Encouraging Appropriate Infant Feeding Practices in Slums: A Positive Deviance Approach

Nutritional Positive Deviant (PD) infants grow ‘bigger’ and ‘faster’ than other infants living in a similarly socio-economically deprived environment. Certain positive feeding and care giving practices adopted by mothers of PD infants enable them rear better nourished and active infants. Limited data is available on using PD mothers as counselors encouraging appropriate and feasible infant feeding practices (IFP) in India. Hence, the present study was undertaken. The study was conducted in a slum of Delhi (India). Twenty-Five infants aged 6-12 months were weighed. Three infants with normal weight for age status (as per Gomez classification) were classified as PD infants. A PD inquiry (PDI) was conducted on current IFP in these families to identify PD behaviours adopted and determinants for the same. PD behaviours identified included: feeding modified family pot (energy dense) complementary food at least two times a day, supervised bowl feeding by the mother and father support to the mother in infant feeding and care giving. Two, of these three PD mothers volunteered to discuss the benefits of PD behaviours they had been practicing with the other 22 members of the group. The strategy promoted collective dialogue and discussion to try the PD behaviours through weekly group discussions over a period of four weeks. After four weeks, feeding modified family pot food with addition of 1 teaspoon of ghee (milk fat) in food (10/22), feeding an extra mid-day cereal snack (12/22) were PD behaviours adopted by other members of the group (22). It can be concluded that i) behaviours requiring least preparation time were easily adopted and ii) PD mothers can be effective counselors to encourage appropriate IFP.