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Complementary Feeding on Child Growth

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More Intervention Effect Estimate Summaries

Reference
Imdad A, Yakoob MY, Bhutta ZA. Impact of maternal education about complementary feeding and provision of complementary foods on child growth in developing countries. BMC Public Health 2011; 11 (Suppl 3): S25.

Background

  • Approximately, 20% of children < 5 years of age in low and middle-income countries are underweight (weight for age Z score <-2) in year 2005 and about 32% of children < 5 years of age in these countries are stunted (height for age Z score <-2) (1)
  • Stunting and wasting (weight for height Z score <-2) along with intrauterine growth restriction are responsible for about 2.1 million deaths worldwide in children <5 years of age (1).
  • Incidence of stunting is highest between 6-24 months of age as children have high demand for nutrients, but limited quality and quantity of available foods, especially after exclusive breastfeeding (2, 3).
  • Complementary feeding for infants is the timely introduction of safe and nutritional foods in addition to breastfeeding, introduced at about six months of age (and provided until 18-24 months of age) (4).

Intervention Effects

Provision of Complementary Foods (+ nutritional counseling) on Weight

  • Increase in weight (weighed mean difference 0.34 SD, 95% CI 0.11-0.56)
  • Actual increase in weight of 0.25kg (+0.18) - 11 studies (moderate quality of evidence)

Provision of Complementary Foods (+ nutritional counseling) on Height

  • Increase in linear growth (weighed mean difference 0.26 SD, 95% CI 0.08-0.43)
  • Actual increase in length of 0.54 cm (+0.38) - 11 studies (moderate quality of evidence)

Nutritional Counseling Alone on Weight

  • Increase in weight (weighed mean difference 0.30 SD, 95% CI 0.05-0.54)
  • Actual increase in weight of 0.30kg (+0.26) - 8 studies (moderate quality of evidence)

Nutritional Counseling Alone on Height

  • Increase in linear growth (weighed mean difference 0.21 SD, 95% CI 0.01-0.41)
  • Actual increase in length of 0.49kg (+0.50) - 7 studies (moderate quality of evidence)

Intervention Recommendation  

  • For children 6-24 months of age, provision of Complementary Foods (+ nutritional counseling) may result in an actual increase in weight of 0.25kg (+0.18) and length of 0.54 cm (+0.38) .  With nutritional counseling alone, the increase in weight is 0.30kg (+0.26) and length is 0.49 cm (+0.50).

References from Imdad Paper Cited Here

  1. Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, Mathers C, Rivera J. Maternal and child undernutrition: global & regional exposures & health consequences. Lancet. 2008;371(9608):243–260. 
  2. Shrimpton R, Victora CG, de Onis M, Lima RC, Blossner M, Clugston G. Worldwide timing of growth faltering: implications for nutritional interventions. Pediatrics. 2001;107(5):E75. 
  3. Dewey KG, Adu-Afarwuah S. Systematic review of the efficacy and effectiveness of complementary feeding interventions in developing countries. Matern Child Nutr. 2008;4(Suppl 1):24–85.
  4. WHO. Report of Informal Meeting to Review and Develop Indicators for Complementary Feeding. Washington, D.C.; 2002.

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