The Relationship Between

Feeding Practices And Children

ages 0-24months

Presented by: Jodi Tyrell

Francena Witter-Martin
 Introduction

 According to World Health Organization (WHO), 2017

breastfeeding is the normal way of providing infants
with adequate nutrients they need for healthy growth and
development.

 Colostrum, the yellowish, sticky breast milk that is

produced at the end of pregnancy, is recommended by
WHO as the perfect food for the newborn, and feeding
should begin within the first hour after birth.

 Exclusive breast feeding is recommended up to six

months of age.
 Introduction

 Breast milk provides nutrition for infants with a mixture of fats,

proteins and vitamins. It contains antibodies to help one’s baby to fight
off viruses and bacteria and also lowers the risk of having asthma and
allergic reactions (Webmed, 2017)

 Infants weaned before 12 months of age should not receive cow's milk
feedings but should receive iron-fortified infant formula. Gradual
introduction of iron-enriched solid foods in the second half of the first
year should complement the breast milk diet.
 Introduction

 Diarrhoea is a disease that affects children between the ages 0-4 years.
It is the second leading cause of death among children under five
worldwide. Forty-three percent of children with diarrhoea receive
treatment. (WHO, 2017).
Research Question
 To determine the relationship between feeding practices
and diarrhoea
 OBJECTIVES
1. Describe the types of feeding practices

2. Determine if there is a relationship between children

who have ever been breastfed and their experience of
diarrhoea in the last two weeks.

3. Determine if there is a relationship between children

who consume formula feed and their experience of
diarrhoea in the last two weeks.
HYPOTHESES
 Ho - There is no relationship between breast feeding and
diarrhoea
 Ha – There is a relationship between breast feeding and
diarrhoea.

 Ho – There is no relationship between formula feed and

diarrhoea
 Ha – There is a relationship between formula feed and
diarrhoea
 LITERATURE REVIEW
Exclusive breastfeeding provides all infants nutritional and fluid needs in the first six months and is a perfect

combination of proteins, fats, carbohydrates and fluids. Exclusively breastfeed children are at a much lower risk of

Infections and it is the best and cost effective intervention to reduce infant morbidities and mortalities .

Over two-thirds deaths occurring world wide during the first year of life children are often associated with

inappropriate feeding practices, especially due to poor exclusive breastfeeding practices. Suboptimal breastfeeding

contributes to 45% of neonatal infectious deaths, 30% of diarrheal deaths and 18% of acute respiratory deaths among

under five years of age children in developing countries. It also accounts on 10% of the disease

burden in children less than 5 years old . A total of 96% of all infant deaths i.e. 1.24 million

deaths occur during the first six months of life are attributable to non exclusive breastfeeding which is much higher in

Asia and Africa.

 LITERATURE REVIEW
Exclusive breastfeeding from birth to six months has the potential to prevent 13% of child mortality.
 LITERATURE REVIEW
 Adequate nutrition plays an enormous role in a child’s
physiological and cognitive development (Horta BL,
Victora CG, 2013)

 Feeding practices have proven to be a very diverse

phenomenon that changes over a short span except for
breast feeding practice.(Horta BL, Victora CG, 2013)

(Horta BL, Victora CG, 2013)

 LITERATURE REVIEW
 Mihrshahi S et al (2007), conducted a study using the Multiple Indicator Cluster Survey, which concluded that
infants aged 0-3 months, had a high prevalence of diarrhoea which was significantly associated with lack of
exclusively breastfeeding.

( Mihrshahi S, Ichikawa N, Shuaib M, Oddy W, Ampon R, Dibley MJ, Kabir AI, Peat JK 2007).
 LITERATURE REVIEW
Compared with exclusive breastfeeding in the first few months of life,

partial or no breastfeeding is associated with a 2.23-fold higher risk of

infant deaths resulting from all causes and 2.40 and 3.94 fold higher

risk of deaths attributable to pneumonia and diarrhea, respectively.

Non exclusive breastfeeding is known to compromise the nutritional

status of children. It results an estimated 40% of under-five stunting in

Western and Central Africa (WCA) and more than 60% in some

other countries.
 POPULATION & SETTING
 The study was conducted in Jamaica in the year 2011 by
the Statistical Institute of Jamaica.

 According to the Statistical Institute of Jamaica

(STATIN, 2011) the census reported a population
approximation of 2,699,838 individuals.
 STUDY DESIGN
 The design used was a quantitative cross-sectional study.
This was used to obtain information on feeding
practices, childhood development, age and care of
illnesses.

