Risk Factors for Severe Acute Malnutrition in Children below 5 y of Age in India: A Case-Control Study

Department of Pediatrics, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi, 110001, India.
The Indian Journal of Pediatrics (Impact Factor: 0.87). 07/2013; 81(8). DOI: 10.1007/s12098-013-1127-3
Source: PubMed


To determine the possible risk factors for severe acute malnutrition (SAM) in children below 5 y admitted in a hospital in north India.
This case-control study was conducted in a medical college hospital in children below 5 y of age. All cases of SAM (diagnosed as per WHO definition) between 6 and 59 mo of age were compared with age-matched controls with weight for height above -2SD of WHO 2006 growth standards. Data regarding socio-demographic parameters, feeding practices and immunization were compared between the groups by univariable and multivariable logistic regression models.
A total of 76 cases and 115 controls were enrolled. Among the 14 factors compared, maternal illiteracy, daily family income less than Rs. 200, large family size, lack of exclusive breast feeding in first 6 mo, bottle feeding, administration of pre-lacteals, deprivation of colostrum and incomplete immunization were significant risk factors for SAM. Regarding complementary feeding, it was the consistency, rather than the age of initiation, frequency and variety which showed a significant influence on occurrence of SAM. Multivariate analysis revealed that the risk of SAM was independently associated with 6 factors, namely, illiteracy among mothers, incomplete immunization, practice of bottle feeding, consistency of complementary feeding, deprivation of colostrum and receipt of prelacteals at birth.
The present study identifies certain risk factors which need to be focused on during health planning and policy making related to children with SAM in India.

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    • "Children having sub optimal frequency of complementary feeding were more likely severely wasted than those children having optimal frequency of complementary feeding were. This result is consistent with many studies conducted in Ethiopia, Africa and globally[11,12,17,18,212223. And the finding of this study also supports one of the health sector policy of strengthening infant and young child feeding practices to prevent child mortality[24]. "

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    ABSTRACT: The authors studied the outcome of 108 infants < 6 mo with severe acute malnutrition (SAM) admitted in the Nutritional Rehabilitation Centres (NRC) at a teaching hospital. The most common symptom that the children presented with, was acute diarrhoea (35.2 %) followed by failure to gain weight (26.9 %). Seventy five (69.4 %) infants were cured after nutritional rehabilitation and 29 (26.8 %) were non responders. Fifty two (48 %) infants showed good weight gain after proper counseling or supplementary suckling technique alone.
    No preview · Article · Nov 2013 · The Indian Journal of Pediatrics
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    ABSTRACT: Background: Poor breastfeeding and complementary feeding practices may contribute to childhood malnutrition in the developing world. Objective: The objective was to examine the determinants of timely initiation of complementary feeding among Nigerian children. Materials and Methods: Using a cross-sectional design, children aged 6-24 months were surveyed in a Nigerian Teaching Hospital. Children with timely initiation of complementary feeding (6-8 months) were compared with children with untimely initiation of complementary feeding early (< 6 months and > 8 months) for clinical and social characteristics using both bivariate and multivariate analysis. Results: Of 156 children, 41%, 53.8%, and 5.1% had timely, early and delayed initiation of complementary feeding. Complementary feeding was initiated with processed cereals (44.8%), locally prepared maize gruel (32.1%) and mashed family diet (23.1%). Bivariate analysis showed significant association between timely initiation of complementary and orthodox maternity care, no prelacteal feeding, exclusive breastfeeding, no siblings and first birth order. Parental education was not associated with timely initiation of complementary feeding. Multivariate analysis identified orthodox maternity care, exclusive breastfeeding and no siblings as independent predictors of timely initiation of complementary feeding. Conclusion: Complementary feeding is most frequently initiated earlier than 6 months in this population. Good breastfeeding practices may influence timely initiation of complementary feeding. Interventions should be targeted at the entire population irrespective of educational and socioeconomic status.
    No preview · Article · Nov 2014 · Nigerian journal of clinical practice
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