Original Article
Child caring and complementary feeding practices among selected households in Dhaka city Bhuyan MAH, Islam K, Ali MY, Kurshed AAM, Rana MM, Khan S The ORION Medical Journal 2010 Jan; 33(1):718-721
Abstract The study was carried out among the 183 mother-infant pairs of the upper, middle and lower socio-economic households (SEH) in Dhaka city and the two stage purposive random sampling methods were applied. The study was conducted in following areas of Dhaka city which were selected purposively as per study objectives and the study places depending upon communication, availability of the samples in Gulshan, Banani, Dhanmondi, Mohammadpur, Maghbazar, Tejgaon, Malibagh, Baridhara, Mirpur and Ramna. From the background information it was found that upper SEH (72.13% Graduate) and middle SEH (52.46% Graduate) were better educated compared to that of lower one (26.23% illiterate). Majority of upper and middle SEH mothers worked in the Govt. and NGO services, while 17% of lower SEH mothers were shopkeeper. In the lower SEH, elder persons and siblings took care of the infant; in middle SEH other family members and siblings took care of the infant; maid servants took care of the infant in upper SEH. There was a significant difference observed in total monthly income and expenditure on foods and non-food items. From the food behavior related information, it was seen that colostrums was given to their babies 1. Dr. Md. Aminul Haque Bhuyan, Ph.D Professor, Institute of Nutrition and Food Science (INFS), University of Dhaka e-mail:
[email protected] 2. Dr. Khaleda Islam, Ph.D Professor of Clinical Nutrition, INFS, University of Dhaka 3. Md. Yousuf Ali Ex. M.S Researcher, INFS, University of Dhaka 4. Ali Abbas Mohammad Kurshed M.S Researcher, INFS, University of Dhaka 5. Md. Masud Rana , M.S Researcher, INFS, University of Dhaka 6. Sabina Khan, Assistant Professor Bangladesh Home Economics College, Dhanmondi Dhaka
The ORION. Vol 33, Issue 1, January 2010
in upper, middle and lower SEH which were 75.11%, 85.25% and 47.54% respectively. Lower SEH preferred to give honey and sugary water. In upper SEH breast feeding initiated within 1 hour, but in middle and lower SEH it was given within 12 hours. The upper SEH mothers gave fruit juices (47.54%) as first complementary foods, on contrast to the middle and lower SEH mothers who gave mainly Khichuri with vegetables and rice/cereal based products respectively. In the lower SEH mothers breast feeding continued longer times more than middle and upper SEH. Majorities of the upper SEH preferred egg, soup or fruit/fruit juices mainly, while the middle SEH preferred meat, egg, Khichuri, fruit purees and lower SEH choose mainly the rice-potato, dal or vegetables. The anthropometric information showed that nutritional status of the upper SEH infants were better than other two groups. Introduction After birth to six-months exclusive breastfeeding is very necessary for the baby. After the end of the six months, complementary food is also necessary for the baby. It is very important for the baby that after completion of the six months, giving complementary food to the baby to meet the nutritional demand and their growth is essential.1 Mothers are the primary caretakers of children only in early infancy.2 Older siblings, Grandparents, and members of the extended household regularly take care of preschool children even when the mother is not employed outside the home. Children's nutrition is often worse with non maternal (particularly sibling) caretakers. The quality of childcare and the employment conditions matter a great deal.
www.orion-group.net/journals www.orion-group.net/medicaljournal
Original Article Care practices and resources for care are important not only for the good nutritional status of children, but also for their growth and development. Care, as it came to be defined during the 1990's, refers to the behavior and practices of caregivers (mothers, siblings, fathers, and childcare providers) who provide the food, health care, psychosocial stimulation and emotional support necessary for the healthy growth and development of children.3 These practices and the ways in which they are performed (with affection and with responsiveness to children) are critical to survival, growth, and development of children. They translate food security and health care into a child's well being. Adequate care is important not only for the child's survival but also for optimal physical and mental development and good health. Care also contributes to the child's general wellbeing and happiness, otherwise termed a good quality of life. Therefore the present study was undertaken among selected socio-economic sections of Dhaka city to understand child caring and complementary feeding practices. Methods and materials Type of study: This was a descriptive type of cross sectional study. Study population: This study was conducted among the upper, middle and lower socioeconomic households (SEH) were having mother-child pair in different selected areas of Dhaka city. Study period: The study was conducted from January 2008 to October 2008 which included questionnaire development, data entry, analysis and final reporting of the study. Data collection period: 15th February 2008 to 15th March 2008. Sampling technique and sample size: Two-stage purposive samplings were applied.
