Exploring Complementary Feeding Practices and their Determinants among 6-24 month old Children: A Cross Sectional Study

探讨6-24个月龄儿童辅食添加方式及其决定因素:一项横断面研究

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Abstract

CONTEXT: Children under two years should be provided with sufficient and suitable complementary foods and breastmilk to ensure proper growth and development. However, their diets fall short in quality, quantity, and frequency. AIMS: To assess complementary feeding practices and their associated predictors in children aged 6-24 months. METHODS AND MATERIAL: A cross-sectional survey was conducted between June 2023 and December 2023, where mothers of 400 children of 6-24 months of age were interviewed. Previous day diets of children were recorded using the open diet recall method on a pretested, validated, and semi-structured questionnaire. Nine indicators given by the World Health Organization were subsequently calculated. The factors influencing complementary feeding were analyzed using multivariate logistic regression. RESULTS: The mean age for the introduction of solid, semi-solid, and soft foods was 6.05 ± 1.676 months. Timely initiation of complementary foods was reported in 73% of subjects. Minimum acceptable diet (MAD), minimum diet diversity (MDD), and minimum meal frequency (MMF) were achieved in 15.5%, 16.5%, and 82.25% of subjects, respectively. While a substantial number of children consume unhealthy foods (52%) and sweet beverages (24.5%), a notable percentage does not consume fruits or vegetables (43.5%), eggs (6.8%), or flesh foods (0%). A smaller proportion of females receive a timely introduction of complementary foods compared to males [AOR: 0.321 (CI: 0.199-0.518)]. Mothers who completed higher levels of studies introduced solid foods timely compared to others [High school AOR: 1.937 (CI: 1.097-3.418); graduate and above AOR: 2.569 (CI: 1.132-5.833)]. MDD is significantly associated with the age of subjects [9-12 months AOR: 8.05 (CI: 1.02-63.41); 13-24 months AOR: 13.85 (CI: 1.84-104.36)]. MMF is significantly linked with age of subjects [13-24 months AOR: 14.364 (CI 5.89-35.01)], mother's occupation [Working mothers AOR: 0.29 (CI 0.09-0.89)], live births [≥2 live births AOR: 2.07 (CI 1.10-3.89)], hours away from child [<5 hours AOR: 3.96 (CI: 1.11-14.14)], and socio-economic status [Upper middle AOR: 5.29 (CI: 1.54-18.15)]. MAD is significantly influenced by the age of subjects [13-24 months AOR: 13.72 (CI: 1.81-104.01)] and the type of family [joint family AOR: 2.04 (CI: 1.09-3.81)]. CONCLUSIONS: There is a concern about the critical importance of timely initiation of complementary feeding and the adequacy of diets provided to young children. One-fourth to half of children under two years consume more sweet beverages and unhealthy foods while missing out on micronutrient-rich foods. Being male and having a mother with higher education significantly influence the timely introduction of complementary foods. As the child's age increases, so does their meal diversity, frequency, and adequacy. Working mothers with more time away from children, with less experience of raising children and belonging to poor socio-economic status, have adverse effects on meal frequency. Contrarily, children of joint families receive an adequate diet.

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