الفهرس 
Early Feeding Patterns
Description of the dietary patternOnly 14 pages are availabe for public view
 |  | from | 111 |  |  |
| | | from | 111 | | |
Abstract
Nutritional status of child is influenced by larg number of factors, one of which is food consumption, when a child intake of food falls below the standard allowances, growth slows and malnutrition ensues, and it can lead to growth failure and to increased susceptibility to disease.
The present survey was conducted to investigate the present status and contributing factors of protein energy malnutrition among under five years children in Alexandria, to estimate the prevalence of underweight, stunting and wasting among under five years children, to identify various factors contributing to the occurrence of protein energy malnutrition among this age group, with emphasis on the role of dietary pattern (habits and intake) in the development of protein energy malnutrition.
The study was carried out in Maternal and Child Health Care centers (MCH) in Alexandria A descriptive cross sectional approach was used to conduct this study. The total sample size was 500 children included in the study.
A pre-designed interview questionnaire was used to collect the following data: Demographic and personal data, Socioeconomic and environmental characteristics, medical history, dietary habits and dietary intake. Method of 24hr recall was used to estimate children dietary intake.
Anthropometric assessment was performed. Weight and height were accurately measured for each child using procedures of Jelliffe et al for measurements of weight and height. The z-score system was used as a measuring system of anthropometric indices.
Statistical analysis was made by using version 17 of SPSS. Levels of significance were set at P value <0.05, tests of significance, Chi squared (x2) test, Monte Carlo Probability (MCP), Fisher’s Exact Probability (FEP) and NcNemar test were used for analysis of categorical data. Z test was used for comparison between two proportions. Children’s t test for comparison between means of two groups logistic regression model for factors affecting underweight, stunting and wasting of the studied sample.
Finding of the present study can be summerised as follows:
The studied sample included 500 children among them 280 boys (230 were urban and 50 were rural) and 220 girls (166 were urban and 54 were rural), their age ranged between 0 - 60 months. 56% of <2 years children and 56% of 2-5 years children were boys and 44% of <2 years children and 44% of 2-5 years children were girls. 35.4% of children were 1st birth order.
36.5% of <2 years children’s fathers and 46.6% of 2-5 years children’s fathers were of university level of education and above. 28.6% of <2 years children’s mothers and 42% of 2-5 years children’s mothers were of university level and above. 66.5% of <2 years children’s mothers and 54.7% of 2-5 years children’s mothers were housewife. 47% of <2years children and 38% of 2-5 years children, their family income was not enough, loan and not repaid. 57.1% of <2years children and 53% of 2-5 years children, their families consist of 3-4 persons. 69.2% of <2years children and 77.8% of 2-5 years children live as below 2 persons in the room. 51.9% of <2years children and 62.4% of 2-5 years children were of high socioeconomic level. 48.1% of <2years children and 37.6% of 2-5 years children were of low socioeconomic level.
57.9% of <2years children and 54.3% of 2-5 years children had diarrhea. Only 11.3% of <2years children and 16.7% of 2-5 years children had vomiting. only 14.7% of <2years children and 32.5% of 2-5 years children had parasitic infestation. Only 30.8% of <2years children and 39.3% of 2-5 years children only had cough. 45.5% of <2years children and 38.9% of 2-5 years children had fever.
87.6% of <2years children and 80.8% of 2-5 years children were breastfed, while the lowest percent of <2years children (4.5%) and of 2-5 years children (7.3%) was fed by both the bottle and breast. 30% of <2years children and 44.1% of 2-5 years children were breastfed exclusively for 4 months, while 22.3% of <2years children and 32.3% of 2-5 years children were breastfed exclusively for 6 months. The majority of <2years children and 2-5 years children (95.8% and 79.5%, respectively) were weaned between 12 and 24 months.
the majority of <2years children (74.6%) and 2-5 years children (97.4%) eat 3 main meals daily. 80.6% of <2years children and 97.4% of 2-5 years children eat 2 snacks daily
The prevalence of underweight of children was 6.2% (7.5% of boys and 4.5% of girls), the prevalence of wasting was 3.4% (4.3% of boys and 2.3% of girls) and the prevalence of stunting was 23.8% (26.4% of boys and 20.5% of girls).
The prevalence of underweight of children was 6.2% (8.6% of <2years children and 3.4% of 2-5 years children). The prevalence of wasting was 3.4% (3% of <2years children and 3.8% of 2-5 years children). The prevalence of stunting was 23.8% (39.8% of <2years children and 5.6% of 2-5 years children).
