Trials of Improved Practices (TIPs) for Promoting Complementary Feeding for Infants Aged 9-12 Months
Keywords:
Trials of Improved Practices (TIPs), complementary feeding, children 9-12 months oldAbstract
This study aims to examine the effectiveness of the ‘Trials of Improved Practices’ (TIPs)’ to improve the promotion of food-based recommendations (FBR) for infants aged 9-12 months. Thirty-two mothers/child caregivers were recruited. TIPs is a participatory formative research. Researchers conducted home visits on days 1, 3, and 7 to provide key FBR messages, i.e., providing egg, liver, blood, and frequency of feeding each food per week, using a poster. A mixed method of quantitative and qualitative methods was used for data collection at baseline and after each home visit on days 1, 3, and 7. Quantitative data included child, mother and family characteristics, child feeding practices, 24 h dietary recall at baseline and 7 days after TIPs to assess frequency of eating the recommended foods and nutrient intakes. Qualitative data was collected by an in-depth interview of mothers/caretakers on FBR knowledge and acceptability, facilitating factors and obstacles to practice the FBR. Mothers/caregivers (n=16) were visited one month later to collect weekly records on child feeding. Proportion of mothers/child caregivers who followed FBR, feeding frequency and amount per feed of each food (egg, liver, blood) significantly increased. Median intakes of energy and macro-nutrients were comparable before and after 7 days. Vitamin A intakes significantly increased (447 [96, 676] vs 1002 [329, 1454]) µg RE/d, p = 0.036)); the increase in iron intakes was not significant (7.98 [2.08, 11.2] vs 8.6 [5.24, 13.9] mg/d, p >0.05). Proportion of children receiving each of the FBR foods and frequency per week during the one-month follow-up were not significantly different. Factors affecting practices on recommended complementary feeding included mothers/caregivers having reliable knowledge and awareness of benefits on child health, child acceptance, influence and support by family members and community, and food environment which mothers/caregivers interact with the food system, encompassing accessibility, affordability, local culture and tradition. In conclusion, use of TIPs for promoting complementary feeding with participation of mothers/caregivers resulted in improved feeding practices and increased key micronutrient intakes. Key factors included mothers/caregivers gained knowledge and supports, acceptability, self-efficacy, and food environment conducive to practices.
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