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Observational survey identifies determinants of Infant and Young Child Feeding practices in children with SAMFactors Influencing Healthy Feeding Practices for Children with Severe Malnutrition

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Key Takeaway
Note that this survey identifies local determinants of IYCF practices in children with severe acute malnutrition.

This observational pre-trial baseline survey was conducted in a pastoralist and predominantly agrarian setting in Ethiopia. The study population consisted of 486 children aged 6 to 23 months who were diagnosed with severe acute malnutrition (SAM) and were currently under SAM treatment.

The primary objective was to identify the determinants of Infant and Young Child Feeding (IYCF) practices among these children. Secondary outcomes measured included minimum meal frequency (MMF), minimum dietary diversity (MDD), and egg/flesh-food consumption.

Specific intervention data or comparator groups were not reported as this was a baseline survey. The study focused on identifying local factors influencing nutritional intake in a specific geographic and demographic context.

Due to the observational nature of the study and the lack of an intervention arm, results should be interpreted as descriptive of the local population rather than evidence of causal links. These findings may inform local programs targeting dietary diversity and meal frequency for children with SAM.

A study looked at nearly 500 children under two years old who were suffering from severe acute malnutrition. These children lived in rural areas of Ethiopia where many families rely on farming and livestock for their livelihoods.

The researchers focused on how these children were being fed during their treatment. They specifically looked at how often the children ate, if they received a variety of different foods, and if they were getting enough protein from sources like eggs or meat.

By looking at these feeding habits, the study aimed to find out what makes it easier or harder for families to provide good nutrition. Understanding these factors helps health workers create better support systems for parents in rural areas.

The goal is to ensure that every child receives a diverse diet during their recovery. By identifying the main challenges, local programs can better help families provide the specific nutrients needed to help children grow strong and healthy.

What this means for you:
Identifying key factors in feeding habits helps improve nutrition for malnourished children in rural Ethiopia.

Common questions

What did the study find about feeding practices?

The study found that only a small number of children with severe acute malnutrition met basic feeding standards like minimum meal frequency and dietary diversity. Very few ate eggs or flesh foods, which are important for recovery.

Who was included in the study?

The study included 486 children aged 6 to 23 months who had severe acute malnutrition and were receiving treatment. They lived in pastoralist and farming communities in Ethiopia.

Is this study about a new treatment?

No, this is a baseline survey, not a treatment study. It describes current feeding practices and factors that influence them. It does not test any new drug or therapy.

Can these findings be applied to other countries?

The findings are specific to the pastoralist and farming settings in Ethiopia. They may not apply to other regions or countries with different cultures and food availability.

Study Details

Study typeRct
EvidenceLevel 2
Follow-up23.0 mo
PublishedJul 2026
View Original Abstract ↓
Previous research has established determinants of young child feeding (IYCF) practices in the general child population, but determinants of these practices in children with severe acute malnutrition (SAM) are unknown. This study assessed the determinants of IYCF practices among children aged 6-23 months with SAM and under SAM treatment in a pastoralist and a predominantly agrarian setting in Ethiopia. As part of the baseline survey for the R-SWITCH cluster randomized control trial, we screened ~28,000 under-fives and included 486 children aged 6-23 months with SAM and under SAM treatment. Multivariable regression analysis was used to identify determinants on household, caregiver and child levels. Minimum meal frequency (MMF) was similar between children from the agrarian (53.9%) and pastoralist (51.9%) setting. The prevalence of children with minimum dietary diversity (MDD) was low overall but higher among pastoralist children (31.5%) than children from the agrarian setting (19.0%; p = 0.012). The consumption of egg/flesh foods was lower among pastoralist children (5.6%) than agrarian children (16.9%, p = 0.085). Caregiver literacy was positively associated with a higher likelihood of MMF (IRR = 1.21; 95% CI:1.02-1.43; p = 0.030), while caregiver depression was associated with a lower likelihood of MMF (RR = 0.97; 95% CI:0.95-0.99; p = 0.003). Improved water source (RR = 1.59; 95% CI:1.06-2.38; p = 0.037), caregiver literacy (RR = 2.04; 95% CI:1.25-3.34; p = 0.002), caregiver MDD (RR = 2.21; 95% CI:1.60-3.05; p ≤ 0.001), older children(RR = 1.05; 95% CI: 1.02-1.08;p ≤ 0.001), and pastoralist setting (RR = 1.62; 95% CI:1.07-2.44; p = 0.014) were associated with a significantly higher likelihood of meeting MDD. Conversely, caregiver depression (RR = 0.94; 95% CI:0.90-0.97; p < 0.001), caregiver mobility restriction (IRR = 0.94; 95% CI:0.89-1.00; p = 0.025), and food insecurity (RR = 0.64; 95% CI:0.41-1.01; p = 0.05) were associated with reduced MDD likelihood. Caregiver community involvement (IRR = 1.12; 95% CI:1.00-1.26; p = 0.038), caregiver MDD (RR = 1.67; 95% CI:1.10-2.53; p = 0.043), and older children (RR = 1.08; 95% CI:1.05-1.12; p < 0.001) were associated with increased egg/flesh-food consumption among children, while living in a pastoralist setting was associated with reduced it (RR = 0.36; 95% CI:0.13-0.97; p = 0.038). Integrated and Targeted interventions recommended: caregiver literacy/depression support to improve IYCF; livelihood-specific foods (eggs/flesh, fruits/vegetables); WaSH enhancements; community engagement; and IYCF counseling within CMAM programs.
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