Can frontline workers be change agents for infant feeding and growth? - A community Trial

Abstract

Background: Role of optimum infant feeding practices on growth and survival of children is well established. Promoting it through routine public health care system is the challenge. Objectives: To assess the change in knowledge and practices of caregivers about infant feeding and physical growth of infants through training of frontline health workers. Methods: A cluster-randomized controlled trial was conducted among 130 infant mother pairs (65 in each group), recruited at birth, in a rural community in Bankura, West Bengal. Frontline health workers of the intervention area received modular training on infant feeding and supported the caregivers in adopting optimum feeding practices. Change in knowledge and practice of caregivers on infant feeding and physical growth of infants were assessed at monthly interval. Results: Knowledge regarding early initiation, duration of exclusive breastfeeding, and timely introduction of semi-solid food was increased significantly at 6th month in intervention area with almost no improvement in control area. At 6th month, exclusive breastfeeding was practiced by 76.9% infants in intervention area and 63.1% in control area, although in both cases, it was reduced from the proportion at birth. Proportion of infants having bottle feeding and intake of other liquid food also increased with time and more so in control area. In 6 months, infants of intervention area gained on average 600 gms more weight than those of control area, but gain in length was almost similar in both the groups. Conclusion: Promotion of infant feeding through frontline workers is a feasible intervention in the present context.

Keywords

• Infant Feeding
• Knowledge
• Practice
• Change
• Frontline Workers
• Training