Paternal involvement in feeding and its association with nutritional status of children in an urban slum in a low-resource setting: A cross-sectional study

Paternal feeding practices and styles: a systematic review

CONTEXT

Studies on parenting, including feeding styles and practices in general, have focused mainly on mothers. Consequently, there is a gap with respect to fathers in the scientific literature.

OBJECTIVE

This study's main objective is to determine paternal feeding styles toward children aged 0 to 18 years and to identify those most commonly used by men.

DATA SOURCES

The PubMed, Scopus, Web of Science, Cochrane, and PsycINFO databases were consulted.

DATA EXTRACTION

Articles that were not published in English, Spanish, or Italian were excluded, as well as those that referred to other subjects, those whose sample did not include men, or those studying children with pathologies that could influence their diet. All the articles ultimately included were assessed using the STROBE checklist.

DATA ANALYSIS

A total of 183 articles were found. Of these, 13 were included in the review. No trend was found for paternal parenting style, and disparities existed among the authoritative, authoritarian, and permissive styles. In terms of feeding practices, men were more likely to use coercion. The most reported feeding styles were authoritarian and permissive.

CONCLUSIONS

The findings of systematic review suggest cultural and gender differences exist with respect to parenting styles and feeding styles and practices. In terms of paternal parenting styles, there is some disparity. However, when it comes to feeding, men showed a tendency toward an authoritarian feeding style and coercive feeding practices.

Exploring global mothers' knowledge, attitudes, and practice of complementary feeding: A scoping review

Complementary feeding refers to the practice of providing solid foods and liquids in addition to breast milk when a baby reaches 6 mo of age. This becomes necessary to meet a baby's nutritional needs because of the potential nutrient insufficiency of breast milk alone. This review serves as an effective means to comprehensively understand the intricate and evolving nature of complementary feeding practices, often influenced by cultural, regional, and parental factors, from a literature perspective that acknowledges the dynamic aspects of complementary feeding. The data in this study were extracted and presented according to the recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews, as guidelines. The studies were conducted using digital databases such as PubMed, Springer Link, and Science Direct from 2014 to 2022. A total of 1205 eligible studies were retrieved from the three databases searched, with 17 articles finally reviewed for data extraction. Overall, there remains a gap between mothers' knowledge, attitudes, and practices regarding complementary feeding. Addressing these disparities within and between countries necessitates targeted interventions and educational programs to enhance mothers' understanding, align attitudes with guidelines, and promote healthier practices for the well-being of children.

Factors Associated with Childhood Stunting in Four North African Countries: Evidence from Multiple Indicator Cluster Surveys, 2014-2019

Stunting remains a significant public health issue among North African children, even though significant progress has been made in reducing hunger and poverty. This study aimed to identify factors associated with stunting among children in four North African countries (Algeria, Egypt, Sudan, and Tunisia). A logistic regression model adjusted for clustering and sampling weights was used to identify factors associated with childhood stunting. It was found that the prevalence of stunting in Algeria, Egypt, Sudan, and Tunisia was 9.7%(95% CI: 9.1, 10.3), 21.1% (95% CI: 19.8, 22.5), 33.8% (95% CI: 32.7, 34.9), and 8.2% (95% CI: 7.3, 9.2), respectively. Stunting was more common among children from Sudan and Egypt. Our analysis showed that a low wealth index, being a boy, low BMI, dietary diversity <5 foods, and low birth weight were associated with stunting from 0 to 23 months; however, rural residency, a low-educated mother, low BMI, family size, and diarrhea were associated with stunting from 24 to 59 months. A collaborative approach that prioritizes maternal health and nutrition, invests in struggling families, and customizes interventions to meet the specific needs of each North African country is essential for eradicating undernutrition by 2030.

Paternal perspectives towards infant and young child feeding (IYCF): a qualitative analysis from Coastal South India

BACKGROUND

The infant and young child feeding practices (IYCF) decide child growth and well-being. Paternal perspectives and involvement in IYCF are of paramount importance and are grossly under-studied.

AIMS

To study the experiences and opinions of fathers of infants and young children towards feeding practices.

SETTINGS AND DESIGN

Two focus group discussions (FGD) were carried out in the community settings in Dakshina Kannada District, Karnataka State.

METHODS AND MATERIAL

FGDs were carried out in the areas of two selected primary health centres. FGD guide was used and the discussions were audio recorded. Themes were derived from the transcript.

RESULTS

Four main themes were generated from the transcripts of two FGDs. Lack of time to involve in child feeding, lack of felt need for increased involvement, sense of being complete in providing paternal care and readiness to learn were the generated themes. All participating fathers had favourable attitudes towards learning more about IYCF.

CONCLUSIONS

Lack of time felt need for higher paternal involvement in IYCF and sense of being complete in providing paternal care were the themes extracted, along with favourable attitude towards increasing their involvement in IYCF.