 This was applicable to the study as a cross-sectional

study was used to examine the relationship between two
variables (health related issues and feeding practices).
 SAMPLE SIZE & STRATEGY
 A stratified random sampling technique was used to
select participants to conduct this study. The Jamaica
Multiple Indicator Cluster Survey was used to select
children for the study.

 The population consisted of 1639 children ages 0-59

months. A sample size of 971 children ages 0-24 months
was used for the secondary analysis.
 DATA COLLECTION
 A total of 360 sample Enumeration Districts was
selected.

 A two-stage stratified probability sampling technique

was used.

 A household listing was carried out. The second stage

of sampling was selected from 20 households from each
Enumeration Districts.

 The household selected from the Enumeration Districts

had a sample size of seven thousand two hundred.
RELIABILITY & VALIDITY
 The data collection tool was pre-tested for validity and
reliability of the questionnaire before approval was
granted.

 The questionnaire was resubmitted to the committee for

approval.
ETHICAL CONSIDERATIONS
 Approval from the Ministry of Health

 Confidentiality-

 Voluntary participation

 Anonymity

 Informed consent

 Non- malificence
 DATA ANALYSIS
 The Proposed System Package Plan (PSPP) software program version 20was used

to critically evaluate the data.

 Two correlation analysis was done to examine the relationship between feeding

practices and childhood illnesses.

 The findings was described using descriptive statistics such as frequency tables.
The main aim of this research project was to examine the relationships between different feeding

practices of mothers and the influence they have on diarrhoea in babies. The study further assesses

the role age and gender play in diarrhea incidences. This section consists of statistical analyses

conducted on secondary data collected. The analysis aimed to meet the following research

objectives:

 To determine the various feeding practices of mothers

 To determine if there is a relationship between children who have ever been breastfed and their

experience of diarrhoea in the last two weeks

 Determine if there is a relationship between children who consume formula feed and their

experience of diarrhoea in the last two weeks

 To determine the association between demographic factors and babies experiencing diarrhoea

This section was divided into three headings (Descriptive statistics, inferential statistics and

summary) for better understanding.

 The descriptive section consists of information on babies’ demographic characteristics, diarrhoea

occurrence and the feeding practices of mothers. On the other hand, the inferential section consists

of chi square tests that were carried out to examine relationships between the variables of interest.

The summary provides a recap of the main findings and indicates whether the null hypotheses were

rejected or accepted.
 Descriptive Statistics
Figure 1 shows that 53% of the babies born were males while 47% were
females
Figure 1: Sex of baby

47%
53%
Male
Female

Figure 1.
In terms of age, fifty nine percent babies were 0-2 years old while
forty one percent were 3-4 years old.
Figure 2: Age group

41%
0-2 yrs old
3-4 yrs old

59%

Figure 2.
The findings of the study confirmed that 95% of babies were previously
breastfed and 26% are still being breastfed. Babies also received
complementary solid and semi-solid foods. The data shows that 89% were
drinking juices, 42% were drinking milk, 24% were eating porridge and 19%
were drinking soup. Importantly, 89% indicated that babies giving plain water
to drink. Lastly, 30% of babies are being fed infant formula.

Child ever been breastfed 95%

Child drank juice or juice drinks yesterday 89%
Child drank plain water yesterday 89%
Child ate solid or semi-solid food yesterday 76%
Child drank milk yesterday 42%
Child drank any other liquid yesterday 38%
Child drank anything else from the bottle with a… 37%
Child drank infant formula yesterday 30%
Child drank or ate vitamin or mineral supplements… 28%
Child still being breastfed 26%
Child ate thin porridge yesterday 24%
Child drank soup yesterday 19%
Child drank or ate yogurt yesterday 1%
Child drank ORS yesterday 1%

0% 20% 40% 60% 80% 100%

The study findings indicate that the majority (94.1%) of babies did not suffer from
diarrhoea. A very small amount of mothers indicated that they were not sure if their
babies suffered from diarrhoea.
 Children who had diarrhoea in the last two(2) weeks

0.1%
5.8%

Yes
No
Don't Know

94.1%
 Research Question 1: Is there a statistically significant relationship between
breastfeeding and diarrhoea?
 H0: There is no relationship between breastfeeding and diarrhoea
 H1: There is relationship between breastfeeding and diarrhoea

