Prevention of Child Malnutrition: Role of Public Health Workers and Nurses in Educating Mothers on Food Diversity in Infant Food.

Nisha Malhotra


Wealth is not a major determinant of adequate feeding of children, and does not seem to determine whether or not children in the 6-8 month age group are offered complementary solid or semi-solid food or more balanced diets from more food groups, though information on nutrition seems to play a significant role. This finding emphasizes the need to counsel and educate mothers about children’s nutritional needs and appropriate feeding practices in accordance with the Indian National Guidelines. Although wealth was found to be an important factor among older children (9-18 months), nutrition information was still a significant determinant for this age group.


If information about feeding children is the key obstacle to improving nutrition, then there is hope; it will be easier to resolve the problem of scarce information than to resolve the problem of acute poverty.

Author Comments

Dr. Nisha Malhotra, PhD
Dr. Nisha Malhotra, PhD
University of British Columbia
Gender, Global Health, Development, Pedagogy
Vancouver, BC | Canada
Among the causes of child malnutrition in India researchers and policymakers consider poverty and inadequate access to food to be the main reasons: my initial results were consistent with earlier conclusions till I started looking into the food infants were receiving: frequency of feeds, food groups in the wealthiest families. Once I included information on nutritional knowledge provided by Anganwadi health workers to mothers - the results changed drastically and this papers is a result of that. Dr. Nisha Malhotra, PhD


Opinion article in LiveMint

Inadequate feeding of infant and young children in India: lack of nutritional information or food affordability?

Dr. Nisha Malhotra, PhD
Dr. Nisha Malhotra, PhD
University of British Columbia
Gender, Global Health, Development, Pedagogy
Vancouver, BC | Canada

Public Health Nutr 2013 Oct 3;16(10):1723-31. Epub 2012 Sep 3.

Faculty of Arts, University of British Columbia, Vancouver, British Columbia, Canada.

Objective: Despite a rapidly growing economy and rising income levels in India, improvements in child malnutrition have lagged. Data from the most recent National Family Health Survey reveal that the infant and young child feeding (IYCF) practices recommended by the WHO and the Indian Government, including the timely introduction of solid food, are not being followed by a majority of mothers in India. It is puzzling that even among rich households children are not being fed adequately. The present study analyses the socioeconomic factors that contribute to this phenomenon, including the role of nutritional information.

Design: IYCF practices from the latest National Family Health Survey (2005-2006) were analysed. Multivariate logistic regression analyses were performed to establish the determinants of poor feeding practices. The indicators recommended by the WHO were used to assess the IYCF practices.

Setting: India.

Subjects: Children (n 9241) aged 6-18 months.

Results: Wealth was shown to have only a small effect on feeding practices. For children aged 6-8 months, the mother's wealth status was not found to be a significant determinant of sound feeding practices. Strikingly, nutritional advice on infant feeding practices provided by health professionals (including anganwadi workers) was strongly correlated with improved practices across all age groups. Exposure to the media was also found to be a significant determinant.

Conclusions: Providing appropriate information may be a crucial determinant of sound feeding practices. Efforts to eradicate malnutrition should include the broader goals of improving knowledge related to childhood nutrition and IYCF practices.

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October 2013
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