UBC Theses and Dissertations
Adherence to complementary feeding guidelines as a predictor of better health outcomes in infants six to twenty four months of age in Cambodia Omidakhsh, Negar
Rates of child malnutrition in Cambodia have continued to rise throughout the last ten years despite marginal improvements in food security. After 6 months of age, when complementary feeding often begins, rates of stunting in Cambodia increase from 16% to 42% (CDHS, 2010). Given that the first two years of life are the most important for physical and cognitive development, addressing the health consequences that result from malnutrition is a priority. In the current thesis, I hypothesized that a) infants whose caregivers adhered to at least 80% of Cambodia’s complementary feeding guidelines were less likely to have had diarrhea in the last two weeks, to be anemic or to be stunted and b) infants whose caregivers adhered to at least 80% of the guidelines would have greater dietary diversity than infants whose caregivers did not adhere. To test these hypotheses, I utilized data from a cross sectional survey conducted by The Joint Program for Children, Food Security, and Nutrition in Cambodia. Infant caregivers were defined as adhering to the guidelines if they complied with at least 80% of each one of Cambodia’s five complementary feeding recommendations. I utilized logistic regression to estimate the risk of diarrhea, anemia and stunting among infants whose caregivers adhered compared to those whose caregivers did not adhere to the guidelines. Only 36 (5.1%) caregivers adhered to at least 80% of Cambodia’s complementary feeding guidelines. I did not observe any excess risk for diarrhea in the preceding two weeks, anemia or stunting among infants whose caregivers did not adhere to the feeding guidelines. There was minimal difference in dietary diversity between the two groups. Consumption of meat, grains, legumes, dairy, and vitamin A rich foods varied by at most 13% between infants whose caregivers adhered and did not adhere to the guidelines. My results indicate that the overwhelming majority of families in Cambodia are not adhering to Cambodia’s current complementary feeding guidelines. Furthermore, adherence is not associated with greater dietary diversity or better pediatric health outcomes. Future studies should consider testing the utility of guidelines that incorporate recommendations for dietary diversity to improve health outcomes.
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