Volume 5, Issue 7, July – 2020 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

Characterization of Complementary Feeding in

Infants of Azogues, Biblián and Déleg
María Alejandra Aguirre Quezada1, María de los Ángeles Estrella González1, Andrés Alexis Ramírez-Coronel1,3, Pedro C. Mar-
tínez Suárez2,3, Mercedes Magdalena Sarmiento Pesántez1, Marina Cecilia
Andrade Molina1, Nancy Beatriz Cordero Zumba1.
1
Faculty of Nursing at the Catholic University of Cuenca, Azogues Campus.
2
Psychometry Laboratory of the Center for Research, Innovation and Technology Transfer (CIITT) of the
Catholic University of Cuenca.
3
Faculty of Clinical Psychology at the Catholic University of Cuenca

Abstract:- Nursing children consume small amounts of With the maintenance of the practice of breastfeeding
food, the quality is essential and determines the im- the child from six months onwards, the introduction of
portance of the complementary feeding. Parents must other foods to cover energy, protein, lipid and micronutri-
Access nutritional information objective to fix healthy ent requirements is vital. However, the growing number of
habits that prevent diet-related diseases. Quantitative, publications on effects on the nutritional status of children
correlational study of cross-section, participated 1760 suggests that it is the responsibility of the father, mother or
boys and girls from one to three years of public child caregiver to establish appropriate feeding habits, but at the
care units of the cantons Azogues, Bible and Deleg. (919 right age to generate significant and replicable learning
boys and girls 841). The measurements were frequency throughout life (4-5-6-8).
of consumption and eating behavior. The results of the
9.77% introduced foods other than breast milk at 4 The ages of six to eleven months represent an undis-
months and the 62.26% did so at 6 months. Most con- puted period of opportunities for work in favour of child
sumed foods are rice, banana, chicken, broccoli, potato nutrition, and it is ideal to be able to take advantage of the
and lentils with average equivalent to the common cate- time so that the child acquires a taste for different tastes,
gory and at least consumed quinoa, grape, the rabbit, textures and smells. Its application demands the under-
the zucchini and soy that are in any category. 86.82% of standing of this feeding phase in which the contribution of
researches say no selection for industrial cereal por- professionals is transcendental otherwise the inadequate
ridge feed. The results of this research are expected to CA will cause irreversible effects (7,9,10,11,27).
provide relevant information on the food pattern of
local children and enable child care institutions to pro- The incidence of nutrition on development and growth
vide specialized child nutrition support. is evident; providing the necessary energy and with the
corresponding nutrients requires an important action of
Keywords:- Complementary feeding, Consumption, infants, prevention of diet-related diseases (12,13,14,25).
breast milk.
The age of introduction of complementary foods is a
I. INTRODUCTION particularly important time in a child's development. The
diet undergoes a radical change from a single food (breast
Breastfed children consume small amounts of food; milk) with fat as the main source of energy to a variety of
however, the quality of the food is paramount and thus foods required to meet nutritional needs (15,16,23).
determines the importance of complementary feeding (CF).
The World Health Organization (WHO) defines CA as "the The diverse CA is the one that contains at least four
process that begins when breast milk is no longer sufficient food groups, among which the following stand out Cereals
to meet all the infant's nutritional needs and other foods are or tubers, legumes, milk derivatives: cheese, yogurt or
therefore needed to supplement it" (1). This period is ideal breast milk substitutes, meats: red, fish, chicken, viscera,
for: 1) promoting the ability to chew; 2) familiarizing the egg, fruits or vegetables (18,19,23). In relation to dairy
child with flavours, aromas and textures; and 3) consuming products, unmodified whole cow's milk is not indicated for
foods with a high density of nutrients (2). CA, because of the possible association with blood loss
through the faeces (20,21).
After exclusive breastfeeding, it is not possible to
cover energy, macro and micronutrient requirements The food group that is most difficult to consume is
through this form of encouragement. For this reason, since meat, an essential source of iron and zinc. When its inges-
2001, the WHO recommends that, without suspending tion, during the first years of life, through the diet is fre-
breastfeeding, it is necessary to start CA from six months of quently inadequate, it causes a decrease in physical capaci-
age (1,3). ty and cognitive performance, and changes in behavior,
among others (24).

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Volume 5, Issue 7, July – 2020 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
In Ecuador, the Ministry of Public Health has stated collect the information, the questionnaire designed by
that it agrees with the recommendation of the WHO and Freire and collaborators (2012) was used, which included
educates the population in its health units so that children categories corresponding to socio-economic conditions,
begin CA from the sixth month of life (25). It is unques- eating behaviour and frequency of consumption, estab-
tionable that CA is much more than simply introducing lished in the National Health and Nutrition Survey of Ecua-
food for the child. It corresponds to a large window of dor.
opportunity for growth, affection and the establishment of
healthy eating habits. In this context, the use of cereals to The socio-economic status variable was studied
prevent energy deficiency and the proper selection of other through the level of education of the mother or caregiver,
food groups that in the right quantities will be the basis of characteristics of the dwelling and occupation of the head
future eating patterns. The purpose of this research was to of household. Breast milk consumption was measured
characterize the complementary feeding of children attend- through the options Yes - No. The age at which she began
ing public childcare units in the cantons of Azogues, Bib- to receive food other than breast milk/formula was the age
lián and Déleg. scale represented by 4, 5, 6.7 months, and the other options,
she does not remember. The age at which food groups were
II. METHODOLOGY introduced was associated with the range of 4-12 months
with cereals, fruits (except citrus), meats, root vegetables,
The type of study corresponded to a quantitative, cor- egg yolk and legumes and the other options were added,
relational, cross-sectional, quantitative-focused and non- does not recall and that food group is not given.
experimental research. The study population corresponds to
the following cantons: Azogues, Biblián and Déleg belong The frequency of consumption variable assessed the
to the province of Cañar, which is located in the south of consumption and the frequency of consumption, consider-
Ecuador, in the geographical area known as the inter- ing it to be very frequent if the consumption is once a day
Andean region or sierra, mainly on the Cañar valley. It was or more than twice a day, frequent two or three times a
carried out in collaboration and under the auspices of the week, infrequent once a week, possibly once a month and
Azogues District 1 of the Ministry of Economic and Social never. The consumption of industrial cereal porridges cor-
Inclusion, with 51 childcare units distributed in the three responded to the categories Yes - No. The causes of the
cantons. At the date of the data collection, there were 2403 non-consumption of industrial porridges were determined
children aged 1 to 3, with an error of 1.5% and a confi- using the options: high cost, taste not accepted by children,
dence level of 98.5%. products are not natural and not easily available. In the data
analysis, the calculation of central tenure measures was
All children enrolled in the study were included, but performed and the Spearman coefficient was used to de-
all those who entered the program during the research pro- termine the correlation, using the SPSS version 25 statisti-
cess were excluded. In addition, one representative per cal program.
child was included and informed consent is available. To

