Observation of Traditional Caregiver-Infant Feeding Behaviours and Porridge and Energy Intakes during One Meal to Define Key Messages for Promoting Responsive Feeding in the Amparafaravola District, Rural Madagascar
2022
Yannick Razafindratsima | Andrimampionona Razakandrainy | Sonia Fortin | Charlotte Ralison | Claire Mouquet-Rivier
Undernutrition is highly prevalent in young children in Madagascar and insufficient intake per meal could be one of the main causes. A cross-sectional survey of infant feeding practices including video-recorded meal observations was carried out with 101 caregiver&ndash:infant pairs in the Amparafaravola district, Northeast Madagascar. The objective was to quantify the porridge/energy intake of 9&ndash:11-month-old children and assess its association with the caregiver&ndash:infant feeding behaviours. Then, key messages for promoting responsive feeding (RF) were developed and tested through focus group discussions. The mean porridge intake was 12.8 ±: 7.5 g/kg body weight (BW)/meal, corresponding to hardly one-third of the 300 kcal recommended from complementary foods for 9&ndash:11-month-old children. Analysis of meal videos suggested that mothers practiced the five positive feeding behaviours (self-feeding, responsive, active, social, and distraction), and rarely the negative ones. Only 6.9% of mothers used positive RF &ldquo:very frequently&rdquo:, although it was associated with higher intakes (p <: 0.05), with mean intake reaching 21 g/kg BW. In focus groups, caregivers approved the six RF messages and related counselling cards. They suggested some modifications to improve their understanding, and counselling cards were revised accordingly. The long-term impact of RF-promoting card use on the meal intakes and the nutritional status of young children must now be assessed.
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