title: Infant feeding practices among mildly wasted children: a retrospective study on Nias Island, Indonesia.
abstract: BACKGROUND
  This study investigated the infant feeding practices of participating mothers who were recruited into a research project aimed at improving the nutritional status of mildly wasted children (< -1.0 to ≥ -1.5 Weight-for-Height Z-scores) aged ≥ 6 to < 60 months on Nias Island, Indonesia.
  
  
  METHODS
  Cross-sectional, questionnaire-based interview of mothers of the index children (n = 215) who were admitted to the community program for mildly wasted children in the study area. Four focus groups and twenty in-depth interviews were conducted to explore further information on infant feeding practices in the study area.
  
  
  RESULTS
  Retrospective results indicated that 6% of the mothers never breastfed. Fifty two percent of mothers initiated breastfeeding within six hours of birth, but 17% discarded colostrum. Exclusive breastfeeding until 6 months of age was practiced by 12%. Seventy-four percent of the mothers offered supplementary liquids besides breast milk within the first 7 days of life, and 14% of infants received these supplementary liquids from 7 days onwards until 6 months of age. Moreover, 79% of the infants were given complementary foods (solid, semi-solid, or soft foods) before 6 months of age. About 9% of the children were breastfed at least two years. Less than one in five of the mildly wasted children (19%) were breastfed on admission to the community program. Qualitative assessments found that inappropriate infant feeding practices were strongly influenced by traditional beliefs of the mothers and paternal grandmothers in the study areas.
  
  
  CONCLUSIONS
  Generally, suboptimal infant feeding was widely practiced among mothers of mildly wasted children in the study area on Nias Island, Indonesia. To promote breastfeeding practices among mothers on Nias Island, appropriate nutrition training for community workers and health-nutrition officers is needed to improve relevant counseling skills. In addition, encouraging public nutrition education that promotes breastfeeding, taking into account social-cultural factors such as the influence of paternal grandmothers on infant feeding practice, is needed.
authors.affiliation: Institute for Social Sciences in Agriculture, Center Gender and Nutrition (430b), University Hohenheim, Fruwirthstrasse 14-16, 70593 Stuttgart, Germany. veronika.scherbaum@uni-hohenheim.de.
authors.forename: Dyah Ayu
authors.initials: DA
authors.lastname: Inayati
authors.forename: Veronika
authors.initials: V
authors.lastname: Scherbaum
authors.forename: Ratna Chrismiari
authors.initials: RC
authors.lastname: Purwestri
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hormann
authors.forename: Nia Novita
authors.initials: NN
authors.lastname: Wirawan
authors.forename: Julia
authors.initials: J
authors.lastname: Suryantan
authors.forename: Susan
authors.initials: S
authors.lastname: Hartono
authors.forename: Maurice Alexander
authors.initials: MA
authors.lastname: Bloem
authors.forename: Rosnani Verba
authors.initials: RV
authors.lastname: Pangaribuan
authors.forename: Hans Konrad
authors.initials: HK
authors.lastname: Biesalski
authors.forename: Volker
authors.initials: V
authors.lastname: Hoffmann
authors.forename: Anne Camilla
authors.initials: AC
authors.lastname: Bellows