the state is accompanied by a significant reduction in rural poverty and improved human development indicators. Despite significant development, Haryana exhibits high rates of undernutrition and Malnutrition continues to be a development challenge in Haryana. The ongoing programmes are making efforts to improve nutrition but anaemia and undernutrition among children and pregnant women are rising alarmingly in Haryana. India has issued the National Guidelines on Infant and YoungChildFeeding in 2006 and enacted the Infant Milk Substitutes Feeding Bottles, and Infant Foods (Regulation of Production, Supply and Distribution) Act 1992, (IMS Act) which was further amended in 2003. Now according to the most recent guidelines for enhancing optimal Infant and Youngchildfeedingpractices (2013) it is defined as a set of well-known and common recommendations for appropriate feeding of new- born and children under two years of age. 1
Table 2 presents infant and youngchildfeedingpractices in the study area. About half of mothers (49%) initiated breastfeeding within one hour of birth. More than quar- ter (37%) was exclusively breastfeeding up to six months, while 68% were predominantly breastfeeding under six months in the last 24 h preceding the survey. Seventy- percent of mothers introduced solid, semi-solid or soft foods during six to eight months of age. Only 38% of children (6–23 months) received the minimum meal fre- quency, 10% received the recommended minimum diet- ary diversity, and 8% received the minimum acceptable diet in the last 24 h preceding the survey. Almost all children (99.9%) were ever breastfed equally, both boys and girls. Eighty-two percent of mothers continued breastfeeding up to one year of age, while 75% continued up to two years of age. Age appropriate breastfeeding (0–23 months) was 78%. Overall 12% of mothers used bottle feeding (14% for boys & 10.4% for girls). Other IYCF practices for both genders were not remarkably different.
Ensuring health, growth and development of children requires adequate nutrition during infancy and early childhood . Therefore, optimal feeding during the first two years of life provides opportunity for prevention of growth faltering and under-nutrition . Hence, Improvement of infantfeedingpractices for children less than two years should be a high priority globally . A global strategy for optimal infant and youngchildfeeding (IYCF) was set up by World Health Organization (WHO) and United Nations Children’s Fund (UNICEF)  in order to reduce malnutrition among the children. The strategy ecommends early initiation of breastfeeding within one hour of birth, exclusive breastfeeding for the first six months, and introduction of appropriate, adequate, and safe complementary foods along with continuing breastfeeding up to two years and beyond. Improving infant and youngchildfeedingpractices is important to reduce under-nutrition and its consequences .
Prelacteal feedingpractices also differed by ethnicity. Infant formula was the main prelacteal food for the newborn, which was found in previous studies in Vietnam  and other low-income countries [33–36]. Feedinginfant formula in the 3 days after birth was common not only among the Kinh but also among some ethnic minority groups (eg, the Tay-Nung and E De- Mnong) who had very low food security, suggesting that formula companies might have expanded their reach to low-income and disadvantaged families in rural and mountainous areas. Previous studies with Vietnamese mothers in the country [29, 37] or who had migrated to high-income countries [9, 12] reported a perception that mothers after delivery need to rest, and thus would pre- fer having the newborn fed infant formula if available. Herbal solutions and chewed rice were the main Table 2 ORs (95 % CIs) for factors associated with selected breastfeeding practices by ethnicity in mothers with children 0 – 23 months old a
Our study suggested that PBF was protective against diar- rhoea among Tanzanian children, and this was consistent with previous studies from Nigeria , Bangladesh  and other SSA countries with high diarrhoea mortality . However, studies from developing countries (such as Ethiopia and Burkina Faso) have shown that PBF increased the likelihood of the infant to experience diarrhoea [6, 24, 42 – 44] as parents or caregivers often insist that water — often ‘ unimproved ’ and a primary source of infection — induces suckling or quenches an infant ’ s thirst after breastfeeding [45–47]. Although PBF has the potential to increase the likelihood of the infant to experience diarrhoea because of the introduction of food-based fluids, Rajiv and colleagues have argued that promoting both EBF and PBF may be more beneficial than promoting EBF over PBF. The authors also noted that there is limited evidence to differentiate the benefits of EBF from those of PBF . Our analysis underscores the fact that both EBF and PBF may have similar impacts on diarrhoea prevention among children aged 0–5 months in Tanzania. Nevertheless, efforts must be made to promote EBF over PBF as the possibilities of water or water-based food contamination in Tanzania are high because of limited access to improved drinking water source, improved sanitation and high-quality food storage facilities for mothers from low SES group and those living in urban slums or rural areas .
