Growing normally in an urban environment: positive deviance among slum children of Vadodara, India.

Objective: To assess factors contributing to positive deviance among the urban poor of Vadodara city.

Methods: Mothers of sixty 6-18 mo old children- 30 each in positive deviant (PD: normal by weight-age) and negative deviant (ND: grade II by weight-age) groups-were interviewed through home visits using semi-structured questionnaires.

Results: Factors contributing significantly to PD (p < 0.01): PD children (vs. ND), were older (12-18 mo vs. 6-11 mo); families were smaller (5-7 vs. >7 members), of lower parity (1-2 vs. 3-4), greater birth interval (>3 y vs. 1-2 y); received colostrum (96% vs. 26%), breastfed at least 8-9 times/d (86% vs. 20%); were started on complementary feeds (CF) at 6-8 mo (53% vs. 23%); given thicker consistency CF (73% vs. 36%); fed actively (40% vs. 23%), fewer had diarrhea episodes in past 15 d (26% vs. 83%). Mean calorie intake (% RDA) from CF among PD was significantly higher than in ND (68% vs.42%).

Conclusions: Factors contributing to PD in urban poor families are similar to those reported in rural India; which implies that ICDS-Health services for both urban and rural poor need to ensure that national IYCF guidelines-healthcare recommendations are followed by communities. Further research relating PD to desirable complementary feeding and hygiene-healthcare practices in rural and urban areas is required.