Cluster‐randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth and development among rural Indian toddlers
Abstract Inadequate feeding and care may contribute to high rates of stunting and underweight among children in rural families in India. This cluster‐randomized trial tested the hypothesis that teaching caregivers appropriate complementary feeding and strategies for how to feed and play responsively...
| Principais autores: | , , , , , , , , |
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| Formato: | Artigo |
| Idioma: | English |
| Publicado em: |
Wiley
2013-01-01
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| coleção: | Maternal and Child Nutrition |
| Assuntos: | |
| Acesso em linha: | https://doi.org/10.1111/j.1740-8709.2012.00413.x |
| _version_ | 1826529877224849408 |
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| author | Shahnaz Vazir Patrice Engle Nagalla Balakrishna Paula L. Griffiths Susan L. Johnson Hilary Creed‐Kanashiro Sylvia Fernandez Rao Monal R. Shroff Margaret E. Bentley |
| author_facet | Shahnaz Vazir Patrice Engle Nagalla Balakrishna Paula L. Griffiths Susan L. Johnson Hilary Creed‐Kanashiro Sylvia Fernandez Rao Monal R. Shroff Margaret E. Bentley |
| author_sort | Shahnaz Vazir |
| collection | DOAJ |
| description | Abstract Inadequate feeding and care may contribute to high rates of stunting and underweight among children in rural families in India. This cluster‐randomized trial tested the hypothesis that teaching caregivers appropriate complementary feeding and strategies for how to feed and play responsively through home‐visits would increase children's dietary intake, growth and development compared with home‐visit‐complementary feeding education alone or routine care. Sixty villages in Andhra Pradesh were randomized into three groups of 20 villages with 200 mother–infant dyads in each group. The control group (CG) received routine Integrated Child Development Services (ICDS); the complementary feeding group (CFG) received the ICDS plus the World Health Organization recommendations on breastfeeding and complementary foods; and the responsive complementary feeding and play group (RCF&PG) received the same intervention as the CFG plus skills for responsive feeding and psychosocial stimulation. Both intervention groups received bi‐weekly visits by trained village women. The groups did not differ at 3 months on socioeconomic status, maternal and child nutritional indices, and maternal depression. After controlling for potential confounding factors using the mixed models approach, the 12‐month intervention to the CFG and RCF&PG significantly (P < 0.05) increased median intakes of energy, protein, Vitamin A, calcium (CFG), iron and zinc, reduced stunting [0.19, confidence interval (CI): 0.0–0.4] in the CFG (but not RCF&PG) and increased (P < 0.01) Bayley Mental Development scores (mean = 3.1, CI: 0.8–5.3) in the RCF&PG (but not CFG) compared with CG. Community‐based educational interventions can improve dietary intake, length (CFG) and mental development (RCF&PG) for children under 2 years in food‐secure rural Indian families. |
| first_indexed | 2025-03-14T01:10:32Z |
| format | Article |
| id | doaj.art-43785e3f30514488988578869c50e689 |
| institution | Directory Open Access Journal |
| issn | 1740-8695 1740-8709 |
| language | English |
| last_indexed | 2025-03-14T01:10:32Z |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Maternal and Child Nutrition |
| spelling | doaj.art-43785e3f30514488988578869c50e6892025-03-13T13:16:19ZengWileyMaternal and Child Nutrition1740-86951740-87092013-01-01919911710.1111/j.1740-8709.2012.00413.xCluster‐randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth and development among rural Indian toddlersShahnaz Vazir0Patrice Engle1Nagalla Balakrishna2Paula L. Griffiths3Susan L. Johnson4Hilary Creed‐Kanashiro5Sylvia Fernandez Rao6Monal R. Shroff7Margaret E. Bentley8Behavioral Sciences Unit of Field Studies, National Institute of Nutrition (ICMR), Hyderabad, IndiaDepartment of Psychology and Child Development, Cal Poly State University, San Luis Obispo, California, USADivision of Statistics, National Institute of Nutrition (ICMR), Hyderabad, IndiaSchool of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UKDepartment of Pediatrics, Section of Nutrition, University of Colorado Denver, Aurora, Colorado, USAInstituto de Investigación Nutricional, Av. La Molina 1885, Lima, PeruBehavioral Sciences Unit of Field Studies, National Institute of Nutrition (ICMR), Hyderabad, IndiaDepartment of Epidemiology, University of Michigan, Michigan, USADepartment of Nutrition, University of North Carolina, Chapel Hill, North Carolina, USAAbstract Inadequate feeding and care may contribute to high rates of stunting and underweight among children in rural families in India. This cluster‐randomized trial tested the hypothesis that teaching caregivers appropriate complementary feeding and strategies for how to feed and play responsively through home‐visits would increase children's dietary intake, growth and development compared with home‐visit‐complementary feeding education alone or routine care. Sixty villages in Andhra Pradesh were randomized into three groups of 20 villages with 200 mother–infant dyads in each group. The control group (CG) received routine Integrated Child Development Services (ICDS); the complementary feeding group (CFG) received the ICDS plus the World Health Organization recommendations on breastfeeding and complementary foods; and the responsive complementary feeding and play group (RCF&PG) received the same intervention as the CFG plus skills for responsive feeding and psychosocial stimulation. Both intervention groups received bi‐weekly visits by trained village women. The groups did not differ at 3 months on socioeconomic status, maternal and child nutritional indices, and maternal depression. After controlling for potential confounding factors using the mixed models approach, the 12‐month intervention to the CFG and RCF&PG significantly (P < 0.05) increased median intakes of energy, protein, Vitamin A, calcium (CFG), iron and zinc, reduced stunting [0.19, confidence interval (CI): 0.0–0.4] in the CFG (but not RCF&PG) and increased (P < 0.01) Bayley Mental Development scores (mean = 3.1, CI: 0.8–5.3) in the RCF&PG (but not CFG) compared with CG. Community‐based educational interventions can improve dietary intake, length (CFG) and mental development (RCF&PG) for children under 2 years in food‐secure rural Indian families.https://doi.org/10.1111/j.1740-8709.2012.00413.xfeeding methodsresponsive complementary feedingtoddlergrowth and development |
| spellingShingle | Shahnaz Vazir Patrice Engle Nagalla Balakrishna Paula L. Griffiths Susan L. Johnson Hilary Creed‐Kanashiro Sylvia Fernandez Rao Monal R. Shroff Margaret E. Bentley Cluster‐randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth and development among rural Indian toddlers Maternal and Child Nutrition feeding methods responsive complementary feeding toddler growth and development |
| title | Cluster‐randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth and development among rural Indian toddlers |
| title_full | Cluster‐randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth and development among rural Indian toddlers |
| title_fullStr | Cluster‐randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth and development among rural Indian toddlers |
| title_full_unstemmed | Cluster‐randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth and development among rural Indian toddlers |
| title_short | Cluster‐randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth and development among rural Indian toddlers |
| title_sort | cluster randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake growth and development among rural indian toddlers |
| topic | feeding methods responsive complementary feeding toddler growth and development |
| url | https://doi.org/10.1111/j.1740-8709.2012.00413.x |
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