Fathers' level of involvement in childcare activities and its association with the diet quality of children in Northern Ghana

OBJECTIVE

This study assessed the level of fathers' involvement in childcare activities and its association with the diet quality of their children in Northern Ghana.

SETTING

The study was carried out in the Northern, Upper East and Upper West regions of Ghana. The people in the study area mostly depend on agriculture as their main occupation.

DESIGN

A community-based comparative analytical cross-sectional study.

PARTICIPANTS

A sample of 422 rural mother-father pairs who had at least one child aged 6-36 months.

RESULTS

The overall level of fathers' involvement in childcare and feeding activities was high among 63·5 % of the respondents in the 6 months prior to the study. The most common childcare activity men were involved in was providing money for the purchase of food for the child. Minimum acceptable diet was higher for children with a higher level of paternal involvement in childcare activities (adjusted OR = 3·33 (95 % CI: 1·41, 7·90)), compared to their counterparts whose father's involvement was poor. Fathers who had a positive attitude to childcare and feeding were 2·9 more likely to get involved in childcare activities (adjusted OR = 2·90 (95 % CI: 1·87, 4·48)).

CONCLUSIONS

The findings confirm earlier studies that show that fathers' involvement in childcare activities including feeding is positively associated with improved child feeding practices. The findings point to the need to have a policy shift in which both men and women are key actors in interventions designed to improve child nutritional status in rural settings of Northern Ghana.

Module intervention to improve involvement and practices of fathers towards infant and young child feeding (IYCF) in Coastal South India - a randomized controlled trial

Background: Overall child health depends on nutrition and its related practices. At the family level, responsibility of child feeding lies with both parents. There is no uniform and systematic way to determine and assess the practices of fathers in infant and young child feeding (IYCF). Also, there is a paucity of evidence related to interventions for fathers in improving their practices and involvement in the feeding of their infant or young child (aged less than two years).

Methods: This was a community-based randomized control trial, conducted among 120 fathers with infants and/or young children in Dakshina Kannada District of Karnataka. Fathers with poor level of involvement and practices towards IYCF, during the initial assessment, were included as the study participants. For the intervention, a module in the flipchart format was developed. Simple randomization technique was used to allot the participants into two groups - intervention and control. Participants in the intervention group received module intervention, in addition to the care which they received routinely, and the control group received only routine care. The participants in the intervention group were paid a monthly visit to implement the module, for six months. The post-intervention assessment was done at the end of 6 months.

Results: A total of 117 participants provided post-intervention data. The mean age was 34.7 (+/- 5.48) years in the intervention group and 34.36 years (+/- 5.26) in the control group. The intervention group showed significantly higher improvement in knowledge, attitude, and practice components at 6 months (p<0.05), in both unadjusted and adjusted models.

Conclusions: The extent of increase in practice and involvement in child feeding was clearly higher among the intervention group. The module developed was successful in improving the practices of fathers in feeding their infants and young children.

Clinical Trials Registry India: CTRI/2017/06/008936 (29/06/2017)

Paternal Involvement in and Sociodemographic Correlates of Infant and Young Child Feeding in a District in Coastal South India: A Cross-Sectional Study

Context: The feeding practices during first 2 years of life determine the overall health and survival during childhood and beyond. Child nutrition is responsibility of both parents and so far emphasis has been laid mostly on mothers. Fathers' involvement toward Infant and Young child feeding (IYCF) has been proved to be of paramount importance and yet it is given limited importance.

Objectives: This study aims to study the level of paternal involvement toward IYCF and its associated factors and to assess the knowledge, attitude, and practices toward IYCF in Dakshina Kannada District in South Indian State of Karnataka.

Settings and Design: This community-based cross-sectional study was conducted in the coastal District of Dakshina Kannada; Karnataka State in India.

Methods: The study included 450 fathers of infant and young children (aged <2 years) in five taluks of Dakshina Kannada district. They were assessed for knowledge, attitude, and practices related to IYCF. Median score for the practice component was considered cut off to classify involvement in IYCF. Data were analyzed using IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp. Chi-square-test and Binary Logistic Regression with Hosmer-Lemeshow goodness-of-fit model were used. Unadjusted and adjusted odds ratios were generated. A p-value of <0.05 was considered statistically significant.

Results: Mean age of the study population was 34.6 years (SD, 5.4). The practice scores median (IQR) was 34.0 (IQR, 31.0–39.0), and 40.9% of the participants had poor involvement in IYCF. This was significantly higher among fathers from predominantly urban area. Those who had education above graduation and younger fathers had better involvement in IYCF.

Conclusions: Less than half of fathers had poor involvement in IYCF, and it was lower among fathers from urban areas, higher age, and lower educational levels.

