Inappropriate Feeding Practices associated with Maternal Education and Growth Outcomes among Bhutanese Children <24 months

Abstract

Background: Inappropriate infant and young child feeding (IYCF) practices are one of the major contributors to high prevalence of underweight, stunting, and wasting in children. There are limited reports on the risk factors of IYCF practice and growth status among Bhutanese children <24 months. Objective: The study is hypothesized that maternal education would be one of the factors associated with inappropriate feeding practices, and that IYCF practices on infant and young children’s growth status measured by stunting, wasting and underweight. Method: A cross-sectional study was conducted in rural (Lhuentse and Phuentsholing) and urban (Thimphu and Phuentsholing) areas of Bhutan. We recruited 144 infants and young children aged < 24m following oral consent of their mothers and caregivers in 2011(n=49) and 2014 (n=95). Results: Interestingly, we observed that mothers who had at least one year of schooling were 78% less likely to achieve adequate minimum meal frequency as compared to mothers who did not go to school (OR=0.22, 95% CI:0.06, 0.75). The prevalence of stunting, wasting and underweight were 27.7%, 16.9% and 13.6%, respectively, in Bhutan. Further, stunting and underweight displayed inverse association with consumption of iron-rich and iron fortifies foods (OR=0.30, 95% CI: 0.11, 0.80) and introduction of complementary foods at 6-8 months (OR=0.18, 95% CI: 0.04, 0.77). Conclusion: This study suggests urgent need for intervention to promote improved IYCF practices in Bhutan. Bhutanese researchers need to focus more on promoting IYCF practice to uneducated mothers and also to indentify other risk factors that influence inappropriate IYCF practices.