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Severe wasting among Indian infants under six months of age

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The burden and risk factors for wasting among infants under six months of age in India are not well documented. Data from India’s National Family Health Survey 4 were used to estimate the prevalence of severe wasting, defined by weight-for-length <-3SD, among 18,898 infants under six months of age. The association of severe wasting with household, maternal and child-related factors was examined using multivariable logistic regression analysis. Results reveal prevalence of severe wasting among infants under six months of age of 14.8%, ranging from 3.5% to 21% across different states. Higher odds of severe wasting were associated with low birth weight (LBW), defined as <2,500 grams (adjusted odds ration (AOR) 1.40, 95% Confidence Interval (CI) (1.19,1.65)); mother not utilising supplementary nutrition from government during lactation (AOR 1.23, 95% CI (1.05,1,43); and anthropometry assessment occurring during summer (AOR 1.37, 95% CI (1.13, 1.65) and monsoon months (AOR 1.53, 95% CI (1.20, 1.95). Infants aged two to three months (AOR 0.78, 95% CI (0.66, 0.93) and four to five months (AOR 0.65, 95% CI (0.55, 0.73) had lower odds of being severely wasted compared to infants aged up to one month.

Results reveal a high burden of severe wasting in infants under six months of age in India, with significant variability across states. Given the short- and long-term consequences of severe wasting, it is imperative that actions are taken for its prevention and management. Ambitious life-course approaches to achieve improved health and nutrition among women of reproductive age, including during the antenatal period, should be explored for effective prevention of LBW. Appropriate care practices at facilities and post-discharge with extra attention to infants born LBW and sick, often lacking in India, are also important to prevent further deterioration in nutrition status. More research is needed to assess the possible association between season and severe wasting in this age group.


1 Choudhary TS, Srivastava A, Chowdhury R, et al. Severe wasting among Indian infants < 6 months: Findings from the National Family Health Survey 4. Matern Child Nutr. 2019;e12866. https://doi.org/10.1111/mcn.12866

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