Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Prevalence and Predictors of Complementary Feeding Practices Among Children Aged 6-23 Months in Indonesia

  • Siti, Nurokhmah (Department of Nutrition, Faculty of Medicine, Universitas Indonesia) ;
  • Lucinda, Middleton (Research Institute for the Environment and Livelihoods, Charles Darwin University) ;
  • Aryono, Hendarto (Department of Child Health, Dr. Cipto Mangunkusumo National Central Hospital, Faculty of Medicine, Universitas Indonesia)
  • Received : 2022.05.05
  • Accepted : 2022.09.30
  • Published : 2022.11.30
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Abstract

Objectives: Poor complementary feeding practices have consistently contributed to the burden of child undernutrition in Indonesia. This study aimed to estimate the prevalence and predictors of the time of the introduction of solid, semi-solid, and soft foods (ISSSF), minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD). Methods: We analyzed 4804 last-born infants aged 6-23 months from the 2017 Indonesia Demographic and Health Survey, which employed multistage cluster random sampling. The outcomes were calculated based on the 2021 World Health Organization/United Nations Children's Fund guidelines. The predictors of the 4 complementary feeding indicators were assessed using multivariate Poisson regression with robust variance adjusting for potential confounders and study design. Results: The prevalence of ISSSF, MDD, MMF, and MAD was 86.1%, 54.3%, 71.8%, and 37.6%, respectively, with younger children less likely to meet 3 out of the 4 outcomes. Parental education, the presence of a birth attendant, and maternal media consumption were among the predictors of MDD and MAD. Children from families with higher income were more likely to meet MDD than those from low-income households (adjusted prevalence ratio [aPR], 1.16; 95% confidence interval [CI], 1.05 to 1.28). Living in an urban area was positively associated with MMF (aPR, 1.09; 95% CI, 1.04 to 1.15) and MAD (aPR, 1.12; 95% CI 1.02 to 1.24). In eastern regions, the prevalence of children achieving MDD and MAD was lower than in those living in Java and Bali. Conclusions: It is crucial that more attention and efforts are made to improve the recommended practices throughout Indonesia, since the prevalence of adequate complementary feeding practices remains low.

Keywords

Acknowledgement

We would like to thank the DHS program for the authorization to use the datasets.

