A community pediatric nursing evaluation of feeding and hygiene practices in the prevention of infant diarrhea (0-6 months)

Abstract

Diarrhea remains a major cause of infant morbidity and mortality in low- and middle-income countries. Inappropriate feeding practices, non-exclusive breastfeeding, poor hygiene, and inadequate bottle sanitation are suspected to increase infants' exposure to enteric pathogens. However, research addressing these factors in infants under six months of age is limited in the literature. Therefore, the study was conducted to evaluate feeding and hygiene practices among this population. The study employed a cross-sectional design to achieve its research objectives. Data collection was conducted from September to December 2024 in Kendari City, Indonesia. The study used a purposive sampling method based on eligibility criteria. The inclusion criteria were mothers of infants aged 0-6 months, willingness to participate, provision of written informed consent, the ability to provide complete and accurate information. On the contrary, the exclusion criteria included mothers who were uncooperative during data collection or infants with congenital gastrointestinal disorders. A total of 315 participants were engaged in the study. Data were collected using questionnaires covering feeding practices, breastfeeding behavior, hygiene, and infant health history. All instruments underwent validity and reliability testing, yielding satisfactory results that confirmed their suitability for data collection. Data were analyzed using descriptive statistics, chi-square tests, and multivariate logistic regression. The significance level was set at p<0.05 for hypothesis testing. Results showed that early complementary feeding, absence of exclusive breastfeeding, and poor bottle hygiene were significantly associated with diarrhea (p<0.001). Poor bottle hygiene was the dominant determinant (OR=44.885; 95% CI=0.031-108.269), followed by lack of exclusive breastfeeding (OR=9.136; 95% CI=0.845-98.804) and early complementary feeding (OR=8.763; 95% CI=0.806-95.318). These findings indicate that suboptimal feeding and hygiene practices increase the risk of diarrhea among infants. The research contributes baseline evidence to the field of nursing, supporting future scholarly work in Indonesia and across the globe. 

Keywords: Bottle hygiene, complementary feeding, exclusive breastfeeding, hygiene practice, infant diarrhea