III. RESULTS

By applying Spearman's correlation coefficient by hierarchy, to know the degree of association of the variables level of edu-
cation of the mother/carer, consumption of breast milk, level of social class of the head of household and consumption of industri-
al cereal porridge; an average positive correlation is concluded (table 1).

Consumo de leche materna p

Mother/caregiver's level
of education Yes No
f % f %
None 1 0,06 0 0

1 - 3 years of primary 64 3,64 3 0,18

school 0.313
4 - 5 years of primary 520 29,54 2 0,12
school
1 - 3 years of high school 242 13,74 5 0,28

4 - 6 years of high school 585 33,24 45 2,56

Superior 203 11,52 90 5,12

Total 1615 91,74 145 8,26

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Volume 5, Issue 7, July – 2020 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Social class level of the Consumption of industrial cereal porridge
head of household
Yes No
f % f %
Upper-middle stratum 121 6,88 133 7,55
Middle layer 87 4,94 284 16,14
High popular stratum 18 1,02 629 35,74 0,429
Low popular stratum 6 0,34 482 27,39
Total 232 13,18 1528 86,82
Table 1:- Educational level of the mother or caregiver and social class level of the head of household.

The age at which she began to receive food other than warns of an inadequate contribution of nutrients from an
breast milk is presented in Table 2, highlighting 9.76% and early age. When observing the introduction of food groups
62.27% corresponding to 4 months and 6 months respec- in relation to age, it is observed that when CA begins, the
tively, the average age of onset of CA is 5.86 months. selection of cereals, fruits, vegetables and tubers predomi-
nates. Unlike groups such as legumes and meats. The se-
The description of the food groups and age of con- quence of introduction of egg yolk, meats and legumes
sumption is presented in Table 2, observing that the se- generates interest, as they are introduced during all the
quence with which they are added to the diet is done in a months of the study and they even profile as those who do
disorderly manner and early in certain cases or late in an- not select for CA. Not offering cereals could suggest some
other. This disfigures the proposed international scheme. It relation with celiac situations probably. The groups that
is also identified that the food group that parents decide not show similar behaviour in CA in this study population are
to include in the CA is meat and egg yolk, a situation that fruits, vegetables and tubers.

Age at which she began to regain food other than f % Central tendency meas-
breast milk urements
4 months 172 9,76 Media = 5.86
Mode = 6
5 months 102 5,80 Standard deviation = 0.78
6 months 1096 62,27
7 months 224 12,73
Other 0 0.00
He doesn't remember. 166 9,44
Total 1760 100
Table 2:- Age at which she started receiving food other than breast milk

The summary of the consumption frequency statistics IV. DISCUSSION

for the food groups is detailed, highlighting that the most
consumed foods are rice, banana, chicken, broccoli, potato The present study identified, the early introduction of
and lentil with averages equivalent to the very frequent foods before six months, complexity in the sequence of
category and the least consumed are quinoa, grapes, rabbit, introduction of food groups and even foods that are not
zucchini and soya which are located in the eventual indica- included in the CA plans, situations that could impact on
tor. The consumption of industrial cereal porridges and the the nutrition of infants and that move away from the
description of the causes of the lack of consumption are compliance with the international provisions of the WHO
presented in table 5, observing that 86.82% of the people (1).
surveyed state that they do not select industrial cereal por-
ridges for their diet and among the causes they point out By observing the characterization of the group
that children do not like the flavours, they are not natural investigated, an early displacement of breastfeeding can be
products, they are not easily obtained and the cost. The inferred at this important stage, and it should be
perception of the father, mother or caretaker in relation to emphasized that the foods produced in the area are
eating behavior was evaluated, highlighting that 14.44% eventually selected, despite their excellent nutritional
and 14.99% report that children rarely and never respectful- properties and the availability that exists, demonstrating a
ly have an appetite, as described. lack of cultural relevance in this selection. It is important to
recognize that at this stage of life, children depend on the
food provided by the family and it will manifest the
practice of raising each household that reaffirms the eating
habits of the nucleus and will also maintain a relationship
with the family economy, since foods rich in nutrients are

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Volume 5, Issue 7, July – 2020 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
often of animal origin, are expensive in relation to basic [4]. Castro TG, Baraldi LG, Muniza PT & Cardoso MA.
foods such as rice and do not allow them to be acquired on Dietary practices and nutritional status of 0-24-month-
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