012. A study on infant and young child feeding practices among mothers attending an urban health center in East Delhi. Indian J. Public Health, 56: 301-304.
Kabir, I., M. Khanam, K.E. Agho, S. Mihrshahi, M.J. Dibley and S.K. Roy, 2012. Determinants of inappropriate complementary feeding practices in infant and young children in Bangladesh: Secondary data analysis of demographic health survey 2007. Mater. Child Nutr., 8: 11-27.
Mekonnen, T.C., S.B. Workie, T.M. Yimer and W.F. Mersha, 2017. Meal frequency and dietary diversity feeding practices among children 6-23 months of age in Wolaita Sodo town, Southern Ethiopia. J. Health Popul. Nutr., Vol. 36, No. 1.
UNICEF., 2016. Global nutrition report 2016: From promise to impact: Ending malnutrition by 2030. International Food Policy Research Institute, Washington, DC.
Dewey, K.G. and K.H. Brown, 2003. Update on technical issues concerning complementary feeding of young children in developing countries and implications for intervention programs. Food Nutr. Bull., 24: 5-28.
WHO., 2010. Saudi Arabia country profile. Nutrition, 2010. World Health Organization. http://apps.who.int/nutrition/landscape/report.aspx?iso=sau.
MOH., 2010. The Health Statistical Year Book. Ministry of Health, Riyadh, Kingdom of Saudi Arabia.
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