• 식품보건융합연구
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• 제5권4호
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• pp.1-10
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• 2019

Significant low knowledge and poor attitudes on complementary feeding undermine the practices. This study was a cluster randomized controlled trial in which 284 study participants were assigned into two groups. One intervention group and a control group in a ratio of 1:1. Nutrition education on complementary feeding was carried out among the caregivers in the intervention group but the caregivers in the control group were not educated. To determine complementary feeding knowledge and attitudes, data was collected from caregiver at baseline, midline and at endline using researcher-administered questionnaires. Quantitative data were analyzed using SPSS version 22.0. From the analysis, there was a significant difference in complementary feeding knowledge of the caregivers after the intervention. The baseline difference was -0.06, the midline difference was 3.85 the endline difference was 4.00 and the DID of the baseline and endline was 4.06 which was significant at p=0.001. There was a significant difference in the attitude of the caregivers towards complementary feeding at baseline (-0.14), midline (2.09), endline (3.82) and the DID of baseline and endline was 3.96 which was significant at p=0.001. The intervention improved the caregivers' knowledge on complementary feeding and it improved the attitudes of the caregivers towards adequate complementary feeding.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권6호
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• pp.535-545
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• 2021

Purpose: This study aimed to analyze the practice of complementary feeding and its influencing factors in children under 2 years of age in Indonesia. Methods: This cross-sectional study used data obtained from the 2017 National Socioeconomic Survey. The sample totaled 1,751 households with children under 2 years of age, who received complementary feeding in urban and rural communities. Furthermore, the practice of complementary feeding was evaluated on the basis of the variations in provided food grouped into two categories: complete and incomplete. This study applied bivariate and multivariate analytical methods. Multivariate analysis was performed using binary logistic regression. Results: The proportion of children under 2 years of age who received complementary feeding with complete variant food was 15.9%, while that with incomplete variant food was 84.1%. Furthermore, the factor influencing the practice of complementary feeding among the children was the mother's educational level (odds ratio: 1.481, 95% confidence interval: 0.245-0.943). Conclusion: Complete complementary feeding, which involves a variety of food sources, is the best approach to improve the nutritional status of infants. Therefore, the source of food for complementary feeding must be accessible to all communities.

• 대한지역사회영양학회지
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• 제24권2호
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• pp.97-105
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• 2019

Objectives: This study examined whether the infant feeding type and duration are related to the introduction of complementary feeding, and whether the appropriate introduction of complementary feeding in infancy is related to tooth decay in toddlers. Methods: The subjects were 1,521 toddlers among 2~3 year old children in the Korea National Health and Nutrition Examination Survey from 2008 to 2015. The toddlers were divided into the appropriate group (4~6 months) and delayed group (>6 months) according to the timing of complementary feeding introduction. Results: The delayed group were 26.5% of subjects and the formula feeding period in the appropriate group and delayed group was 8.4 and 10.3 months, respectively (P=0.002). On the other hand, there was no difference in the breastfeeding period between the appropriate group and delayed group (P=0.6955). Early childhood caries was more common in the delayed group (P=0.0065). The delayed introduction of complementary feeding was associated with a risk of early childhood caries according to the logistic models (OR 1.81, 95% CI 1.27-2.57). Conclusions: The introduction of complementary feeding is associated with early childhood caries. Therefore, the importance of the proper introduction of complementary feeding in infancy should be emphasized, and public relations and education for maternal care and breastfeeding should be provided through health care institutions.

• 한국식생활문화학회지
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• 제35권1호
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• pp.97-106
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• 2020