 A Chi-Square test was carried out to determine if a statistically significant
relationship exists between babies that are being breastfed and their
chance of having diarrhoea. Based on the results there is a statistical
significant association between the two variables, χ2 (1,) = 8.086, p<0.05.
Statistically significant associations are more likely to vary with sample
sizes; therefore, it is important to examine the effect size to understand if
the association observed is meaningful. For Chi-square test, the two
measures of effect size used are Phi and Cramer’s V. Both measure the
strength of association of categorical variables. For this study, the variables
were babies being breastfed and having diarrhoea. Phi is appropriate when
there are two dichotomous variables to analyze, while Cramer’s V can be
used in other instances. Therefore, Phi effect size was utilized in this study.
It was discovered that there was a very weak negative association between
breastfeeding and diarrhea, Phi= -.072, p <0.05. Hence, there is a higher
chance of babies that are not being breastfed to encounter diarrhea.
Specifically, Table 1 shows that diarrhea was 3.8% higher in babies that
were not being breastfed.
 Table 1: Chi square analysis of Child still being breastfed and having diarrhoea
(N=1540)

Child had diarrhoea in last 2 weeks

Child still being breastfed Yes No c2 Φ

Yes 3.0% 97.0% 8.086** -0.072

No 6.8% 93.2%

Note: **= 2 =8.086, df = 1, p < .05.

 Research Question 2: Is there a statistically significant relationship between
formula feed and diarrhoea?

 H0:There is no relationship between formula feed and diarrhoea

 H1: There is relationship between formula feed and diarrhoea

 Another chi square was carried out to determine if there is a relationship

between babies that are being given infant formula and having diarrhoea.

The results confirmed that there was no statistical significant association

between the variables of interest, χ2 (1,) = 8.086, p>0.05. Hence, the

likelihood of a baby having diarrhoea was independent of if the baby was

receiving infant formula (Table 2).

Chi square analysis of Child drank infant formula and having diarrhoea (N=1630)

Child had diarrhoea in last 2 weeks

Child drank infant formula

yesterday Yes No c2

Note: *= 2 =.924, df = 1, p > .05

Yes 4.9% 95.1% .924*

No 6.1% 93.9%
 Research Question 3: Is there a statistically significant relationship
between babies’ age and diarrhoea?

 H0: There is no relationship between babies’ age and diarrhoea

 H1: There is relationship between babies’ age and diarrhoea

 A third chi square analysis was carried out to further examine the

possible contributing factors to diarrhoea in babies (Table 3). In this

case, the age of the babies were examined. The statistical test

indicated that there were no significant relationship between babies’

age and the likelihood of having diarrhoea, χ2 (1,) = .020, p>0.05.

 Note: *= 2 =.020, df = 1, p > .05

Child had diarrhoea in last 2 weeks

Age Group Yes No c2

0-2 years old 5.9% 94.1% .020*

3-4 years old 5.7% 94.3%

 Research Question 4: Is there a statistically significant relationship between

babies’ sex and diarrhoea?

 H0: There is no relationship between babies’ sex and diarrhoea

 H1: There is relationship between babies’ sex and diarrhoea

 A final chi square test was carried out to determine if the incidence of

diarrhoea was significantly different across sexes. The tests confirmed that

there was indeed a statistically significant difference in diarrhoea

occurrence across sexes, χ2 (1,) = .4.464, p<0.05. Furthermore, analysis

indicated that there was a weak association between sex of babies and

having diarrhea, Phi= .053, p <0.05. Additionally, the findings shows that

occurrence of diarrhea in male babies was 2.5% higher than female babies.
 Chi square analysis of Child’s Sex and having diarrhoea (N=1637)

Child had diarrhoea in last 2 weeks

Age Group Yes No c2

0-2 years old 5.9% 94.1% .020*

3-4 years old 5.7% 94.3%

Note: *= 2 =.020, df = 1, p > .05

 Research Question 4: Is there a statistically significant relationship

between babies’ sex and diarrhoea?

 H0: There is no relationship between babies’ sex and diarrhoea

 H1: There is relationship between babies’ sex and diarrhoea

A final chi square test was carried out to determine if the incidence of

diarrhoea was significantly different across sexes. The tests confirmed that

there was indeed a statistically significant difference in diarrhoea

occurrence across sexes, χ2 (1,) = .4.464, p<0.05. Furthermore, analysis

indicated that there was a weak association between sex of babies and

having diarrhea, Phi= .053, p <0.05. Additionally, the findings shows that

occurrence of diarrhea in male babies was 2.5% higher than female babies.
 Chi square analysis of Child’s Sex and having
diarrhoea (N=1637)

Child had diarrhoea in last 2 weeks

Sex Yes No c2 Φ

Male 7.0% 93.0% 4.564** 0.053

Female 4.5% 95.5%

Note: *= 2 =4.564, df = 1, p < .05

 Table 4
 Summary

 Breastfeeding practices
 The findings of the study confirmed that most babies were being breastfed. However, babies were given infant
formulas, juice, milk and solid and semi-solid form of foods including soup and porridge.
 Research Question 1: Is there a statistically significant relationship between breastfeeding and diarrhoea?

