The Changes in the body weight of toddlers after the implementation of Responsive Feeding Plus in the Work Area of Tawiri Community Health Center, Ambon City

Abstract

Malnutrition among children under five remains a public health concern, particularly in Maluku, where the prevalence of underweight exceeds the national estimate. This study aimed to compare changes in body weight among underweight children receiving Responsive Feeding Plus (RF Plus) and routine nutrition services in the working area of the Tawiri Community Health Center, Ambon City. A quasi-experimental pretest–posttest control-group design was conducted among 30 children aged 12–59 months recruited through total sampling, with 15 children allocated non-randomly to the RF Plus group and 15 to the control group. RF Plus consisted of three main meals and two energy-dense snacks per day, caregiver education on hunger and satiety cues, responsive feeding without coercion or distraction, and twice-weekly monitoring. Body weight was measured at baseline and after 40 days. Within-group changes were analyzed using the Wilcoxon signed-rank test, while differences in weight change between groups were assessed using the Mann–Whitney test. Mean body weight increased from 10.09±2.05 to 11.42±2.02 kg in the RF Plus group and from 9.95±1.39 to 10.31±1.31 kg in the control group. Mean weight gain was 1.33±0.53 kg (95% CI: 1.04–1.62) in the RF Plus group compared with 0.35±0.22 kg (95% CI: 0.23–0.48) in the control group. The difference in weight change between groups was statistically significant (p<0.001). RF Plus was associated with greater short-term weight gain than routine services among underweight children. However, these findings should be interpreted cautiously because of the small sample size, non-random allocation, potential residual confounding and clustering at the Posyandu level, and short follow-up period.