Infant and young child feeding practices in Southeast Asia: associations with socioeconomic status, child nutrition and longer-term growth trajectories

Abstract

Despite a breadth of research evidencing the association between exclusive breastfeeding and child growth, little is known about infant feeding practices and diet diversity in low- and middle-income countries. In these settings, the weaning transition offers a critical window in which nutritional inputs can help establish the path to lifelong health, yet only one in six young children receives an adequate diet necessary for optimal growth and development. A distinctive nutrition transition in Southeast Asia has coincided with significant economic growth, with the emergence of a double burden of malnutrition. Chronic and persistent undernutrition in young Southeast Asian children is increasingly coupled with rising prevalence of malnutrition, as diets rapidly “westernize” in line with GDP growth and increasing socioeconomic inequalities. This thesis aimed to examine the role of early feeding practices on child nutritional status and growth in light of this nutrition transition, in three economically and culturally diverse Southeast Asian countries (Cambodia, Myanmar and Indonesia). Given the rapid economic and socio-cultural shifts in this region, the role of socioeconomic status on early life feeding practices and dietary diversity is a focus throughout the thesis. Using the most recent DHS data from all three countries, the first analysis in this thesis presents a sub-regional snapshot of the socioeconomic factors associated with exclusive breastfeeding in children aged 0 to <6 months and minimum dietary diversity in children aged 6 to <24 months. The second analysis used structural path analysis to examine the role of continued breastfeeding and dietary diversity in pathways to stunting in Cambodia and how these varied according to contextually relevant, underlying socioeconomic factors. The final analysis in this thesis applied group-based trajectory modelling to longitudinal data from the Indonesian Family Life Survey, to identify BMI growth trajectories and examine early life feeding practices associated with BMI trajectory membership. Overall, evidence from Cambodia, Myanmar and Indonesia demonstrates that exclusive and continued breastfeeding and dietary diversity in young children are clearly defined by socioeconomic conditions. The research presented in this thesis further suggests that feeding practices during the first two years of life play significant mediating roles in the complex pathways between underlying socioeconomic factors and short-term nutritional status in young children, however these associations are harder to identify over longer periods of study, due to the limitations of observational studies. Keywords: Dietary diversity; breastfeeding; Southeast Asia; child nutrition; nutrition transition

More information

Identifiers

ORCID for Sabu Padmadas: orcid.org/0000-0002-6538-9374

Catalogue record

Export record