Study Location: Dhaka, Bangladesh
Type of Paper: Original Article; Prospective Cross-Sectional Study
Purpose: To describe the reasons for fostering children in the urban slums of Dhaka, Bangladesh and to describe their feeding patterns and nutritional and health status.
- Physical growth: standard anthropometry [height, weight, head circumference (OFC)]. Z scores were calculated using the National Centre for Health Statistics standards.
- Feeding practices
Participants: 46 pairs of mothers and their foster children under the age of 24 months who were living in seven slum areas of Dhaka City. Children entered foster care on average 20 days after birth (range 1 to 120 days). 82 pairs of mothers and their biological children of similar age were included as a comparison group. The average age of the children at assessment was just under 5 months.
Methods: Standard anthropometry (weight and length) was collected by physicians during home visits. Information regarding morbidity and feeding practices were also collected through parental report.
- Physical growth: Children living in foster care were smaller than those living with their biological mothers. Average z scores in children living in foster care were:
- Height for age (HAZ): –2. 7 (comparison group: -1. 2)
- Weight for age (WAZ): -3. 5 (comparison group: -0. 9)
- Weight for height (WHZ): -2. 3 (comparison group: 0. 1)
- Diarrhea (three or more passages of watery/loose stools during the previous 24 hours): More children living in foster care had diarrhea (47%) compared to those living with their biological mothers (33%).
- Feeding patterns:
- 90% of the children living in foster care were fed either formula or animal milk during the first month of life. The other 10% received either sugar water or other liquids. 100% of the comparison group was fed breastmilk during the first month.
- 58% of those living in foster care were introduced to solid or semi-solid foods prior to 4 months of age compared to 14% in the comparison group.
Conclusions & Clinical Implications: Children living in foster care in the slums of Dhaka, Bangladesh have poor nutritional status and are exposed to inappropriate feeding practices compared to children living with their biological mothers who are living in poverty in the same regions. Children living in foster care display growth failure on all measures of physical growth. The authors discuss that the poor nutritional status (i.e., physical growth) may be due to the inappropriate feeding practices (e. g. , early introduction of solids) in combination with diseases such as diarrhea. The authors discuss that infant and child mortality is prevalent in Bangladesh, and foster care may contribute to the high rates of undernutrition and mortality. They emphasize that improving the nutritional status and feeding practices, as well as disease prevention, in these children is critical to improving their health.
Limitations of the Nutritional Results: No significant limitations.
Reference: Sarkar NR, Biswas KB, Khatun UHF, Datta AK. Characteristics of young foster children in the urban slums of Bangladesh. Acta Pædiatrica. 2003; 92 (7): 839-842. http://www.ncbi.nlm.nih.gov/pubmed/12892165