Feeding practices and child stunting during the COVID-19 pandemic: a qualitative study

Qory Tifani Rahmatika; Sigit Mulyono; Dwi Cahya Rahmadiyah

doi:10.4081/jphia.2023.2580

Authors

Qory Tifani Rahmatika Faculty of Sport Science, Universitas Negeri Malang, Indonesia.
Sigit Mulyono
sigit@ui.ac.id
Faculty of Nursing, Universitas Indonesia, Depok, Indonesia.
Dwi Cahya Rahmadiyah Faculty of Nursing, Universitas Indonesia, Depok, Indonesia.

Background. In the period of the COVID-19 pandemic, the number of children suffering from stunting had escalated globally due to socio-economic challenges. This may worsen the nutritional status and health of children under 5 years. Objective. This study aimed to explore the parental feeding practices among children aged 24-59 months who have stunted growth during the COVID-19 pandemic. Materials and Methods. Eleven semi-structured individual interviews were conducted involving primary caregivers of stunting children in the family. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Results. Three major themes were identified: i) child-feeding practices during the COVID-19 pandemic; ii) feeding style among the primary caregivers of stunting children; iii) parents’ efforts to improve nutritional intake. This finding shows that child feeding is a complex interaction between parent-feeding practices and child-eating behavior that affect the nutritional status of children. Conclusions. The feeding practices of children suffering from stunting during the COVID-19 pandemic have been the greatest challenge faced by many caregivers. The accessibility of food, economic condition, and parental knowledge contributed to this situation. Healthcare providers are expected to strengthen nutrition education to improve proper feeding practices and provide support for families during the pandemic.

Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses. J Adv Res [Internet]. 2020;24:91–8. Available from: https://doi.org/10.1016/j.jare.2020.03.005 DOI: https://doi.org/10.1016/j.jare.2020.03.005

Buszewicz G. COVID-19 : Specific and Non-Specific Clinical Manifestations and Symptoms : The Current State of Knowledge. 2020;2019(December 2019):1–22.

Headey D, Heidkamp R, Osendarp S, Ruel M, Scott N, Black R, et al. Impacts of COVID-19 on childhood malnutrition and nutrition-related mortality. Lancet [Internet]. 2020;396(10250):519–21. Available from: http://dx.doi.org/10.1016/S0140-6736(20)31647-0 DOI: https://doi.org/10.1016/S0140-6736(20)31647-0

Akseer N, Kandru G, Keats EC, Bhutta ZA. COVID-19 pandemic and mitigation strategies: implications for maternal and child health and nutrition. Am J Clin Nutr. 2020;112(2):251–6. DOI: https://doi.org/10.1093/ajcn/nqaa171

Candarmaweni, Rahayu AYS. Tantangan pencegahan stunting pada era adaptasi baru “new normal” melalui pemberdayaan masyarakat di kabupaten pandeglang. J Lebijakan Kesehat Indones. 2020;09(03):136–46.

Roberton T, Carter ED, Chou VB, Stegmuller AR, Jackson BD, Tam Y, et al. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Heal [Internet]. 2020;8(7):e901–8. Available from: http://dx.doi.org/10.1016/S2214-109X(20)30229-1 DOI: https://doi.org/10.1016/S2214-109X(20)30229-1

UNICEF. Maternal and Child Nutrition Unicef Programming Priorities To Respond To the Socio-Economic Impacts of the Covid-19 Pandemic Respond , Recover , and Reimagine. 2020;1–12.

de Onis M, Branca F. Childhood stunting: A global perspective. Matern Child Nutr. 2016;12:12–26. DOI: https://doi.org/10.1111/mcn.12231

Kemenkes RI. Hasil Utama Riset Kesehatan Dasar (RISKESDAS) [Internet]. 2018. Available from: https://kesmas.kemkes.go.id/assets/upload/dir_519d41d8cd98f00/files/Hasil-riskesdas-2018_1274.pdf

Efrizal W. Berdampakkah pandemi covid-19 terhadap stunting di bangka belitung? J Kebijak Kesehat Indones. 2020;09(03):154–7.

Varlina V, Pratiwi S. The Causal Chain of The Covid-19 Pandemic and The Threat of Stunting: A Literature Review. 2022; DOI: https://doi.org/10.4108/eai.31-3-2022.2320661

Fund UN of C. COVID-19 dan Anak-Anak di Indonesia: Agenda Tindakan untuk Mengatasi Tantangan Sosial Ekonomi [Internet]. UNICEF. Jakarta; 2020. Available from: www.unicef.org/indonesia

Streubert HJ, Carpenter DR. Qualitative research in Nursing. 5th Editio. Lippincott Williams & Wilkins. Philadephia; 2011.