 The study confirmed that babies that were not being breastfed were more likely to experience diarrhoea. Therefore, we
failed to accept null hypothesis.

 Research Question 2: Is there a statistically significant relationship between formula feed and diarrhoea?

 The results confirmed that there was no statistical significant association between formula feed and diarrhoea.
Therefore, we failed to reject the null hypothesis.

 Research Question 3: Is there a statistically significant relationship between babies’ age and diarrhoea?

 The study indicated that there were no significant relationship between babies’ age and the likelihood of having
diarrhoea. Therefore, we failed to reject the null hypothesis.

 Research Question 4: Is there a statistically significant relationship between babies’ sex and diarrhoea?

 The research confirmed that there was a statistically significant relationship between sex and diarrhoea. Male babies
were more likely to experience diarrhoea in comparison to female babies. Therefore, we failed to accept the null
hypothesis.

 DISCUSSION
 It is evident based on research that
exclusive breast feeding plays a dominant
role in the development of a child.
 DISCUSSION
 Human milk is made up of two main proteins namely Whey
and Casein, with a ratio 60:40, approximately 60-80% of
human milk is whey protein, which has great infection-
protection properties

 Breast milk produces antibodies that helps the infant to fight

against infectious and chronic diseases

 Antibodies are host proteins that are produced by the immune

system in response to foreign molecules that tries to invade
the body

 How antibodies helps to ward off infections

 DISCUSSION
that prevalence of prolonged diarrhoea was lower in bottle
fed babies and breastfed babies.

 Lack of exclusively interrupts the development of the

child. As a result the immune system is not developed.
This predisposes the child to obesity and other illnesses.
 CONCLUSION
Studies have prove the importance of breastfeeding in
reducing morbidity and mortality due to Pneumonia and
Diahorrea.

It is evident based on literature that breastfeeding promotes

healthy development in a child, and reduces the risk of
childhood illnesses and other predisposing factors.

Breast milk has the right components, (fats, nutrients etc)

promotes bonding, has the right temperature and is
inexpensive.
 REFERENCES
 Carreira, H., Bastos, A., Peleteiro, B., & Lunet, N. (2015). Breast-feeding and Helicobacter pylori infection:

Systematic review and meta-analysis. Public Health Nutrition, 18(3), 500-520.

doi:10.1017/S1368980014000500

 Gillian A Levine, Judd L Walson, Hannah E Atlas, Laura M Lamberti, Patricia B Pavlinac; Defining Pediatric

Diarrhea in Low-Resource Settings, Journal of the Pediatric Infectious Diseases Society, Volume 6,

Issue 3, 1 September 2017, Pages 289–293, https://doi.org/10.1093/jpids/pix024

Horta BL., Victora CG. Short-term effects of breastfeeding: A systematic review on the benefits of

breastfeeding on diarrhoea and pneumonia mortality. Geneva: The World Health Organization; 2013.

Multiple Indicator Cluster Survey (2011). Retrieved from https://mics-surveys

prod.s3.amazonaws.com/MICS4/Latin%20America%20 and%20Caribbean

Quigley MA, Kelly YJ, Sacker A. Breastfeeding and hospitalization for diarrheal and

respiratory infection in the United Kingdom millennium cohort

 REFERENCES
Quigley MA, Kelly YJ, Sacker A. Breastfeeding and hospitalization for diarrheal and respiratory

infection in the United Kingdom millennium cohort study. Pediatrics. 2007;119(4):e837–e842.

doi:10.1542/peds.2006-2256.

Statistical Institute of Jamaica (STATIN), & United Nations Children’s Fund (UNICEF).

(2011). Jamaica Multiple Indicator Cluster Survey 2011: Final Report(Rep.).

Retrieved from https.//micshttps://mics-surveys-

prod.s3.amazonaws.com/MICS4/Latin America and

Caribbean/Jamaica/2011/Final/Jamaica 2011 MICS_English.pdf

World Health Organization (2018). Infant and young child feeding. Retrieved from

https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding.