Nutritional status and home environment as determinants of attainment of developmental milestones in children

Abstract

A study on ‘Nutritional status and home environment as determinants of attainment of developmental milestones in children’ was carried out to find out the relationship between milestone attainment, nutritional status and home environment of children.

The present study was done in Vellanad ICDS project of Thiruvananthapuram District among fifty infants and fifty toddlers.

The data pertaining to the socioeconomic and child’s characteristics, health and nutritional profile was assessed using a suitably structured pretested schedule. Home environment of the subjects was assessed using the modified version of Caldwell’s HOME INVENTORY standardized by Child Development Centre, Govt. Medical College, Thiruvananthapuram. Developmental milestones of the subjects were assessed using Trivandrum Developmental Screening Chart also developed by Child Development Centre, Thiruvananthapuram. The data collected were tabulated, analyzed statistically and the results were interpreted.

Majority of the mothers interviewed were in the age group of 20-25 years. The age group of fathers was between 30-40 years. Socioeconomic data of the subjects indicated that majority of the families were Hindus with a majority belonging to backward caste. Most of the participants were from nuclear family with medium level of education, low monthly income and moderate physical amenities.

Data collected about child’s characteristics revealed that majority of the subjects were males. Majority of them were of first birth order and were delivered normally.

Feeding practices of infants and toddlers revealed that colostrum was given as the first feed. About sixty eight per cent of mothers followed demand feeding.

Problems related to weaning such as diarrhea, vomiting and constipation were common among the children.

Analysis on knowledge of mothers regarding nutrition and child care revealed that majority of them had only medium level of knowledge.

Anthropometric measurements revealed that BMI of twenty two per cent of mothers fell below normal range and one per cent were obese. Anthropometric data on children revealed that majority of the children were normal according to weight for age based on Gomez classification. Based on IAP classification fifty eight per cent of the subjects were normal and forty five per cent were normal based on Z score classification. Based on height for age Z score classification, fifty six per cent of the subjects were normal and eleven per cent were found to have severe malnutrition. Wasting was seen among nine per cent of the subjects and twenty three per cent suffered from wasting and stunting according to Waterlow’s classification. Data on MUAC found that fifteen per cent suffered from severe malnutrition. Twenty per cent were found to be malnourished when head to chest circumference ratio was assessed.

Clinical examination of the subjects revealed non specific symptoms such as discolouration of hair and angular stomatitis in eight and five per cent of children respectively. Anemia was found to be the most common clinical deficiency symptom prevalent.

Nutritional status index of the subjects indicated that 8 per cent of infants and 14 per cent of toddlers had low NSI.

Home environment of the subjects were studied using the HOME INVENTORY scale consisting of 19 items for infants and 21 items for toddlers. The scale consisted of statements grouped under six subscales which included parental responsivity, acceptance of the child, organization of the environment, learning materials, parental involvement and variety in experience. Analysis of home environment based on the modified version of HOME inventory revealed that 14 per cent of the infants and 16 per cent of toddlers did not get adequate home environment.

Developmental milestones were assessed using the Trivandrum Developmental Screening Chart. The chart consisted of 17 items of milestones which is designed for children upto 24 months of age. The child is said to have developmental delay if the child falls short on the vertical line of the left side of the chart. Assessment of developmental milestone ratio in the studied subjects showed that 2 per cent of infants and 6 per cent of toddlers had delayed developmental milestones.

A significant correlation was found between nutritional status and BMI, infant feeding practices, birth order and income and between developmental milestone ratio and economic status and home environment with birth weight. Intercorrelation between dependant variables revealed that there is significant relationship among them. The study highlights the importance of creating more awareness among parents of infants and toddlers about the importance of proper feeding practices and also providing them a stimulating environment for their holistic development.