Assessment of Nutritional Status of under-five year rural children in ...

5. DISCUSSION AND CONCLUSIONSNational population policy 2000 envisaged that about 80% of deliveries shouldbe Institutional and 100% should be conducted by trained personnel 16 . The presentstudy revealed that only 68% were institutional deliveries conducted by trainedhealth personnel. Sixty seven per cent of pregnant women had undergone antenatalcheck-up. However, 26% had undergone the minimum 3 ANCs. About 86% receivedTT immunization in the Damoh district of Madhya Pradesh. According to NFHS-3survey, about 80% of the pregnant women had undergone ANC in the state ofMadhya Pradesh 10 .Birth weights were recorded in about 60% of the newborns, but the recordswere available for only 36% of them. The proportion of low birth weight (LBW) wasabout 31% in the district. The birth weight of an infant is the single most importantdeterminant of new born survival and in developing countries; low birth weight infantsare at increased risk of being malnourished at one year of age, become victims of“infection-malnutrition cycle” which leads to further physical stunting and impairedgrowth and development. 17 In addition, children born with intrauterine growthretardation are at higher risk of developing overweight/obesity and associatedchronic degenerative disorders during adulthood 6 .Infant and young child feeding practices have a significant impact on childhealth and survival. Appropriate feeding including early and exclusive breastfeedingand optimal complementary feeding practices such as right time of initiation, righttype and quantity of complementary foods and frequency of complementary feedingis important for proper physical growth and mental development of the child. In itspolicy statements, the American Academy of Paediatrics (1997) 18 stated that themother’s milk is uniquely superior for infant feeding.Epidemiological research showed that mother’s milk and breastfeeding ofinfants provides advantages with regard to general health, growth and developmentwhile significantly decreasing risk for a large number of acute and chronic diseases.In this study, breastfeeding was the common practice among the mothers. About35% of the mothers reportedly initiated breastfeeding within one hour after deliverywhich is higher than that reported by NFHS-3 (16%), while 26% of mothers initiatedbetween 1-3 hours. Pre-lacteals were given in about 29% of the newborns. Prelactealfeeds might harm the immature gut of the child, especially if they arecontaminated. These undesirable newborn feeding practices observed in the districtis a matter of concern and requires due attention because, early initiation of breastfeeding is the primary determinant of maternal milk production and secretion.Avoidance of other fluids or foods is essential to optimize breast milk intake by thenewborn. Most of the other fluids or foods are less nutritious than breast milk andtherefore, if displacement occurs, the infant may be at a nutritional disadvantageeven if prepared hygienically 19 . In many communities, it is traditionally believed thatcolostrum is unhealthy and therefore is harmful to the baby. However in the presentNutritional Status of