Positive parental attitudes towards infantfeeding are an important component in child nutritional health. The special supplemental women, infants and children (WIC) Program have lower breastfeeding rates and attitudes that do not contribute towards healthy infantfeeding in spite of breastfeeding and nutrition education programs targeting WIC participants. 1 Every time an innocent child suffers the curse of malnutrition; the responsibility goes to the mother, the family and to the community due to their faulty or no knowledge regarding the harmful effects of pre-lacteal feeding, benefits of exclusive breast feeding and initiation of proper weaning at the correct time. 2
complementary feedingpractices in Bangladesh from 1993 – 2011, based on data in Bangladesh Demographic and Health Surveys. The following Bangladesh Demographic and Health Surveys were studied: BDHS 93 – 94, BDHS 96 – 97, BDHS 99 – 00, BDHS 04, BDHS 07 and BDHS 11. Values of indicators for infant and youngchildfeeding proposed by WHO, along with their 95% confidence intervals, were calculated, and trends were assessed. Findings: Among the core indicators, early initiation of breastfeeding, exclusive breastfeeding under six months, introduction of solid, semi-solid and soft foods, and consumption of iron-rich foods have improved, while continued breastfeeding at one year does not display a statistically significant development. Of the optional indicators, the prevalence of age-appropriate breastfeeding and children ever breastfed improved, while the prevalence of predominant breastfeeding under six months witnessed a decline. Median duration of breastfeeding declined, and there was no change in the other optional indicators (continued breastfeeding at two years and bottle feeding). Developments in the other optional indicators were not statistically significant. The ratings of early initiation of breastfeeding and complementary feeding have gone up from poor to fair, those of exclusive breastfeeding under six months from fair to good, while those of bottle-feeding are fair.
Studies from Asian countries showed that mother’s education was significantly associated with infantfeedingpractices; timely initiation of complementary food and minimum acceptable diet. Maternal education has been found to be positively associated with infantfeeding in other studies [12, 14, 28] and the association is consistent in our study. This might be due to the inability of illiter- ate mothers to read health education materials provided while visiting health facilities. A recent study on early ini- tiation of breastfeeding from the Nepal Demographic and Health Surveys highlighted that maternal education has positive impact on early initiation [28, 29]. This study fur- ther adds that the benefit is not limited to early infancy but also goes beyond infancy. Similar information was reported with breastfeeding messages .
A cross sectional study was conducted at immunization OPD at Aundh civil hospital ,a Pune over a period of one month of September.63 mother with children of 0 to 2 years dyads were included in study .A pretested ,validated questionnaire adapted from BPNI IYCF questionnaire was used. Assessment of IYCF practices and nutritional status of children (length, weight and MUAC) was done. ICFI score (InfantChildFeeding Index) was used as a single indicator for complementary feedingpractices in 6 to 24 months children. Length, weight were compared with 32 participants of age 0 to 24 months were included in study.23 participants were of 0 to 6 months age and 40 participants in 6 to 24 months age group. Children delivered by caesarean were 26(41.3%).Children delivered in government setup were 26(41.3%). Prelacteal feed was given in 31(49.2%) of which honey was given in 5(7.9%) and formula milk was given in 23(36.9%) newborns .Initiation of breastfeeding within one hour was done in 28(44.4%) participants. Exclusive ipants. Complementary food introduced at completion of 6 months in 34(85%) participants. Total number of bottle fed children was 3(4.8%). (IFCI) infantchildfeeding score of six was seen in 45% children. Assessment of children in study group had unting in 6(9.5%) participants and wasting was seen in 7(11.11%) children.6 (9.5%) were underweight and moderate acute malnutrition was seen in 7(11.11%) children. Place of birth was statistically significant (p value <0.001) with respect to type of delivery, feed, early initiation of breast feeding and exclusive breastfeeding. An odd of early initiation of breastfeeding was 15 times greater in government hospital, and that of exclusive breastfeeding was 7 times greater in government YCF practices were found to be good in children delivered in government setup as compared to private setup. ICFI score did not found statistically significant with nutritional status of children in study group. Stunting was seen in 6(9.5%) children. Moderate acute malnutrition was seen in 7(11.11%) and 6(9.5%) were underweight and wasting was seen in 7(11.11%) children.
