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Cluster-Randomized Trial on Complementary and Responsive Feeding Education to Caregivers Found Improved Dietary Intake, Growth and Development among Rural Indian Toddlers

Citation

Vazir, Shahnaz; Engle, Patrice L.; Balakrishna, Nagalla; Griffiths, Paula L.; Johnson, Susan L.; Creed-Kanashiro, Hilary M.; Fernandez Rao, Silvia; Shroff, Monal R.; & Bentley, Margaret E. (2013). Cluster-Randomized Trial on Complementary and Responsive Feeding Education to Caregivers Found Improved Dietary Intake, Growth and Development among Rural Indian Toddlers. Maternal & Child Nutrition, 9(1), 99-117. PMCID: PMC3434308

Abstract

Inadequate feeding and care may contribute to high rates of stunting and underweight among children in rural families in India. This cluster-randomized trial tested the hypothesis that teaching caregivers appropriate complementary feeding and strategies for how to feed and play responsively through home-visits would increase children's dietary intake, growth and development compared with home-visit-complementary feeding education alone or routine care. Sixty villages in Andhra Pradesh were randomized into three groups of 20 villages with 200 mother-infant dyads in each group. The control group (CG) received routine Integrated Child Development Services (ICDS); the complementary feeding group (CFG) received the ICDS plus the World Health Organization recommendations on breastfeeding and complementary foods; and the responsive complementary feeding and play group (RCF&PG) received the same intervention as the CFG plus skills for responsive feeding and psychosocial stimulation. Both intervention groups received bi-weekly visits by trained village women. The groups did not differ at 3 months on socioeconomic status, maternal and child nutritional indices, and maternal depression. After controlling for potential confounding factors using the mixed models approach, the 12-month intervention to the CFG and RCF&PG significantly (P < 0.05) increased median intakes of energy, protein, Vitamin A, calcium (CFG), iron and zinc, reduced stunting [0.19, confidence interval (CI): 0.0-0.4] in the CFG (but not RCF&PG) and increased (P < 0.01) Bayley Mental Development scores (mean = 3.1, CI: 0.8-5.3) in the RCF&PG (but not CFG) compared with CG. Community-based educational interventions can improve dietary intake, length (CFG) and mental development (RCF&PG) for children under 2 years in food-secure rural Indian families.

URL

http://dx.doi.org/10.1111/j.1740-8709.2012.00413.x

Reference Type

Journal Article

Year Published

2013

Journal Title

Maternal & Child Nutrition

Author(s)

Vazir, Shahnaz
Engle, Patrice L.
Balakrishna, Nagalla
Griffiths, Paula L.
Johnson, Susan L.
Creed-Kanashiro, Hilary M.
Fernandez Rao, Silvia
Shroff, Monal R.
Bentley, Margaret E.

PMCID

PMC3434308