References

  1. United Nations Children's Fund (UNICEF). The state of the world's children 2021: on my mind: promoting, protecting and caring for children's mental health; 2021 [cited 2022 Feb 26]. Available from: https://www.unicef.org/reports/state-worlds-children2021.
  2. United Nations System Standing Committee on Nutrition. Meeting the challenge to improve complementary feeding; 2003 [cited 2022 Feb 26]. Available from: https://www.ennonline.net/attachments/503/scnnews27-comp-feeding-report.pdf.
  3. World Health Organization, United Nations Children's Fund (UNICEF). Global strategy for infant and young child feeding; 2003 [cited 2022 Feb 26]. Available from: https://www.who.int/publications/i/item/9241562218.
  4. Marriott BP, White A, Hadden L, Davies JC, Wallingford JC. World Health Organization (WHO) infant and young child feeding indicators: associations with growth measures in 14 low-income countries. Matern Child Nutr 2012;8(3):354-370. https://doi.org/10.1111/j.1740-8709.2011.00380.x
  5. Onyango AW, Borghi E, de Onis M, Casanovas Mdel C, Garza C. Complementary feeding and attained linear growth among 6-23-month-old children. Public Health Nutr 2014;17(9):1975-1983. https://doi.org/10.1017/S1368980013002401
  6. Prado EL, Dewey KG. Nutrition and brain development in early life. Nutr Rev 2014;72(4):267-284. https://doi.org/10.1111/nure.12102
  7. World Health Organization, United Nations Children's Fund (UNICEF). Indicators for assessing infant and young child feeding practices: definitions and measurement methods; 2021 [cited 2022 Feb 25]. Available from: https://apps.who.int/iris/handle/10665/340706.
  8. Statistics Indonesia (Badan Pusat Statistik-BPS), Macro International. Indonesia Demographic and Health Survey 2007; 2008 [cited 2022 Feb 25]. Available from: https://dhsprogram.com/pubs/pdf/FR218/FR218%5B27August2010%5D.pdf.
  9. National Population and Family Planning Board (BKKBN), Statistics Indonesia (BPS), Ministry of Health (Kemenkes), ICF. Indonesia Demographic and Health Survey 2017; 2018 [cited 2022 Feb 25]. Available from: https://dhsprogram.com/pubs/pdf/FR342/FR342.pdf.
  10. Harvey CM, Newell ML, Padmadas SS. Socio-economic differentials in minimum dietary diversity among young children in South-East Asia: evidence from Demographic and Health Surveys. Public Health Nutr 2018;21(16):3048-3057. https://doi.org/10.1017/s1368980018002173
  11. Abdurahman AA, Chaka EE, Bule MH, Niaz K. Magnitude and determinants of complementary feeding practices in Ethiopia: a systematic review and meta-analysis. Heliyon 2019;5(7):e01865.
  12. Dhami MV, Ogbo FA, Akombi-Inyang BJ, Torome R, Agho KE; On Behalf of the Global Maternal and Child Health Research Collaboration (GloMACH). Understanding the enablers and barriers to appropriate infants and young child feeding practices in India: a systematic review. Nutrients 2021;13(3):825.
  13. Blaney S, Februhartanty J, Sukotjo S. Feeding practices among Indonesian children above six months of age: a literature review on their magnitude and quality (part 1). Asia Pac J Clin Nutr 2015;24(1):16-27.
  14. Corsi DJ, Neuman M, Finlay JE, Subramanian SV. Demographic and health surveys: a profile. Int J Epidemiol 2012;41(6):1602-1613. https://doi.org/10.1093/ije/dys184
  15. World Health Organization. Indicators for assessing infant and young child feeding practices: conclusions of a consensus meeting held 6-8 November 2007 in Washington D.C., USA; 2008 [cited 2022 Feb 26]. Available from: https://apps.who.int/iris/bitstream/handle/10665/43895/9789241596664_eng.pdf;jsessionid=86872E66D2A5D3F556D8CE3A4A318BC0?sequence=1.
  16. Ng CS, Dibley MJ, Agho KE. Complementary feeding indicators and determinants of poor feeding practices in Indonesia: a secondary analysis of 2007 Demographic and Health Survey data. Public Health Nutr 2012;15(5):827-839. https://doi.org/10.1017/S1368980011002485
  17. Walters CN, Rakotomanana H, Komakech JJ, Stoecker BJ. Maternal determinants of optimal breastfeeding and complementary feeding and their association with child undernutrition in Malawi (2015-2016). BMC Public Health 2019;19(1):1503.
  18. Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol 2003;3:21.
  19. Croft TN, Marshall AM, Allen CK. Guide to DHS statistics: DHS-7 [cited 2022 Feb 26]. Available from: https://dhsprogram.com/pubs/pdf/DHSG1/Guide_to_DHS_Statistics_DHS-7.pdf.