Optimal infant and youngchildfeedingpractices as rec- ommended by the World Health Organization includes early initiation of breast feeding within an hour of birth; exclusive breastfeeding till 6 months of age; introduction of complementary feeding at 6 months while continuing breast-feeding up to 2 years or beyond and ensuring proper use of breast-milk substitutes. However, breast milk substitutes are used commonly worldwide with bottle feeding which should be avoided due to its impact on optimal breastfeeding and appropriate complementary feeding. Moreover, feeding bottles are associated with diarrheal disease morbidity and mortality as it is difficult to keep it clean especially in developing countries where sanitation is poor .
Results: Highest percentage of cases 76.4 % were from the age group 6 months to 24 months. Out of 85 cases 58.8% were with exclusive breastfeeding<6 months and among controls is 37.6%. Association of lack of exclusive breastfeeding for 6 months and anemia is statistically significant. Lack of timely introduction of complementary feeding, poor score for infant and youngchildfeedingpractices, male gender, lack of iron rich foods, small for gestational age babies were also significantly associated.
The strength of this study is its respondent’s diversity. The ideas voiced out can therefore be taken as an exact reflection of community knowledge, beliefs, and prac- tices. Nevertheless, the study suffered from a number of limitations: Firstly, the participants were recruited in only one district, Muhanga, the findings may not be gen- eralized to populations outside this area due to some specificities as well as the less representative sample from one District. However, as data saturation was reached during data collection, the findings were ad- equate to provide a deeper understanding of challenges and responses to infantfeedingpractices that allow for a judgment of the extent to which findings can be relevant and applicable to other similar settings. Secondly, there was inability to observe the actual infant and youngchildfeedingpractices and behaviors as were reported by par- ticipants during the focus group discussions. Future re- search that confirms self-reported interview data with direct observations of IYCF practices in everyday life would be valuable. Thirdly, participants might have over-reported the practices and influences due to social desirability. This might have been more evident for the grandmothers’ responses as grandmothers’ advice and concerns may reflect cultural beliefs and infantfeeding
The development of successful interventions to im- prove child-feedingpractices, in particular, requires ap- propriate instruments that can adequately assess current feedingpractices and monitor the impact of programmes designed to improve them . Therefore, knowledge of the magnitude and predictors of appropriate comple- mentary feedingpractices is an important step in design- ing and evaluating appropriate interventions that seek to address poor infant and youngchildfeedingpractices. However, there is little information on the extent mothers adhere to the WHO recommended infant and youngchildfeedingpractices in Northern Ghana. Fur- thermore, given the strong links between diet diversity and nutritional outcomes [11–14], this study sought to assess the prevalence of appropriate complementary feedingpractices and its determinants among children aged 6–23 months who reside in rural areas of Northern Ghana where child malnutrition is a serious concern.
Background: Infant and youngchildfeedingpractices influence the growth and development of children. The present study was conducted with an objective to find the awareness and practices regarding infant and youngchildfeeding in Chandigarh. Materials and methods: The cross-sectional study was conducted from February to April 2016 among 300 mothers from randomly selected urban, rural and slum areas in Chandigarh. The data was collected using the pre-designed, structured and pre-tested questionnaire on awareness and practices of mothers regarding infant and youngchildfeeding. Descriptive analysis was done. Chi-square test was used as test of significance taking level of significance, p < 0.05. Results: The knowledge-practice gap for initiation of breastfeeding, feeding of colostrum, no pre-lacteal feeding, and exclusive breastfeeding for six months was found to be 03.0% (p=0.45), -03.6% (p=0.17), -0.2.0% (p=0.61) and 54.4% (p=0.00), respectively. The difference between gender of child and colostrum given was found to be significant (p = 0.04). No significant difference was found for sociodemographic variables and last pregnancy related variables with pre lacteal feeding and with exclusive breastfeeding. Most of the participants (74.0%) were aware of the suitable age for weaning. Most commonly given complementary food was found to be dal water / rice water (37.7%). Conclusion: There was a lack of knowledge about initiation of breastfeeding and type of food for starting complementary feeding. The knowledge-practice gap for exclusive breastfeeding for six months was found to be significantly high in urban, rural and slum areas of Chandigarh .
