The preschool child in Suka Village, North Sumatera. I. Feeding practices and measured food intake.

The primary objective of a prospective study conducted over the July 1976-August 1977 period, as part of the joint project of the University of North Sumatra, Medan and the University of Amsterdam, was to determine the duration of prevention against hypovitaminosis A by 1 oral dose of 300,000 IU vitamin A. At 3-month intervals children were examined critically, fresh stool specimens were analyzed on the presence of parasite ova and protozoa, blood specimens were collected for analysis of protein and vitamin A status. Anthropometric measurements were scheduled at monthly (weight, height) and 6 monthly intervals (upper arm circumference and skinfolds). A dietary history was taken at the start of the study. Food consumption was measured separately. In this discussion only the dietary aspects of the study were reported. Families with children age 0-5 years in Suka Vilage, North Sumatra, were included in the prospective study. Childfeeding practices were recorded by interview (dietary history and 24 hour recall method for types of food eaten) and by observation during home visits. For the 1st period 59 children, age 1-4 years, were chosen at random from the total number of children in the respective age group. In the 2nd period in 39 of the same children and in 13 of their older siblings food weighing was repeated. As in most rural areas in Indonesia infants were put to the breast after birth and breastfeeding was continued for about 2 years. After the 1st year the percentage of chidlren breastfed dropped gradually. Exclusive breastfeeding was practiced by most mothers during the 1st 5 months. Few mothers supplemented her own milk with fresh cow's milk or milk formula. The 1st supplementary food given to the infant was almost exclusively rice in different consistencies. After 1 year of age fish was introduced. At age 2 children were given part of the family diet composed of rice, fish, and some vegetables mainly of the nonleafy type. In 2 seasons food consumption of the 59 children was weighed. The habitual diet was somewhat low in energy (65-98% of RDI), ample in protein (108-158% of RDI) but inadequate in calcium (36-86% of RDI), iron (44-48% of RDI), retinol equivalents (26-44% of RDI) and riboflavin (34-41% of RDI). The inadequacy of the diet was primarily due to improper use of available foods, cultural habits, and mother's permissiveness towards the child. In this village nutrition and health education along with improved child care can make a contribution to the diversification and improvement of the preschool child's diet.