Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-23T21:24:06.008Z Has data issue: false hasContentIssue false

The role of care in nutrition programmes: current research and a research agenda

Published online by Cambridge University Press:  28 February 2007

Patrice L. Engle*
Affiliation:
Department of Psychology, Cal Poly State University, San Luis Obispo, CA 93405, USA
Margaret Bentley
Affiliation:
Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA
Gretel Pelto
Affiliation:
Department of Nutrition and Food Policy, Cornell University, Ithaca, NY 14852, USA
*
*Corresponding author: Professor Patrice L. Engle, fax +1 805 756 1134, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The importance of cultural and behavioural factors in children’s nutrition, particularly with regard to feeding, has been recognized only recently. The combination of evidence regarding the importance of caregiving behaviour for good nutrition, and improved strategies for measuring behaviour have led to a renewed interest in care. The UNICEF conceptual framework suggests that care, in addition to food security and health care services, are critical for children’s survival, growth and development. The present paper focuses on the care practice of complementary feeding, specifically behavioural factors such as parental interaction patterns, feeding style and adaptation of feeding to the child’s motor abilities (self-feeding or feeding by others). Three kinds of feeding styles (Birch & Fisher, 1995) are identified: controlling; laissez-faire; responsive. Probable effects of each feeding style on nutrient intake are described. A number of studies of feeding behaviour have suggested that the laissez-faire style is most frequently observed among families and communities with a higher prevalence of malnourished children. Nutrition interventions that have been able to show significant effects on outcomes, such as the Hearth Model in Vietnam (Sternin et al. 1997), have usually incorporated behavioural components in their intervention. At this time, there have been no tests of the efficacy of behavioural interventions to improve feeding practices. Research is needed to understand behavioural factors in complementary feeding, and to identify and test intervention strategies designed to improve nutrient intake of young children. Finally, the paper concludes with a discussion of how nutrition programmes might change if care were incorporated.

Type
Reproduction and Development Group Symposium on ‘Feeding, nurture and childhood development’
Copyright
Copyright © The Nutrition Society 2000