Gut Microbial Profile Is Associated With Residential Settings and Not Nutritional Status in Adults in Karnataka, India

Undernutrition is a leading contributor to disease and disability in people of all ages. Several studies have reported significant association between nutritional status and gut microbiome composition but other factors such as demographic settings may also influence the adult microbiome. The relationship between undernourishment and gut microbiome in adults has not been described to date. In this study, we compared the gut microbiome in fecal samples of 48 individuals, from two demographic settings (rural and urban slum) in Karnataka, India using 16S rRNA sequencing. Nutritional status was assessed based on BMI, with a BMI of < 18.5 kg/m2 classified as undernourished, and a BMI in the range 18.5-25 kg/m2 as nourished. We analyzed 25 individuals from rural settings (12 undernourished and 13 nourished) and 23 individuals from urban slum settings (11 undernourished and 12 nourished). We found no significant difference in overall gut microbial diversity (Shannon and Unweighted UniFrac) between undernourished and nourished individuals in either geographical settings, however, microbial taxa at the phylum level (i.e., Firmicutes and Proteobacteria) and beta diversity (unweighted UniFrac) differed significantly between the rural and urban slum settings. By predicting microbial function from 16S data profiling we found significant differences in metabolic pathways present in the gut microbiota from people residing in different settings; specifically, those related to carbohydrate and lipid metabolism. The weighted sum of the KEGG Orthologs associated with carbohydrate metabolism (Spearman's correlation coefficient, ρ = -0.707, p < 0.001), lipid metabolism (Spearman's correlation coefficient, ρ = -0.330, p < 0.022) and biosynthesis of secondary metabolites (Spearman's correlation coefficient, ρ = -0.507, p < 0.001) were decreased in the urban slum group compared to the rural group. In conclusion, we report that the geographical location of residence is associated with differences in gut microbiome composition in adults. We found no significant differences in microbiome composition between nourished and undernourished adults from urban slum or rural settings in India.

Modular intervention to improve paternal involvement and support for better infant and young child feeding in a district of coastal South India: a randomized controlled trial protocol

Background: The major determinant to the well-being of infants and young children (IYC) is their feeding practices. These practices are the responsibility of both parents, meaning that fathers have an equal role to mothers. Fathers' involvement can have an impact on the overall health of the children. Despite this, paternal involvement towards IYC feeding (IYCF) have not been studied adequately. Methods: This randomized control trial (n=120) will be conducted among fathers of infants (children aged <1 year) and young children (children aged 12-23 months) in selected households in Dakshina Kannada District of the southern Indian State of Karnataka. The study will be conducted after an initial baseline assessment on awareness, attitude and involvement of fathers in IYCF. Fathers with scores less than the 50 th percentile in the practice component will be categorized as fathers with poor involvement and will be potential participants for the trial. A visual module will be developed and validated for improving paternal involvement in IYCF. Using a simple randomization technique, the participants will be allocated to modular intervention and control group (1:1 allocation). Each participant in the intervention arm will be visited once a month to implement the module, for six months on a one-to-one basis. Following the intervention, a post-test assessment will be done for both groups to measure the level of paternal involvement in IYCF. Ethics and dissemination: Approval has been obtained from the Institutional Ethics Committee of Kasturba Medical College, Mangalore, India. The dissemination plans include scientific conferences and publication in scientific journals. Registration: The study is registered with Clinical Trial Registry of India ( CTRI/2017/06/008936).

Modular intervention to improve paternal involvement and support for better infant and young child feeding in a district of coastal South India: a randomized controlled trial protocol

Background: The major determinant to the well-being of infants and young children (IYC) is their feeding practices. These practices are the responsibility of both parents, meaning that fathers have an equal role to mothers. Fathers' involvement can have an impact on the overall health of the children. Despite this, paternal involvement towards IYC feeding (IYCF) have not been studied adequately. Methods: This randomized control trial (n=120) will be conducted among fathers of infants (children aged <1 year) and young children (children aged 12-23 months) in selected households in Dakshina Kannada District of the southern Indian State of Karnataka. The study will be conducted after an initial baseline assessment on awareness, attitude and involvement of fathers in IYCF. Fathers with scores less than the 50 th percentile in the practice component will be categorized as fathers with poor involvement and will be potential participants for the trial. A visual module will be developed and validated for improving paternal involvement in IYCF. Using a simple randomization technique, the participants will be allocated to modular intervention and control group (1:1 allocation). Each participant in the intervention arm will be visited once a month to implement the module, for six months on a one-to-one basis. Following the intervention, a post-test assessment will be done for both groups to measure the level of paternal involvement in IYCF. Ethics and dissemination: Approval has been obtained from the Institutional Ethics Committee of Kasturba Medical College, Mangalore, India. The dissemination plans include scientific conferences and publication in scientific journals. Registration: The study is registered with Clinical Trial Registry of India ( CTRI/2017/06/008936).