Study characterized infant dietary patterns and examined relations between caregivers feeding behaviors and infant dietary diversity among infants 6-24mo in rural Guatemala where undernutrition is high.
Data were collected on 336 mother-infant dyads enrolled in an integrated nutrition and early child development cluster randomized trial (Project MIEL). A context specific 25-item feeding behaviors questionnaire was developed; factor analysis revealed 3 theoretically derived constructs of feeding: responsive (4-items), forceful/indulgent (8-items), and restrictive (4-items). A continuous score was created for each. Daily and weekly dietary diversity scores (DDS;range 0-7) were derived using FFQ data based on the intake of >= 1 food per food group (grains, legumes, dairy, meat, eggs, vitamin A-rich fruits/vegetables(FV), other FVs). Daily and weekly servings consumed by food groups were also examined. Relations were examined using linear mixed effect regression models to account for confounding variables and geographic clustering.
Daily and weekly dietary diversity was low with mean intakes at 2.76 and 5.76 food groups, respectively. Responsive feeding was positively associated with weekly DDS (ß:0.36;95%CI:0.045,0.68), reflected by higher weekly servings of grains (ß:0.69;95% CI:0.013,1.25), Vitamin A-rich FVs (ß:0.31;95%CI:0.07,0.55), other FVs (ß:1.14;95%CI:0.028,2.0), and a marginally higher intake of legumes (ß=0.25;CI:-0.02,0.52,p=0.07). No significant relations were found between forceful/indulgent or restrictive feeding behaviors and dietary diversity or between responsive feeding behaviors and daily DDS or weekly servings of eggs, dairy, and meat(p>0.05).
Findings suggest that in the context of high undernutrition, responsive feeding behaviors were associated with better dietary diversity in grains, FV, and legumes (p=0.07) but not animal source foods.