References

Academy for Educational Development (1995) Final Report: Mali Nutrition Communication Project 1989–1995.Washington, DC: AED.Google Scholar
Academy for Educational Development (1996) Final Report: Nutrition Communication Project.Washington, DC: AED.Google Scholar
Allen, LH, Backstrand, JR, Chavez, A & Pelto, GH (1992) People Cannot Live by Tortillas Alone: The Results of the Mexican Nutrition CRSP. Final Report to the US Agency for International Development.Washington, DC: USAID.Google Scholar
Bentley, M, Black, M & Hurtado, E (1995) Child feeding and appetite – What can programs do? Food and Nutrition Bulletin 16, 340348.Google Scholar
Bentley, M, Caulfield, L, Torun, B, Schroeder, D & Hurtado, E (1992) Maternal feeding behavior and child appetite during acute diarrhea and subsequent health in Guatemala. FASEB Journal 6, A436.Google Scholar
Bentley, M, Stallings, R, Fukumoto, M & Elder, J (1991) Maternal feeding behavior and child acceptance of food during diarrhea episodes, convalescence, and health in the Central Northern Sierra of Peru. American Journal of Public Health 83, 15.Google Scholar
Bentley, MB, Engle, PE, Caulfield, L, Creed, H & Penny, M (1999) Caregiver style of infant feeding as a determinant of dietary intake: The need for promotion of ‘interactive feeding’. FASEB Journal 13, 195.1 Abstr.Google Scholar
Birch, LL (1998) Psychological influences on the childhood diet. Journal of Nutrition 128, Suppl. 2, 407S410S.CrossRefGoogle ScholarPubMed
Birch, LL & Fisher, JA (1995) Appetite and eating behavior in children. Pediatric Clinics of North America 42, 931953.CrossRefGoogle ScholarPubMed
Brown, KH, Dewey, K & Allen, L (1998) Complementary Feeding of Young Children in Developing Countries: a Review of Current Scientific Evidence. WHO/NUT/98.1.Geneva: WHO.Google Scholar
Brown, KH, Dickin, KL, Bentley, ME, Oni, GA, Obassajju, VT, Esrey, SA, Mebrahtu, S, Alade, I & Stallings, RY (1988) Consumption of weaning foods from fermented cereals: Kwara State, Nigeria. In Improving Young Child Feeding in Eastern and Southern African Household-level Food Technology: Proceedings of a Workshop, pp. 181197 [Alnwick, D, Moses, S Schmidt, OG, editors]. Ottawa, Ont.: IDRC.Google Scholar
Brown, LV, Zeitlin, MF, Peterson, KE, Chowdhury, AMR, Rodgers, BL, Weld, LH & Gershoff, SN (1992) Evaluation of the impact of weaning food messages on infant feeding practices and child growth in rural Bangladesh. American Journal of Clinical Nutrition 56, 9941003.Google Scholar
Caulfield, LE, Huffman, SL & Piwoz, E (1999) Interventions to improve complementary food intakes of 6–12 month old infants: What have we been able to accomplish? Food and Nutrition Bulletin 20, 183200.Google Scholar
Connolly, K & Dalgleish, M (1989) The emergence of tool-using skill in infancy. Developmental Psychology 25, 894912.Google Scholar
Dettwyler, K (1989) Styles of infant feeding: parental/caretaker control of food consumption in young children. American Anthropologist 91, 696703.CrossRefGoogle Scholar
Dijkhuizen, P (1992) Comment on ‘weaning foods – new uses of traditional methods’. SCN News 7, 4445.Google Scholar
Division of Child Health and Development, World Health Organization (1998) Integrated Management of Childhood Illness.Geneva WHO/CHD.Google Scholar
Engle, PL (1992) Care and Child Nutrition. Report for International Congress on Nutrition.New York: UNICEF.Google Scholar
Engle, PL, Immink, M & Quieroz, P (1997a) Report of a Workshop on Care in Brasil. New York: UNICEF.Google Scholar
Engle, PL, Lhotska, L & Armstrong, H (1997b) The Care Initiative: Assessment, Analysis, and Action to Improve Care for Nutrition. New York: UNICEF.Google Scholar
Engle, PL, Menon, P & Haddad, L (1999) Care and nutrition: concepts and measurement. World Development 27, 13091338.Google Scholar
Engle, PL & Zeitlin, M (1996) Interactive feeding behavior compensates for low child demand among Nicaraguan one-year-olds. Journal of Nutrition 126, 18081816.Google Scholar
Engle, PL, Zeitlin, M, Medrano, Y & Garcia, LH (1996) Growth consequences of low income Nicaraguan mothers’ theories about feeding one year olds. In Parents’ Cultural Belief Systems. pp. 428446 [Harkness, SSuper, C, editors]. New York: Guilford Press.Google Scholar
Gisel, EG (1991) Effect of food texture on the development of chewing of children between six months and two years of age. Developmental Medicine and Child Neurology 33, 6979.Google Scholar
Gittlesohn, J, Shanker, AV, West, KP, Faruque, F, Gnywali, T & Pradhan, ED (1998) Child feeding and care behaviours are associated with xeropthalmia in rural Nepalese households. Social Science and Medicine 47, 477486.Google Scholar