This study aimed to evaluate dietary behaviors and food allergy status of preschool children in Gwangsan-gu, Gwangju Metropolitan city. The survey included 592 preschool children aged 1-5 years old in 31 childcare facilities. General characteristics, feeding type, complementary feeding, food allergy, dietary behaviors based on the NQ-P questionnaire, and dietary habits of their family were considered. Exclusively breast-fed children was 32.2% of the subjects and the breast feeding duration was 6.5 months. Subjects who had complementary feeding within 6 months was 77.2% and starting time of complementary feeding was 6.1 months. Fifteen percent of the subjects had food allergies and foods that induced allergy were instant foods, eggs, milk and dairy products, nuts, seafood. Food allergy was not related to breast feeding nor complementary feeding. The NQ-P score and its 3 factors including 'balance', 'moderation', and 'environment' were 59.9, 61.1, 56.0, 62.6, respectively. There were positive relations between children's dietary behaviors and family dietary habits such as breakfast eating frequency and meal regularity. As age of children increased, instant food intake increased and breakfast eating frequency decreased. Proper nutrition education is needed to children, their parents, and their care givers at childcare facilities to improve children's dietary behavior and health.

• Journal of Preventive Medicine and Public Health
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• 제55권6호
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• pp.549-558
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• 2022

Objectives: Poor complementary feeding practices have consistently contributed to the burden of child undernutrition in Indonesia. This study aimed to estimate the prevalence and predictors of the time of the introduction of solid, semi-solid, and soft foods (ISSSF), minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD). Methods: We analyzed 4804 last-born infants aged 6-23 months from the 2017 Indonesia Demographic and Health Survey, which employed multistage cluster random sampling. The outcomes were calculated based on the 2021 World Health Organization/United Nations Children's Fund guidelines. The predictors of the 4 complementary feeding indicators were assessed using multivariate Poisson regression with robust variance adjusting for potential confounders and study design. Results: The prevalence of ISSSF, MDD, MMF, and MAD was 86.1%, 54.3%, 71.8%, and 37.6%, respectively, with younger children less likely to meet 3 out of the 4 outcomes. Parental education, the presence of a birth attendant, and maternal media consumption were among the predictors of MDD and MAD. Children from families with higher income were more likely to meet MDD than those from low-income households (adjusted prevalence ratio [aPR], 1.16; 95% confidence interval [CI], 1.05 to 1.28). Living in an urban area was positively associated with MMF (aPR, 1.09; 95% CI, 1.04 to 1.15) and MAD (aPR, 1.12; 95% CI 1.02 to 1.24). In eastern regions, the prevalence of children achieving MDD and MAD was lower than in those living in Java and Bali. Conclusions: It is crucial that more attention and efforts are made to improve the recommended practices throughout Indonesia, since the prevalence of adequate complementary feeding practices remains low.

• Clinical and Experimental Pediatrics
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• 제64권8호
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• pp.408-414
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• 2021

Background: Complementary food in infancy is necessary for human growth, neurodevelopment, and health. However, the role of allergen consumption in early infancy and its effects on the development of food allergy or tolerance remain unclear. Purpose: To investigate the influence of age at the time of complementary food introduction on the development of asthma and atopic dermatitis in Korean children aged 1-3 years. Methods: We combined data from the Korea National Health and Nutrition Examination Survey collected from 2010 to 2014 and analyzed 1619 children aged 1-3 years who were included in the survey. Multivariate regression analysis was used to identify associations among type of feeding, age at the time of complementary food introduction, and doctor-diagnosed atopic dermatitis and asthma. Results: Age at the time of complementary food introduction was not significantly associated with doctor-diagnosed atopic dermatitis and asthma in children aged 1-3 years. In the univariate analysis, children with asthma showed higher water and sodium intake levels than nonasthmatic children. However, this relationship was not significant in the multivariate regression analysis. Conclusion: The present study revealed no statistically significant relationship between age at the time of complementary food introduction and the risk of atopic dermatitis and asthma in young Korean children. A national prospective study is needed to clarify the influence of age at the time of complementary food introduction on the development of allergic diseases.

