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. 2009 Jul;5(3):260-75.
doi: 10.1111/j.1740-8709.2008.00179.x. Epub 2009 Feb 10.

Inadequate feeding practices and impaired growth among children from subsistence farming households in Sidama, Southern Ethiopia

Rosalind S Gibson  1 , Yewelsew Abebe, K Michael Hambidge, Isabel Arbide, Aklilu Teshome, Barbara J Stoecker
Affiliations

Inadequate feeding practices and impaired growth among children from subsistence farming households in Sidama, Southern Ethiopia

Rosalind S Gibson et al. Matern Child Nutr. 2009 Jul.

Abstract

Whether current child feeding practices and behaviours among rural households in Sidama, Southern Ethiopia conform to the World Health Organization (WHO) guiding principles for complementary feeding is uncertain. We assessed socio-demographic status, anthropometry, breastfeeding, complementary feeding practices and behaviours, and motor development milestones in a convenience sample of 97 breastfed children aged 6-23 months from three rural Sidama communities. Energy and nutrient intakes from complementary foods were also calculated from 1-day in-home weighed records. Prevalence of stunting ranged from 25% for infants aged 6-8 months to 52% for children aged 12-23 months, whereas for wasting, the corresponding prevalence was 10% and 14%, respectively. Very few children were exclusively breastfed up to 6 months of age (n = 2), or received solids/semi-solids for the recommended minimum number of times containing the recommended number of food groups. Responsive feeding was not practised and no cellular animal products were consumed. Median intakes of energy, and intakes and densities of micronutrients from complementary foods (but not protein) were below WHO recommendations, assuming average breast milk intakes; greatest shortfalls were for retinol, vitamin C and calcium densities. Mothers of stunted children were shorter and lighter, and from households of lower socio-economic status than non-stunted children (P < 0.05). Acquisition of some motor development milestones was delayed in stunted infants compared with their non-stunted counter-parts. In conclusion, interventions that address the WHO guiding principles for complementary feeding practices and behaviours, as well as prenatal influences on growth, are urgently required in this setting.

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Conflict of interest statement

Key messages

  1. •

    Interventions among subsistnce farming households in Sidama, Southern Ethiopia need to promote exclusive breastfeeding up to 6 months of age, and the use of cereal‐based porridges in place of maize bread for complementary feeding.

  2. •

    Cereal‐based porridges should be enriched with micronutrient‐rich animal‐source foods such as eggs or animal milk, as well as fruits and vegetables such as mango, papaya, pumpkin, kale and/or avocado containing provitamin A carotenoids, vitamin C and in some cases fat.

  3. •

    Caregivers should be educated on the importance of responsive feeding, especially during and after illness, and the safe preparation and storage of complementary foods.

  4. •

    Interventinos should also address prenatal influences on growth to reduce the high rate of stunting during early childhood in subsistence farming households in rural Sidama.

References

    1. Abebe Y., Bogale A., Hambidge K.M., Stoecker B.J., Arbide I., Teshome A. et al. (2008) Inadequate intakes of dietary zinc among pregnant women from subsistence households in Sidama, Southern Ethiopia. Public Health Nutrition 11, 379–386. - PubMed
    1. Abebe Y., Bogale A., Hambidge K.M., Stoecker B.J., Bailey K., Gibson R.S. et al. (2007) Phytate, zinc, iron and calcium content of selected raw and prepared foods consumed in rural Sidama, Southern Ethiopia, and implications for bioavailability. Journal of Food Composition and Analysis 20, 161–168.
    1. Ågren G. & Gibson R.S. (1968) Food composition table for use in Ethiopia. Report No. 16. Child Nutrition Unit: Addis Ababa, Ethiopia.
    1. Allen L.H., Backstrand J.R., Stanek E.J., Pelto G.H., Chavez Molina E., Castillo J.B. et al. (1992) The interactive effects of dietary quality on the growth and attained size of young Mexican children. American Journal of Clinical Nutrition 56, 353–364. - PubMed
    1. Anderson V.P., Cornwall J., Jack S. & Gibson R.S. (2008) Intakes from non‐breast milk foods for stunted toddlers living in poor urban villages of Phnom Penh, Cambodia are inadequate. Maternal & Child Nutrition 4, 146–159. - PMC - PubMed

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