Guldan, GS, Zeitlin, MF, Beiser, AS, Super, CM, Gershoff, SN & Datta, S (1993) Maternal education and child feeding practices in rural Bangladesh. Social Science and Medicine 36, 925935.Google Scholar
Johnson, SL & Birch, LL (1994) Parents' and children's adiposity and eating style. Pediatrics 94, 653661.Google Scholar
Kanishiro, HC, Fukumoio, M, Bentley, ME, Jacoby, E, Versoza, C & Brown, KH (1991) Use of recipe trials and anthropological techniques for the development of a home-prepared weaning food in the central highlands of Peru. Journal of Nutrition Education 23, 3035.Google Scholar
Kennedy, E & M, Garcia (editors) (1993) Effects of Selected Policies and Programs on Women's Health and Nutritional Status International Food Policy Research Institute Report.Washington, DC: IFPRIGoogle Scholar
Kirskey, A, Harrison, GG, Galal, OJ, McCabe, GP, Wachs, TD & Rahmanifer, A (1992) The Human Costs of Moderate Malnutrition in an Egyptian Village. Final Report to the US Agency for International Development.Washington, DC: USAID.Google Scholar
Kotchabhakdi, NJ, Winichagoon, P, Smitasiri, S, Dhanamitta, S & Valyasevi, A (1987) The integration of psychosocial components of early childhood development in a nutrition education programme of Northeast Thailand. Asia Pacific Journal of Public Health 1, 1625.Google Scholar
Manoff, Group Inc. (1991) The Weaning Project: Improving Young Children's Feeding Practices in Indonesia: Project Overview. Washington, DC: Nutrition Directorate, Ministry of Health, Indonesia, and The Manoff Group Inc.Google Scholar
Milla, PJ (1991) Feeding, tasting, and sucking. In Pediatric Gastrointestinal Disease, Vol. 1, pp. 217223.Philadelphia, PA: BC Decker.Google Scholar
Morrow, AL, Lourdes Guerro, M, Sjults, J, Calva, JJ, Lutter, C, Bravo, J, Ruiz-Palacios, G, Morrow, RC & Butterfoss, FD (1999) Efficacy of home-based peer counselling to promote exclusive breastfeeding: a randomized controlled trial. Lancet 353, 12261231.Google Scholar
Myers, R (1992) The Twelve Who Survive.The Hague: Routledge Press.Google Scholar
Pelto, G, Dickin, KL & Engle, PL (1999) A Critical Link: Interventions to Promote Growth and Development.Geneva: Child and Adolescent Health and Development, WHO.Google Scholar
Pollitt, E, Gorman, K, Engle, P, Martorell, R & Rivera, J (1993) Early Supplementary Feeding and Cognition: Effects over Two Decades. Monograph of the Society for Research in Child Development, Vol. 58, no. 235. Chicago: Society for Research in Child Development/University of Chicago Press.Google Scholar
Pollitt, E, Gorman, KS, Engle, PL, Oh, S-Y, Rivera, J & Martorell, R (1995) Nutrition in early life and the fulfillment of intellectual potential. Journal of Nutrition 125, Suppl. 4, 1111S1118S.Google Scholar
Ruel, MT, Levin, C, Armar-Klemesu, M, Maxwell, D & Morris, SS (1999) Good Care Practices can Mitigate the Negative Effects of Poverty and Low Maternal Schooling on Children's Nutritional Status: Evidence from Accra. International Food Policy Research Institute Discussion Paper no. 62.Washington, DC: IFPRI.Google Scholar
Shankar, AV, Gittelsohn, J, West, KP, Stallings, R, Gnywali, T & Faruque, F (1998) Eating from a shared plate affects food consumption in vitamin A-deficient Nepali children. Journal of Nutrition 128, 11271133.Google Scholar
Sigman, M, Neumann, C, Baksh, M, Bwibo, N & McDonald, MA (1989) Relationship between nutrition and development in Kenyan toddlers. Journal of Pediatrics 115, 357364.Google Scholar
Sternin, M, Sternin, J & Marsh, D (1997) Rapid, sustained childhood malnutrition alleviation through a ‘positive deviance’ approach in rural Vietnam: Preliminary findings. In The Hearth Nutrition Model: Applications in Haiti, Vietnam, and Bangladesh, pp. 4962 [Wollinka, O, Keeley, E, Burkhalter, RB Bashir, N, editors]. Washington, DC: Basics.Google Scholar
Trinh, UA, Marsh, D & Schroeder, DG (1999) Sustained Positive Deviant Child Care Practices and their Effects on Child Growth in Vietnam.Atlanta, GA: Emory University (In the Press).Google Scholar
United Nations Children's Fund (1990) Strategy for Improved Nutrition of Children and Women in Developing Countries. UNICEF Policy Review 1990–1 E/ICEF/1990/L.6.New York: UNICEF.Google Scholar
United Nations Children's Fund (1998). State of the World's Children. New York: UNICEF.Google Scholar
Zeitlin, M (1996) Child Care and Nutrition: The Findings from Positive Deviance Research. Cornell International Nutrition Monograph Series no. 27.Ithaca, NY: Cornell University Food and Nutrition Policy Program.Google Scholar
Zeitlin, MF, Ghassemi, H, Mansour, M, Levine, RA, Dillanneva, M, Carballo, M & Sockalingam, S (1990) Positive Deviance in Child Nutrition.Tokyo: United Nations University Press.Google Scholar