• Clinical and Experimental Pediatrics
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• 제60권10호
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• pp.320-326
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• 2017

Purpose: This study aimed to evaluate a pilot project of the Nursing Feeding Center "Posyandu Plus" (NFCPP) through local food-based complementary feeding (LFCF) program designed to improve the nutritional status of children aged 6-36 months at community health centers in Indonesia. Methods: A quasi-experimental design was used to obtain data regarding the nutritional status of 109 children who participated in the project from 6 rural areas. The NFCPP was conducted for 9 weeks, comprising 2 weeks of preintervention, 6 weeks of intervention, and one week of postintervention. The LFCF intervention consisted of 12 sets of recipes to be made by mothers and given to their children 4 times daily over 6 weeks. The weight-for-age z score (WAZ), height-for-age z score (HAZ), weight-for-height z score (WHZ), and body mass index-for-age z score (BAZ) were calculated using World Health Organization Anthro Plus version 1.0.3. Results: LFCF intervention significantly increased WHZ, WAZ, and BAZ scores but decreased HAZ scores (P<0.001). Average scores of WHZ ($0.96{\pm}0.97$) and WAZ ($0.45{\pm}0.72$) increased; BAZ increased ($1.12{\pm}0.93$) after 6 weeks of LFCF. WAZ scores postintervention were 50.5% of normal, and WHZ scores were 77.1% of normal. However, the HAZ score decreased by $0.53{\pm}0.52$, which indicated 57.8% had short stature. Conclusion: The NFCPP program with LFCF intervention can improve the nutritional status of children in rural areas. It should be implemented as a sustained program for better provision of complementary feeding during the period of lactation using local food made available at community health centers.

• Nutrition Research and Practice
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• 제14권6호
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• pp.654-666
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• 2020

BACKGROUND/OBJECTIVES: This study aimed to evaluate how breastfeeding and complementary nutrition practices of mothers of 0-24-month-old children comply with the World Health Organization (WHO) recommendations for infant and young child feeding and to compare the results with selected demographic parameters related to the mother and child. SUBJECTS/METHODS: The research sample comprised mothers (n = 250) with children less than 2 years old. Data were obtained via questionnaire and were analyzed using SPSS 20.0 package program. The Pearson χ² or Fisher's exact tests were used for assessing relationships between categorical variables. The one-sample t-test was used for comparisons with reference values. RESULTS: Most mothers (97.2%) breastfed their babies immediately after birth. The mean time to breastfeeding after delivery was 47.8 ± 14.8 minutes, and 40.8% of the mothers complied with the WHO recommendation. Furthermore, 59.8% of the mothers exclusively breastfed their children for 6 months (mean 5.2 ± 1.5 months). The mean duration to the start of providing complementary food was 5.8 ± 0.6 months, and 76.1% of mothers who complied with the WHO recommendation. Only 12.3% of mothers breastfed their children for at least 12 months (mean 7.7 ± 3.3 months). On average, mothers gave cow milk to their children for the first time at 10.1 ± 1.7 months and honey at 11.8 ± 2.3 months. The mothers' rates of compliance with the WHO recommendations on cow milk and honey feeding were 32.0% and 71.6%, respectively. The rate of mothers who complied with the WHO minimum meal frequency recommendation was 88.3%. CONCLUSIONS: We suggest that the WHO recommendations on this subject will be realized more fully by emphasizing the importance of the positive effects of breastfeeding until the age of 2 years and of a timely start of complementary food provision. Such changes will affect child health over the long term.

• Clinical and Experimental Pediatrics
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• 제52권10호
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• pp.1090-1102
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• 2009