7.5% of underweight and 92.5% of normal children were boys and 4.5% of underweight and 95.5% of normal children were girls. 16.8% of underweight and 83.2% of normal children aged under 6 months. The lowest percent (no one of underweight and 100% of normal children) aged between 18 and 24 months. 6.8% of underweight and 93.2% of normal children were 1st order. 9.3% of underweight and 90.7% of normal children were of low socioeconomic level. 3.9% of underweight and 96.1% of normal children were of high level. The mean of socioeconomic level score of underweight was 29.39 ± 1.73 and of normal children was 34.29 ± 0.428.
4.3% of wasted and 95.7% of normal children were boys and 2.3% of wasted and 97.7% of normal children was girls. 9.5% of wasted and 90.5% of normal children were between 48 and 60 months. The mean of the weight at birth of wasted was 3.09 ± 0.12 and of normal children was 3.26 ± 0.02. 4% of wasted and 96% of normal children were 1st order. 4.6% of wasted and 95.4% of normal children were of high socioeconomic level. 1.9% of wasted were of high level and 98.1% of normal children were of low socioeconomic level. The mean of socioeconomic level of wasted was 36.88 ± 1.99 and of normal children was 33.88 ± 0.427. 102
26.4% of stunted and 73.6% of normal children were boys and 20.5% of stunted and 79.5% of normal children was girls. 51.4% of stunted and 48.6% of normal children were under 6 months. The mean of weight at birth of stunted was 3.15 ± 0.05 and of normal children was 3.29 ± 0.02 kg. 33.3% of stunted, and 66.7% of normal children were 3rd and 4th and above. 31% of stunted was of high middle level and 69% of normal children were of low socioeconomic level. 18.3% of stunted and 81.7% of normal children were of high socioeconomic level. The mean of the socioeconomic level of stunted was 30.67 ± 0.84 and of normal children was 35.02 ± 0.47.
6.2% of underweight and 93.8% of normal children were breast fed. 99% of normal children were breastfed exclusively for 4 months, while 5.3% of underweight and 94.7% of normal were breastfed exclusively for 6 months. the majority (1.8% of underweight and 98.2% of normal children) were weaned between 12 and 24 months. The lowest percent, 0% of underweight and 100% of normal children were weaned between 6 and 12 months.
2.6% of wasted and 97.4% of normal children were breast fed. 1.5% of wasted and 98.5% of normal children were breastfed exclusively for 4 months, while 6.2% of wasted and 93.8% of normal were breastfed exclusively for 6 months. 1.2% of wasted and 98.8% of normal children were weaned between 12 and 24 months.
24.4% of stunted and 75.6% of normal children were breast fed. 14.6% of stunted and 85.4% of normal children were breastfed exclusively for 4 months, while 14.2% of stunted and 85.8% of normal were breastfed exclusively for 6 months. 2.9% of stunted and 97.1% of normal children was weaned between 12 and 24 months.
2.5% of underweight and 97.5% of normal children, 2.8% of wasted and 97.2% of normal children and 12% of stunted and 88% of normal children had eaten 3 main meals daily
The significant studied factors that directly correlated with weight were age, weight at birth, socioeconomic score, duration of breastfeed, number of breastfeeds, number of main meals, number of snacks, and intake of energy, protein, fat and CHO. But only duration of exclusive breastfeeding was indirectly significantly correlated with weight.
The significant studied factors that directly correlated with height were age, socioeconomic score, number of breastfeeds, number of main meals, number of snacks, and intake of energy, protein, fat and CHO. While the indirectly significantly factors were birth order and duration of exclusive breastfeeding was correlated with weight.
The significant factors led to underweight were young age, decrease weight at birth and high socioeconomic level. The significant factor led to wasting was low socioeconomic level. The significant factors led to stunting were male sex, advance in age and decrease weight at birth.
The recommendations of the present study will be:
• Breastfeeding children within the first half hour after delivery, breastfeed children exclusively in the first six months of life and to continue breastfeeding until 24 months of age.
• Guiding mothers to proper complementary feeding.
• Guiding mothers to care and feeding for children during and after diseases.
• Improving hygienic practices at the household level: personal hygiene, environmental hygiene and food hygiene.
• Promoting nutrition education and encourage production and usage of food at the household level to improve the diet for children.
• Producing nutrient-rich food sources easy to consumed by baby.
• Guiding to processing reasonable meals for the family and complementary foods for children (regular activity).
• Promoting social mobilization of malnutrition prevention activities.