  20. Ali M, Arif M, Shah AA. Complementary feeding practices and associated factors among children aged 6-23 months in Pakistan. PLoS One 2021;16(2):e0247602.
  21. Agize A, Jara D, Dejenu G. Level of knowledge and practice of mothers on minimum dietary diversity practices and associated factors for 6-23-month-old children in Adea Woreda, Oromia, Ethiopia. Biomed Res Int 2017;2017:7204562.
  22. Patel A, Pusdekar Y, Badhoniya N, Borkar J, Agho KE, Dibley MJ. Determinants of inappropriate complementary feeding practices in young children in India: secondary analysis of National Family Health Survey 2005-2006. Matern Child Nutr 2012;8(Suppl 1):28-44. https://doi.org/10.1111/j.1740-8709.2011.00385.x
  23. Mithra P, Unnikrishnan B, T R, Kumar N, Holla R, Rathi P. Paternal involvement in and sociodemographic correlates of infant and young child feeding in a district in coastal South India: a crosssectional study. Front Public Health 2021;9:661058.
  24. Martin SL, McCann JK, Gascoigne E, Allotey D, Fundira D, Dickin KL. Mixed-methods systematic review of behavioral interventions in low- and middle-income countries to increase family support for maternal, infant, and young child nutrition during the first 1000 days. Curr Dev Nutr 2020;4(6):nzaa085.
  25. Allotey D, Flax VL, Ipadeola AF, Kwasu S, Adair LS, Valle CG, et al. Fathers' complementary feeding support strengthens the association between mothers' decision-making autonomy and optimal complementary feeding in Nigeria. Curr Dev Nutr 2022;6(7):nzac098.
  26. Komatsu H, Malapit HJ, Theis S. Does women's time in domestic work and agriculture affect women's and children's dietary diversity? Evidence from Bangladesh, Nepal, Cambodia, Ghana, and Mozambique. Food Policy 2018;79:256-270. https://doi.org/10.1016/j.foodpol.2018.07.002
  27. Roshita A, Schubert E, Whittaker M. Child-care and feeding practices of urban middle class working and non-working Indonesian mothers: a qualitative study of the socio-economic and cultural environment. Matern Child Nutr 2012;8(3):299-314. https://doi.org/10.1111/j.1740-8709.2011.00298.x
  28. Oddo VM, Ickes SB. Maternal employment in low- and middleincome countries is associated with improved infant and young child feeding. Am J Clin Nutr 2018;107(3):335-344. https://doi.org/10.1093/ajcn/nqy001
  29. Martin SL, McCann JK, Gascoigne E, Allotey D, Fundira D, Dickin KL. Engaging family members in maternal, infant and young child nutrition activities in low- and middle-income countries: a systematic scoping review. Matern Child Nutr 2021;17(S1):e13158.
  30. Gatica-Dominguez G, Neves PA, Barros AJ, Victora CG. Complementary feeding practices in 80 low- and middle-income countries: prevalence of and socioeconomic inequalities in dietary diversity, meal frequency, and dietary adequacy. J Nutr 2021;151(7):1956-1964.
  31. Chakona G. Social circumstances and cultural beliefs influence maternal nutrition, breastfeeding and child feeding practices in South Africa. Nutr J 2020;19(1):47.
  32. Dhami MV, Ogbo FA, Osuagwu UL, Agho KE. Prevalence and factors associated with complementary feeding practices among children aged 6-23months in India: a regional analysis. BMC Public Health 2019;19(1):1034.
  33. Blaney S, Februhartanty J, Sukotjo S. Feeding practices among Indonesian children above six months of age: a literature review on their potential determinants (part 2). Asia Pac J Clin Nutr 2015;24(1):28-37.
  34. Malhotra N. Inadequate feeding of infant and young children in India: lack of nutritional information or food affordability? Public Health Nutr 2013;16(10):1723-1731. https://doi.org/10.1017/S1368980012004065
  35. Na M, Aguayo VM, Arimond M, Narayan A, Stewart CP. Stagnating trends in complementary feeding practices in Bangladesh: an analysis of national surveys from 2004-2014. Matern Child Nutr 2018;14(Suppl 4):e12624.
  36. Na M, Aguayo VM, Arimond M, Dahal P, Lamichhane B, Pokharel R, et al. Trends and predictors of appropriate complementary feeding practices in Nepal: an analysis of national household survey data collected between 2001 and 2014. Matern Child Nutr 2018;14(Suppl 4):e12564.
  37. Nguyen PH, Menon P, Ruel M, Hajeebhoy N. A situational review of infant and young child feeding practices and interventions in Viet Nam. Asia Pac J Clin Nutr 2011;20(3):359-374.
  38. Dickin KL, Litvin K, McCann JK, Coleman FM. Exploring the influence of social norms on complementary feeding: a scoping review of observational, intervention, and effectiveness studies. Curr Dev Nutr 2021;5(2):nzab001.