Maternal Nutritional Status and Child Feeding Practices in Santal Communities of West Bengal

Background

  • Geographic Context: Study focused on Santal communities in Birbhum District, West Bengal, India.
  • Health Statistics: The National Family Health Survey (NFHS-4, 2015-16) highlighted significant rates of undernutrition and anemia among scheduled tribe women and children.

Research Goals

  • Objective: Assess maternal nutritional status and child feeding practices with an aim to inform clinical practices and shape future interventions.
  • Focus: Relationship between maternal and child nutritional status, particularly in the context of child feeding practices.

Research Methods

  • Participants: 288 mothers and 307 children enrolled via a baseline survey in 21 tribal villages.
  • Data Collection: Utilization of HemoCue Hb201+ for hemoglobin levels and anthropometric measurements (height/length, weight, MUAC).
  • Interview Focus: Questionnaire-based interviews covered child feeding practices, childcare dynamics, family scheduling, and prenatal care.

Findings

Maternal Nutritional Status
  • Undernutrition Impact: 49.4% of mothers identified as underweight (BMI < 18.5). Severe anemia affected 86.2% of mothers.
  • Nutrition Correlation: Poor maternal nutrition correlates with the poor nutritional status of children, highlighting intergenerational transmission of malnutrition.
Child Feeding Practices
  • Breastfeeding Rates: 99.6% of infants under 12 months were breastfed. Initiation within the first hour post-birth occurred in 75.7% of cases.
  • Colostrum: About 32.2% of children missed out on receiving colostrum.
  • Exclusive Breastfeeding (EBF): Only 32.9% of infants were exclusively breastfed for the recommended 6 months.
  • Complementary Feeding (CF): 89.6% received CF, but only 46.8% of children aged 6-23 months met the minimum acceptable diet criteria (2-3 meals per day across ≥4 food groups).
Child Nutritional Indicators
  • Hemoglobin Levels: Average Hb level for children was 9.1 g/dl, indicating widespread anemia.
  • Anthropometric Data: Children showed signs of chronic (HAZ -2.03) and acute malnutrition (WHZ − 1.19).

Discussion

Maternal and Child Health Interrelation
  • Emphasized the significant link between maternal nutrition and child health outcomes, necessitating intervention targeting both mothers and children.
  • Educational Needs: Highlighted the need for educational initiatives on proper infant and young child feeding (IYCF) practices.
Challenges in Practices
  • Cultural Beliefs: Traditional practices influencing feeding, such as the use of pre-lacteal feeds, need addressing.
  • Economic Factors: Household income levels impact feeding practices; higher income associated with less time spent on child care.

Recommendations

  • Design and implement community-specific nutritional programs focusing on:
    • Education about the importance of breastfeeding and proper CF practices.
    • Nutritional supplements during pregnancy and lactation.
    • Kitchen gardening initiatives to improve dietary diversity and accessibility.

Conclusion

  • The study revealed both high rates of undernutrition and anemia. Despite some positive practices in breastfeeding, essential improvements in complementary feeding and education about child nutrition are critical for enhancing maternal and child health outcomes. Future programs should focus on the interplay between maternal health and child nutrition to break the cycle of malnutrition.