Impact of a Homestead Food Production Intervention on Infant and Young Child Feeding and Home Environment in Bangladesh

Abstract

Objectives: Optimal child growth and development depend on many factors including proper nutrition and feeding practices as well as a stimulating home environment. We aimed to assess the impact of a Homestead Food Production (HFP) program on infant and child feeding as well as child stimulation practices as part of the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster‐randomized trial in rural Bangladesh. Methods: The HFP program promoted increased dietary diversity and improved child feeding practices based on the WHO's Essential Nutrition Actions, including responsive feeding and the importance of vitamin A capsules. Practices for child stimulation were not promoted although both intervention and control groups received toys (e.g., finger puppets, balls, etc.) during data collection. The 2019–20 FAARM endline survey included measures on infant and young child feeding (IYCF), responsive feeding, and family care indicators. Data were collected on 1,142 children (0–39 months of age) and sub‐samples were analyzed based on age restrictions for IYCF (6–23m) and responsive feeding (6–39m). We used multilevel linear and logistic regression to assess intervention impact, adjusting for child age and cluster. Results: Children in the FAARM intervention group were more likely to have achieved minimum dietary diversity (OR (95% CI): 1.9 (1.3, 2.7)), minimum adequate diet (OR (95% CI): 1.9 (1.3, 2.7)), and more likely to have received a vitamin A capsule in the last six months (OR (95% CI): 1.6 (1.2, 2.1)). In their home environment, children in the intervention group had toys from a greater number of sources and were more likely to have toys for pretending. No differences were seen in exclusive breastfeeding, iron‐rich food consumption, or responsive feeding indicators. Conclusions: The FAARM intervention was able to improve children's diets and selected aspects of child stimulation. Funding Sources: The Federal German Ministry of Education and Research (BMBF) is the primary funder of the FAARM trial and its HFP intervention.