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Behavior-change trials to assess the feasibility of improving complementary feeding practices and micronutrient intake of infants in rural Bangladesh.
Food and Nutrition Bulletin. 2004 Sep; 25(3):228-238.This study used simple rapid-assessment techniques to test the feasibility of increasing the consumption of complementary foods by infants by asking mothers to increase meal quantity or frequency or by altering the viscosity/energy density of the food. The feasibility of using micronutrient supplements either added directly to food or administered as liquid drops was also examined. The study was conducted in rural Bangladesh and involved four separate short-term behavioral change trials. Depending on the trial, fieldworkers recruited 30 to 45 infants 6 to 12 months of age. Following recommendations to increase the amount of food provided to infants, the mean intakes from single meals increased from 40 ± 23 g on day 1 to 64 ± 30 g on day 7 (p < 0.05). In a second trial, the mean meal frequency increased from 2.2 ± 1.3 on day 1 to 4.1 ± 1.3 on day 7 (p < 0.05). Provision of high-energy-density diets, prepared by decreasing viscosity with a-amylase or by hand-mashing rice and dhal into a paste before feeding, increased single-meal energy consumption from 54 ± 35 kcal to 79 ± 52 kcal or 75 ± 37 kcal (p < 0.05), respectively. Both types of micronutrient supplements were well accepted and used according to recommendations. In conclusion, it was possible to change short-term child-feeding behaviors to promote increased food intake, meal frequency, energy density, and micronutrient consumption. Because each of these interventions lasted for only about 1 week, however, the long-term sustainability of these changes is not known. Moreover, the effect of increased feeding of complementary foods on intakes of breastmilk and total daily consumption of energy and nutrients requires further study. (author's)
[Unpublished] 1997. Presented at the Annual Meeting of the Population Association of America, Washington, D.C., March 27-29, 1997. , 25 p.The authors review and analyze available anthropometric and food consumption data to dispel the notion that women and children are routinely discriminated against in intrahousehold food allocation throughout the developing world. Little evidence was found that the youngest children tend to get less than their fair share of household food supplies. Researchers recording food consumption data have often omitted infant breast milk consumption, making it seem as though infants and young children are being underfed. Moreover, female children do not consistently have poorer growth than male children, even in india. Among Indian elites, however, there is strong evidence that women are discriminated against in the allocation of both food and health care. Adult women actually have better diets than adult men, except when lactating or pregnant. These findings suggest that, in the interest of both maternal and child health, nutrition and nutrition education interventions be targeted to pregnant and lactating women rather than to the broad population of women and children.
In: Programmes to promote breastfeeding, edited by Derrick B. Jelliffe and E.F. Patrice Jelliffe. Oxford, England, Oxford University Press, 1988. 344-8.This health problem caused by excessive marketing of breast milk substitutes has been termed a commerciogenic disease. Nutrition educators can curb the Market by understanding its functioning, using its own tools in social marketing of breast feeding, and monitoring compliance with the International Code for the Marketing of Breast-Milk Substitutes. The Market's strategy is to expand the artificialization and industrialization of the food supply. This is an amoral process: it may operate for the benefit or the detriment of consumer's health. The tools of the market are the mass-media, the distribution system, sales and promotion devices, price policies, sampling, research and evaluation. The most powerful or these is mass-media advertising, which has a profound impact on the behavior and value systems of the audience. New social policy initiatives involving mass-media access and nutrition-directed food policies are needed. Commercial advertising and marketing practices should also be regulated. The International Code for Marketing of Breast Milk Substitutes is an example of surveillance assigned to agencies that do not understand the Market. Although use of substitutes by mother's decision when needed is legitimate, inducement purely for commercial purposes is an anti-social act. Nutrition professionals must monitor the Code including food marketing practices, the market situation, use of advertising media, and sampling, demonstration and promotion practices, especially those done through the health care system, quality control of products, and distribution.