The ORION. Vol 33, Issue 1, January 2010
Selection of socio-economic households: At first, a pilot survey was done among the different locations of Dhaka city and the information about socio-economic conditions such as income, expenditure, savings-lone, profession, uses of transport system, place of living areas, condition of living areas, personal hygiene, socio-culture behavior and food intake pattern were collected. After collecting these information depending on their income and life styles, it is divided into three socio-economic classes. Upper socio-economic households (Upper SEH), middle socio-economic households (Middle SEH) and lower socioeconomic households (Lower SEH). Upper socio-economic households (Upper SEH): Economically they were sound and their life styles are luxurious, they used personal car, sometimes taking food from aristocratic hotel and restaurant and fast foods shop. They are highly educated as well as done a good job, or have an established business of different Govt. officer, national and multinational authorities. Although upper class was seen throughout the Dhaka city, they are mostly included from Gulshan, Banani and Dhanmondi areas of Dhaka city. Their monthly family income was purposively taken to be above Taka 50 thousand only. Middle socio-economic households (Middle SEH): Economically they are also sound but they do not have luxurious life. They are educated and have a good job also, but they are bonded with the family and all the members are not self-dependent. Their income and expenditure is more or less same and they were living the entire city but mainly included from Mohammadpur, Mirpur and Ramna areas of Dhaka city. Their monthly family income was purposively taken to be between Taka 20 to 30 thousand only. Lower socio-economic households (Lower SEH): Economically they are poor or deprived of many modern amenities of life. Their income is very poor, professionally they are employees www.orion-group.net/journals www.orion-group.net/medicaljournal
Original Article of government & private, petty business men, shop keepers at the same time they mainly live in extended family. Their living rooms or conditions is not good enough as well as their surrounding hygienic condition. They were mainly included from Maghbazar, Tejgaon, Malibagh. Their monthly family income was purposively taken to be below Taka 20 thousand only.
graduate. Among The upper socio-economic households 72.13% were completed graduate and 24.59% passed HSC level. The table also shows that in upper socio-economic households 32.79% & 42.62%, middle socio-economic households 16.39% & 31.15% and lower socioeconomic households 13.11% and 21.31% respondents' mothers were involved in Govt. and NGO job respectively.
Collection of data: The selected 183 motherinfant pairs of upper, middle and lower socioeconomic households were interviewed separately through questionnaire. In this way data were collected from 183 mothers in different classes in the different areas of Dhaka city.
Table 1: Information about Socio-economic information of the respondents
Data analysis: The data set were first checked, cleaned and entered into the computer from the numerical codes on the form. The data was edited if there is any discrepancy. The frequency distributions of the entire variables were checked by using SPSS. 12.0 windows program. For purposive data analysis, the raw anthropometric data of SPSS 12.0 were transferred to 'anthro' version 1.01 to obtain derived indices of anthropometric measurements, such as weight for age Z-score (WAZ), height for age Z-score (HAZ) and weight for height Z-score (WHZ), percentiles and median of children and BMI for adults. The indices obtained from 'anthro' version 1.01 were then transferred again to the SPSS 12.0 windows for further analysis on the basis of different socio-economic and cultural aspects. For tabular, charts and graphical representation Microsoft word and Microsoft excel were used. Results Socio-economic characteristics of the respondents: Table-1 Shows that more than 26.23% of the lower socio-economic households were illiterate, 29.51% completed primary level, and 19.67% accomplished SSC level. Among the middle socio-economic households 19.67% completed SSC level, 27.87% completed HSC level and 52.46% were The ORION. Vol 33, Issue 1, January 2010
Middle Upper sociosocioCharacteristics economic economic households households Educational level Illiterate 0(0.0) 0(0.0) Primary 0(0.0) 0(0.0) SSC 2(3.28) 12(19.67) HSC 15(24.59) 17(27.87) Graduate 44(72.13) 32(52.46) Occupation House wife 10(16.39) 25(40.98) Business man 5(8.20) 6(9.84) Govt. service 20(32.79) 10(16.39) holder Privt. Service 26(42.62) 19(31.15) holder Shop keeper 0(0.0) 0(0.0) Others 0(0.0) 1(1.64) Familly size 8 3(4.92) 6(9.48)
Lower socioeconomic households 16(26.23) 18(29.51) 12(19.67) 9(14.75) 5(8.2) 7(11.48) 12(19.67) 8(13.11) 13(21.31) 17(27.87) 4(6.56) 12 (19.67) 26(42.62) 23(37.70)
More than seventy percent (70.49%) of the upper socio-economic households had smaller family size i.e. less than five members while 57.38% middle socio-economic households and 19.67% lower socio-economic households had smaller family size. On the other hand, 37.70% of the lower socio-economic households had larger family size i.e. more than eight members while 9.84% middle socio-economic households and 4.92% lower socio-economic households had larger family size. Child caring practices: Figure 1 shows the distribution of the working respondents spend their times in the outside and indicated that 57% of lower socio-economic households www.orion-group.net/journals www.orion-group.net/medicaljournal
Original Article respondent mothers spent more than 8 hours time outside home while in case of upper and middle socio-economic households respondent mothers it was 21.57% and 22.22% respectively.
Table 2 : Distribution of the infants by their age Age(Month)
