Appropriate Complmentary Feeding Strategies in Infants
Condition: Anemia
MeSH terms: Anemia
Study type: Interventional

Summary: 
      The purpose of this study has been to understand the prevalence of under nutrition and
      develop effective interventions for improving growth and micronutrient status of infants
      receiving complementary foods.

      In this community based randomized clinical trial, the nutrition education package
      implemented aimed to improve hematological parameters including the micronutrient status and
      to see effect on growth indicators.
    

Detailed description: 
      Transition from exclusive breast feeding to complementary feeding poses many challenges as
      the demand for nutrients necessary for optimum growth and development increases steadily.
      Malnutrition and micronutrient malnutrition can be inter-generational and affect pregnant
      mothers and consequently the baby may be born with deficient micronutrient stores, especially
      those of iron. This deficiency can be further exacerbated by sub-optimal practices of breast
      feeding. Globally, iron deficiency is the most common cause of anemia estimated to affect
      nearly 2 billion people especially preschool children. In Pakistan, 56 % of children under
      the age of five years are estimated to have iron deficiency anemia and 13 % are also severely
      malnourished. These deficiencies affect not only physical growth but also mental development
      with significant impact on immunity and increased burden of infections. It is uncertain what
      the most appropriate intervention strategy is and a wide range of options are mentioned
      including dietary diversification through nutrition education, provision of fortified foods,
      iron supplementation and home-based fortification of complementary foods with micronutrient
      powders such as Sprinkles.

      In an effort to understand the prevalence of under nutrition and develop effective
      interventions for improving growth and micronutrient status of infants receiving
      complementary foods, I undertook a prospective community-based randomized controlled efficacy
      trial in a representative urban population of Karachi. Infants and mothers were identified
      after birth and enrolled in the study to receive one of the interventions through community
      health workers at the age of six months. The enrolled infants were placed in three groups -
      defined as Nutr Education (Nutr Edu), Oral iron supplementation (OIS) and Multiple
      micronutrient fortification (MMF). Nutrition education component was common to all the
      groups. Through nutritional education sessions held in the community, dietary diversification
      along with continuation of breast feeding was stressed to enhance the intake of diet, rich in
      iron, and other micronutrients. A cohort of 451 infants (177 in group Nutr Edu, 141 in group
      OIS and 133 in MMF) were followed for three months (till the end of treatments) for growth,
      micronutrient status, and morbidity rate and thereafter followed for another three months to
      evaluate anthropometric parameters.
    

Intervention name(s): Nutritionl Education; Oral Iron Supplementation along with Nturition Eductaion; Multiple micronutrient fortification plus Nutrition Education
Intervention type(s): Behavioral; Dietary Supplement; Dietary Supplement
Intervention description(s): to assess the change in behaviour
Intervention MeSH terms: Micronutrients; Trace Elements
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: Anemia; Growth; Infants; Focus of the study is to assess the level of anemia and growth indicators among the infants