목 적:이유기의 영양은 영유아의 성장과 발달 뿐 아니라 성인 건강에도 장기적으로 영향을 미친다. 또한 이 시기의 영양섭취는 전적으로 보호자에게 의존하므로 보호자의 이유기 보충식에 대한 인식이 중요하다. 이에 본 영양위원회에서는 이유기 보충식 현황을 조사하여 과거 영양위원회 보고와 비교하고, 어머니의 이유기 보충식에 대한 인식 수준을 조사분석하여 문제점을 파악하고 영유아 영양 상담의 방향과 개선책을 제시하고자 하였다. 방 법:2008년 9월에서 12월까지 전국 14개 종합병원 소아청소년과를 방문한 9-15개월 영유아의 어머니를 대상으로 본 위원회에서 만든 설문지를 작성하도록 하였다. 총 1,078매 설문지를 SAS 9.1 통계프로그램을 이용하여 분석하였다. 결 과:이유기 보충식을 4-7개월에 89.3%에서 시작하였다. 93.3 %에서 처음 준 음식은 쌀미음이었고, 96.5%에서 숟가락으로 주기 시작하였다. 12-15개월 영유아를 대상으로 식품 도입 시기를 보면 6-7개월에 쇠고기를 준 경우는 43.2%였고 12개월 이전 소금 뿌린 김을 준 경우 35.3%, 된장국을 준 경우는 50.7%, 생우유를 준 경우는 10.7%였다. 이유기 보충식에 대한 정보원은 육아 책이나 잡지(57.9%), 친구나 또래 엄마(29.9%), 인터넷(28.7%), 부모나 친지(14.1%), 의료인(4.4%) 순이었다. 영양위원회에서 시행한 1993년 조사와 비교하면 4개월 이전 이유기 보충식을 시작한 경우(0.4% vs. 20.6%)와 시판 이유기 보충식으로 시작한 경우(6.7% vs. 38.8%)가 현저히 감소하였다. 숟가락으로 시작한 경우(96.5% vs. 57%)는 현저히 증가하였다. 어머니의 이유기 보충식에 대한 인식 수준에 대한 10문항을 점수화 하였을 때 평균 인식 점수는 $7.5{\pm}2.1$였고 다음 4문항에서 동의율이 낮았다: 고기를 이유기 초기에 도입해야 한다(57.4%), 분유(우유)가 두유보다 좋다(65.1%), 아기에게 이온음료를 먹일 필요가 없다(66.6%), 분유병은 15-18개월에 떼야 한다(67.5%). 인식 점수는 출생 순서가 빠른 경우, 어머니의 나이가 30대인 경우, 학력이 대졸 이상인 경우, 거주 지역이 서울과 경기 지역인 경우, 이유기 보충식에 대한 정보원이 의료인과 책이나 잡지인 경우에 가장 높았다. 결 론:이유기 보충식 실행 방법은 과거와 비교하여 현저하게 개선되었다. 소아청소년과 의사는 어떤 음식을 언제 도입하는지에 대한 체계적인 이유기 보충식 스케줄을 제공해야 하며 다양한 이유기 보충식에 대한 정보원을 관리 감독 해야 할 것이다.

• Nutrition Research and Practice
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• 제12권6호
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• pp.512-520
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• 2018

BACKGROUND/OBJECTIVES: The 6-23 months for infants is the longest period in the "first 1,000 days" of life. This period is very important for child development, so complementary feeding (CF) practices should be optimized to maximize children's potential for growth and development. The aim of this study was to analyze the CF practices and nutritional status of children aged 6-23 months. SUBJECTS/METHODS: For this cross-sectional study, 392 children aged 6-23 months were selected using stratified random sampling. Socio-demographic data were collected through interviews. CF practices, collected by interviews and repeated 24-hour food recall method, were the timely introduction of CF, minimum meal frequency, dietary diversity and minimum acceptable diet, consumption food rich in proteins and vitamin A. Nutritional status was assessed using the indicators of underweight, wasting and stunting. To analyze the association between socio-demographic indicators and CF with nutritional status, the chi-square test with a confidence interval of 95% was used. RESULTS: Results showed that 39% were exclusively breastfed, only 61% received prolonged breastfeeding and 50% received timely introduction of CF. Minimum meal frequency was met by 74% of subjects, but dietary diversity and minimum acceptable diet were only realized in 50% and 40% of the children, respectively. The prevalence of underweight, wasting, and stunting were 26%, 23%, and 28%, respectively. Age of the child, birth order, birth weight, parents' education level, family size and incidence of fever and diarrhea during the previous two weeks were associated with underweight, while child's birth order, fathers' education level, mother's age, family size, completion of the age-appropriate vaccination and fish consumption frequency were associated with wasting. Age of the child, incidence of fever and acute respiratory infection, and fortified food consumption were associated with stunting. CONCLUSIONS: Suboptimal CF practices and high prevalence of underweight, wasting and stunting were found among children aged 6-23 months old in Aceh. These results highlight the need to improve CF and nutritional status.