The study was conducted in Sinam VDC of Taplejung district of Nepal. It is descriptive cross sectional study and analysis was done relating independent study variables to dependent variables.
Methods: The data collection methods were used for this study was semi structure questionnaire to assess practice and structured guideline for FGD to understand the beliefs and taboos on weaning in the area.
A total of 120 mothers with children aged between 3 month to around 3 years were included to assess the weaning practice of which 49.2% were below 1 year, 35% were within 2 years of age, 14.2% less than or of 3 years of age, 1.7% were above 3 years.52.5% of children were male and 47.5% were female.33.3% of families had 2 children and 15.8% of families had 5 children. Majority of them belonged to Janajati(35%) which was predominant ethnic group. Majority of respondents belonged to Hindu religion (66.7%) 34.7% of respondents had primary level of education. There is significant relationship between mother’s education and weaning practice in the study. Farming (25%) and foreign employment (51.7%) were major source of income and occupations followed in the area.
90.8% belonged to middle class in the wealth index. Calculations showed that there is positive association between income range and weaning practice.47.5% of mothers introduced weaning foods before 6 months of age of infants, 40% after 6 months and 12.5% before 1 month.
Most common types of weaning foods in this study area were sarbottam pitho(81.8%) and khole (47.1) with rice as a staple diet.85.83% of respondents still breastfed their child along with complementary feeding.14.17% of them expressed their view that breast milk was not sufficient and not required after certain age.75% of respondents were conscious enough to do night feeding to the baby and remaining 25% were reluctant to the practice.58.3% of respondents had the knowledge on need of sterilization of feeding equipment.72.5% of them had appropriate weaning practice.
Focused group discussion on beliefs and taboos revealed that Cultural factors and taboos have a powerful influence on feeding practices and eating patterns. Young mothers often find it impossible to ignore their ill-informed elders or peer group. Children were being fed three or more meals daily for reasons of hunger and satiety, stomach capacity and adequate growth. Traditional/cultural food preparation beliefs/practices were still adhered to. However, some participants thought that some of these practices were old fashioned and needed to be changed.
Child health in developing countries is a serious concern with a large number of children still suffering from malnourishment. South Asian region has the highest global burden of child under nutrition, with almost 41% of children stunted, 16% wasted and 33% underweight. In Nepal the prevalence is 48.3%.1 There are various factors that lead to high prevalence of malnutrition in children and among them infant feeding practices is one of the most important. Whether it is breastfeeding or complementary feeding, the practices adopted by mothers or caretakers have direct effect on child health.
World Health Organization (WHO) recommends that children should be exclusively breastfed during the first 6 months of life as breast milk alone is sufficient to meet the nutritional requirements of children till then.2 In communities undergoing social changes, the incidence and duration of breast-feeding has decreased whereas bottle and solid feeding are introduced earlier.
Complementary feeding is another very important component of infant feeding. After 6 months, mother’s milk is not sufficient for the growing child and complementary feeding should be started, timely and in adequate amounts.
Weaning is the process of gradually introducing a mammal infant to what will be its adult diet and withdrawing the supply of its mother's milk.
The process takes place only in mammals, as only mammals produce milk. The infant is considered to be fully weaned once it no longer receives any breast milk (or bottled substitute).3
Weaning in human infants is a subject of controversy in terms of its initiation and correct method of doing it. The ideal age of weaning is six months. The desirable weaning food should be inexpensive, home available, clean and easily digestible .It should be rich in calories and protein with adequate amount of trace elements like iron, calcium, vitamins etc.
Weaning is a gradual process starting around the age of 6 months because the mother’s milk alone is not sufficient to sustain growth beyond 6 months. Natural weaning occurs as the infant begins to accept increasing amounts and types of complementary feedings while still breastfeeding on demand. When natural weaning is practiced, complete weaning usually takes place between two and four years of age. Planned weaning occurs when the mother decides to wean without receiving signals from the infant that he is ready to stop breastfeeding. It should be supplemented by suitable foods rich in proteins and other nutrients. These are also called supplementary foods. They vary with socio-economic stratification and are regulated by a variety of factors such as education, customs, beliefs and taboos.
The study design adopted for the study was combination of both quantitative and qualitative study design. The study design was cross sectional, descriptive study. Quantitative methods were applied for assessing the weaning practices and Focused group discussions were done as a part of qualitative study. Focus group discussions were recorded on mobile telephone and interpreted accordingly.
The study was conducted for one month (November to December 2013) which included all the study activities for data collection.
Population: Mothers with children aged between 3 months to 3 years in the Sinam VDC of Taplejung district were taken as study population Sample and sample size: Each VDC consists of 9 wards. The population is not distributed uniformly. All mothers having a child in age group 3 month to 3 year was selected during the study period. According to the previous studies, approximately 70% of mothers have certain beliefs and taboos on weaning. Based on this estimate sample size of 180 mothers was worked out allowing an error of 10% of the estimate.However, 120 mothers were taken as sample that included all mothers of the VDC having infant aged 3 month to 3 years.