Evaluation of the impact of messages to improve the diets of lactating rural Bangladeshi women on their dietary practices and the growth of their breast-fed infants.

A community-based nutrition education intervention taught 48 Bangladeshi families with breast-feeding infants how to improve the mothers diet. The energy adequacy of the womens diets and of 30 comparable controls averaged 65% +or- 14% of the FAO/WHO/UNU requirement at baseline and declined to 55% +or- 7% immediately after the education (Post1) and to 52% +or- 6% after eight months of study (Post2). This decline was probably a seasonal effect resulting from lower food availability at Post1 and Post2. The adjusted declines in adequacy of treatments and controls did not differ at Post1 (-9.9% vs. -9.5%; p = .806) when behavioral changes were expected. Adjusted declines from baseline to Post2 were significantly less for treatment than controls (-10.1% vs. -15.5%; p = .001) but results may have been influenced by flooding that affected food distribution and production. Arm circumferences (MUAC) of both groups remained along the fifth percentile of the international reference. No significant differences were found between the average weight for age (WAZ) or MUAC of the breast-fed children in the two groups although a greater percentage of control children became severely malnourished (p = .011). The evaluation raises concerns about the effectiveness of nutrition education for improving the diets of poor women if given in isolation of programs that make improvements affordable. (authors)