(P24-041-24) Changes in Norms About Infant and Young Child Feeding in Rural Bangladesh During the Alive & Thrive Initiative

Objectives: Norms play an important role in shaping infant and young child feeding (IYCF) practices. IYCF interventions to improve child feeding practices among mothers may ultimately translate into norms in their communities. The Alive and Thrive (A&T) initiative, beginning in 2009, implemented social, and behavior change interventions to improve IYCF practices like breastfeeding and complementary feeding in rural Bangladesh. This study aimed to understand the normative patterns of IYCF practices and how they changed over time.

Methods: Data were gathered during the intervention midline assessment in 2012 and the follow-up in 2016 from 90 focus groups, of which 30 were in the non-intensive comparison areas and 60 were in the intensive intervention areas. The free-listing method was used to ask groups of community members to list all foods usually given to infants and young children in their household or village. Notes from the free-listing forms were transcribed and translated to English. Analysis was done using t-tests.

Results: In both 2012 and 2016, rice and khichuri (porridge) were the most reported foods for children under 24 months. Besides cereal-based foods, snack foods, particularly biscuits, were frequently reported. Twenty-seven of the 31 most-listed foods were reported by a greater proportion in 2016 than 2012, including small fish, colostrum, chips, and chicken liver, indicating a greater variety of foods being frequently given to children. Four foods (i.e., rice gruel, water, cow liver, and rice powder) were reported by a lesser proportion in 2016 than 2012.Whereas breastmilk was consistently most reported for children under six months in both years, other foods including cow’s milk, tinned milk, honey, rice gruel, and sugar water were also frequently reported, indicating that breastfeeding was not exclusive up to the age of 6 months.

Conclusions: A longer duration of exposure to the A&T intervention was associated with a greater variety of foods being frequently reported, indicating that feeding a greater variety of foods was normative in 2016. These results provide insight into the time required for IYCF intervention messages to translate into norms.

Funding Sources: A&T is managed by FHI 360, and funded by Bill & Melinda Gates Foundation, Government of Ireland, and other donors.