Complementary Feeding in Children From 9 to 24 Months in a Northeastern Brazilian Low-Income Urban Community

Abstract

ObjectivesThe study aimed to characterize complementary feeding of children aged 9 to 24 months in a Brazilian community. MethodsData from the Brazilian site of The Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health study (MAL-ED), located in a low-income urban community (favela) in the city of Fortaleza, Ceará, were used. In the present analysis, food consumption of n = 233 children was analyzed at 9, 15, and 24 months of age, using data from the 24 h recalls. The infant and young child feeding practices were accessed by the WHO core indicators. Foods consumed were also categorized in unprocessed, minimally processed foods, processed foods, and ultra-processed food products. ResultsThe number of breastfed children decreased over time, from 77.6% at 9 months to 55.0% at 15 months and 45.1% at 24 months. 88.6% of the children reached the minimum meal frequency at 9 months, 99.5% at 15 months, and 97% at 24 months. Dietary diversity was reached by 81.9%, 95.1%, and 98.2%of the children at 9, 15, and 24 months, respectively; and 74.6%, 95.1%, and 95.1% of the studied children reached the minimum acceptable diet at 9, 15, and 24 months, respectively. Unprocessed foods consumption reduced from 9 to 24 months of age [a median of 3.0 (1.0 – 4.0)/day at 9 months, 2.0 (1.0 – 5.0)/day at 15 months, and 2.0 (1.0 – 2.0)/day at 24 months, p < 0.0005]. Ultra-processed foods consumption increased over time (p < 0.0005), from 2.0 (1.0 – 2.0)/day at 9 months, to 2.0 (2.0 – 3.0)/day at 15 months, and 3.0 (2.0 – 3.0)/day at 24 months. ConclusionsMost of the studied children presented adequate complementary feeding indicators. However, when observing the processing of the foods consumed, there was an increase in the consumption of ultra-processed foods and a decrease in unprocessed foods, which may be unfavorable to children’s health. Funding SourcesNIH grant OPP47075 and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil, Finance Code 001.