Are we practising responsive feeding effectively in Sri Lanka?

The nutritional indices of children under 5 years of age in Sri Lanka have remained stagnant from 2006–2016. There is increasing evidence that feeding behaviours and styles influence the acceptance of food and dietary intake thereby affecting the growth of the infant and young child. We reviewed the published literature available online, government/ non-government websites, peer reviewed journals as well as postgraduate thesis on breastfeeding and complementary feeding in Sri Lanka from January 2006 to October 2019 with regard to responsive feeding (RF) in Sri Lanka to identify the gaps in knowledge and practices. RF is not taking place in the majority (80-90%) of the children, according to small studies done in Colombo, Bibile, Anuradhapura, Nuwara-Eliya and Jaffna, even though it is a part of the Infant and Young Child Feeding Guideline in Sri Lanka. Data regarding RF are not collected in the national surveys. Neither mothers, preschool teachers nor the PHMs appear to have the required knowledge or the necessary skill, and walking around with the child and using distraction methods appear to be the main strategy used in infant feeding as shown in both qualitative and quantitative studies. This appears to be due to deep rooted cultural practices which appear to be unaffected with current interventions provided by the PHM. Health care workers should be trained with the skills and knowledge required to empower all care givers including mothers, fathers and grandparents, to practise the authoritative/ democratic / responsive parenting style in order to facilitate RF. Data regarding responsive feeding should be routinely collected through the national nutritional surveys to provide a consistent monitoring tool.

Sri Lanka Journal of Child Health, 2021; 50(1): 134-144