Nguyen PH, Kachwaha S, Pant A, Tran LM, Ghosh S, Sharma PK, et al. Impact of COVID-19 on household food insecurity and interlinkages with child feeding practices and coping strategies in Uttar Pradesh, India: A longitudinal community-based study. BMJ Open. 2021;11(4). DOI: https://doi.org/10.1136/bmjopen-2021-048738

Mullins L, Charlebois S, Finch E, Music J. Home food gardening in Canada in response to the covid-19 pandemic. Sustain. 2021;13(6). DOI: https://doi.org/10.3390/su13063056

Muthuri SK, Wachira L joy M, Onywera VO, Tremblay MS. of the Neighborhood Environment and Childhood Physical Activity : Results from ISCOLE-Kenya. J Phys Act Heal. 2016;333–43. DOI: https://doi.org/10.1123/jpah.2014-0595

Khamis AG, Mwanri AW, Ntwenya JE, Kreppel K. The influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania. BMC Pediatr. 2019;19(1):1–9. DOI: https://doi.org/10.1186/s12887-019-1897-5

Darapheak C, Takano T, Kizuki M, Nakamura K, Seino K. Consumption of animal source foods and dietary diversity reduce stunting in children in Cambodia. Int Arch Med. 2013;6(1). DOI: https://doi.org/10.1186/1755-7682-6-29

Beal T, Tumilowicz A, Sutrisna A, Izwardy D, Neufeld LM. A review of child stunting determinants in Indonesia. Matern Child Nutr. 2018;14(4):1–10. DOI: https://doi.org/10.1111/mcn.12617

Dranesia A, Wanda D, Hayati H. Pressure to eat is the most determinant factor of stunting in children under 5 years of age in Kerinci region, Indonesia. Enferm Clin [Internet]. 2019;29(xx):81–6. Available from: https://doi.org/10.1016/j.enfcli.2019.04.013 DOI: https://doi.org/10.1016/j.enfcli.2019.04.013

Shloim N, Edelson LR, Martin N, Hetherington MM. Parenting styles, feeding styles, feeding practices, and weight status in 4-12 year-old children: A systematic review of the literature. Front Psychol. 2015;6(DEC). DOI: https://doi.org/10.3389/fpsyg.2015.01849

Ek A, Sorjonen K, Eli K, Lindberg L, Nyman J, Marcus C, et al. Associations between parental concerns about preschoolers’ weight and eating and parental feeding practices: Results from analyses of the child eating behavior questionnaire, the child feeding questionnaire, and the lifestyle behavior checklist. PLoS One. 2016;11(1):1–20. DOI: https://doi.org/10.1371/journal.pone.0147257

Mugode RH, Puoane T, Michelo C, Steyn NP. “Feeding a child slowly:” a responsive feeding behavior component likely to reduce stunting: Population-based observations from rural Zambia. J Hunger Environ Nutr [Internet]. 2018;13(4):455–69. Available from: https://doi.org/10.1080/19320248.2017.1403409 DOI: https://doi.org/10.1080/19320248.2017.1403409

Melbye EL, Hansen H. Promotion and prevention focused feeding strategies: Exploring the effects on healthy and unhealthy child eating. Biomed Res Int. 2015;2015. DOI: https://doi.org/10.1155/2015/306306

Yohana A, Mulyono S. The impact of digital era: Intensity of excessive use of gadget causing eating difficulty on children. Enferm Clin [Internet]. 2021;31:S6–9. Available from: https://doi.org/10.1016/j.enfcli.2020.10.005 DOI: https://doi.org/10.1016/j.enfcli.2020.10.005

Polanunu MR, Hudawarrahmah N, Hartojo H, Hanindita MH, Wijaya NA, Hidayati SN, et al. Parent’S Strategy To Attract Children To Eat, Feeding Duration, and Its Relation To Weight for Age Z-Score in Children. Media Gizi Indones. 2020;15(1):27. DOI: https://doi.org/10.20473/mgi.v15i1.27-30

Gramm MM, Vollmer RL, Harpel TS, McDaniel B, Schumacher J. Relationship Between Parent Distraction with Technology at Mealtimes and Child Eating Behavior: a Pilot Study. J Technol Behav Sci. 2020;5(1):15–9. DOI: https://doi.org/10.1007/s41347-019-00109-7

Yunita A, Ames SS, Hana YW. Effectiveness of Tui Na Massage in Increasing Appetite Infants Aged 1-5 Years in The Work Area UPTD Puskesmas Bendo Kediri Regency. 2021;3(1):321–8.

Gao L, Jia CH, Ma SS, Wu T. Pediatric massage for the treatment of anorexia in children: A meta-analysis. World J Tradit Chinese Med. 2018;4(3):96–104. DOI: https://doi.org/10.4103/wjtcm.wjtcm_12_18

Johari S, Haghgou H, Daemi M, Rezaeiyan T, Mosala Nejad Z. The Effect of Massage on Weight Gain of Low-Weight Hospitalized Infants: A Randomized Clinical Trial. Phys Treat Specif Phys Ther. 2016;5(4):205–10. DOI: https://doi.org/10.15412/J.PTJ.07050403

Rahmatika, Q. T., Mulyono, S., & Rahmadiyah, D. C. (2023). Feeding practices and child stunting during the COVID-19 pandemic: a qualitative study. Journal of Public Health in Africa, 14(s2). https://doi.org/10.4081/jphia.2023.2580