Support to the mother at the community level is crit- ical as a link between initiation of breastfeeding and continued breastfeeding and other infant and youngchildfeedingpractices, and is recommended by the WHO and UNICEF [14, 43]. Different forms of support for mothers in the community have been described and explored. These include counseling by lay CHWs, peer support groups run by trained mothers, mother support groups run by women in collaboration with health/nutri- tion professionals, and mother-to-mother support groups run by mothers [44–46]. Different forms of sup- port will be differently effective in different contexts, hence the need for context-specific adaptation of the type of support through formative research in the study context . We will conduct formative studies to adapt the intervention to the local context for example with regards to the counselling on nutritious, locally available foods. We will use CHWs to counsel mothers at the household level. The effectiveness of CHWs in health care delivery, particularly in child survival programs has been documented [35, 47, 48]. A study involving a non- randomized design in rural Kenya to determine the effect- iveness of the government’s Community Health Strategy (that involves use of CHWs to promote health in the com- munity) found that the strategy improved the prevalence
Natural disasters often worsen infant and youngchildfeedingpractices and cause great psychological distress to parents and other caretakers. Promoting optimal infant and youngchildfeedingpractices before, during, and after a disaster is critical for children’s long-term health and development. The findings of this review support the recommendations in the Operational Guidance on Infant and YoungChildFeeding. This systematic review identified complex relationships between breastfeeding, breastmilk substitutes, complementary feedingpractices, stress, and infant and youngchildfeedingpractices. Longitudinal research is needed to improve our understanding of these relationships as causal pathways, in addition to
The first 1000 days of life is considered as the critical window period for growth and development of children. WHO and UNICEF had put emphasis on this formative period i.e. 270 days in uterus and first two years after birth as an optimal period for adequate physical, mental and cognitive growth and development of the children. 1 Adequate nutrition during the infancy period is an early, appropriate and ideal intervention which helps the children to grow into full potential and reduces the risk of illness. 2 Though infant and youngchildfeedingpractices have been followed more than a decade, and globally it has failed to witness a remarkable progress except in exclusive breastfeeding. In 2015, only 45% of newborns
Objective quantification in the form of complementary feeding indices using WHO Indicators for assessing infant and youngchildfeedingpractices will enhance our efforts to focus on the various lacunae. WHO previously used the indicator ‘Timely complementary feeding rate’ which was a combination of 2 practices, i.e. continued breastfeeding and consumption of solid, semi-solid or soft foods, so it could not differentiate which out of the two was lacking, later on it was divided into 3 different set of indicators ‘Introduction of solid, semi-solid or soft foods’ and ‘Continued breastfeeding at 1 year’ and ‘Continued breastfeeding at 2 years’. 4
The present study was an attempt to gather evidence with regard to infant and youngchildfeedingpractices in community settings using standardized methods recommended by the WHO, allowing to plan and implement appropriate measures. WHO guidelines recommend that initiation of breastfeeding should begin soon after birth. 7 In the present study initiation of breastfeeding within one hour after birth was 88% which was higher as compared to NFHS-4 data in rural areas of Puducherry (53.2%). 5 This higher proportion of early initiation of breastfeeding could be probably attributed to effective antenatal advice delivered by healthcare providers leading to increased knowledge regarding importance of early initiation of breastfeeding.
Breastfeeding provides young infants with the nutrients they need for healthy growth and development. Apart from being a natural source of nourishment, human milk contains glycans and secretory immunoglobulin, which offer protection against infectious disease   reducing the morbidity and mortality due to infectious diseases in childhood . During the first six months of life, when digestive systems are not yet mature, exclusive breastfeeding offers additional protection from illness by limiting exposure to contaminated foods and liquids. This is particularly important in poor environments where early introduction of formula/animal milk is of par- ticular concern because of the risk of pathogens, contamination and over dilution of milk leading to increased risks of morbidity and under-nutrition. A pooled analysis of studies carried out in middle/low income countries showed that breastfeeding substantially lowered the risk of death from infectious diseases in the first two years of life  and optimal breastfeeding practices could prevent a substantial proportion of hospital admissions due to diarrhea and lower respiratory tract infection . A systematic review by Kramer et al. confirmed that exclu- sive breastfeeding in the first 6 months decreased morbidity from gastrointestinal and allergic diseases, without any negative effects on growth . A pooled analysis of data from 3 countries indicated that either predomi- nately or exclusively breastfed infants were at substantially lower risk for infant mortality than non-breastfed infants . Over the past decades, available evidence for the health advantages of breastfeeding has continued to increase and these health benefits are seen to extend into adulthood . Breastfeeding has protective roles against obesity, hypertension, dyslipidemia, and type II diabetes mellitus during adulthood that would have long-term beneficial health effects at individual and population levels . Given such evidences, the WHO has recommended that every child should be exclusively breastfed for the first six months of life with partial breast- feeding continued until two years of age .