Abstract
Background: Optimal complementary feeding is critical for adequate growth and development in infants and young children. The associations between complementary feeding and growth have been studied well, but less is known about the relationship between complementary feeding and micronutrient status. Methods: Using data from a national cross-sectional survey conducted in Ghana in 2017, we examined how multiple WHO-recommended complementary feeding indicators relate to anemia and the micronutrient status of children aged 6–23 months. Results: In total, 42%, 38%, and 14% of the children met the criteria for minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD), respectively. In addition, 71% and 52% of the children consumed iron-rich foods and vitamin A-rich foods, respectively. The prevalence of anemia, iron deficiency (ID), iron deficiency anemia (IDA) and vitamin A deficiency (VAD) was 46%, 45%, 27%, and 10%, respectively. Inverse associations between MMF and socio-economic status were found, and MMF was associated with an increased risk of ID (55%; p < 0.013) and IDA (38%; p < 0.002). Conclusion: The pathways connecting complementary feeding and micronutrient status are complex. Findings related to MMF should be further investigated to ensure that complementary feeding programs account for the potential practice of frequent feeding with nutrient-poor foods.
Highlights
The “1000-day window”—the period between conception and a child’s 2nd birthday—is a key period of growth and development
More than half of the children lived in rural households, and almost half of all children resided in the middle belt stratum
Consumption of iron-rich foods is likely associated with a decreased risk of anemia by improving children’s iron stores and subsequent production of hemoglobin. Both consumption of iron-rich foods and iron status were independent predictors of anemia, suggesting that consumption of iron-rich foods may represent other characteristics that could influence anemia status. One such characteristic could be vitamin C intakes from vitamin C-rich fruits that can enhance the bioavailability of non-heme iron leading to improved iron stores, and this possibility is supported by exploratory bivariate analyses showing that a significantly higher proportion of children who consumed iron-rich foods consumed two food groups that would contain some vitamin-C rich foods: vitamin A-rich foods and vegetables (p < 0.01) and other fruits and vegetables (p < 0.001)
Summary
The “1000-day window”—the period between conception and a child’s 2nd birthday—is a key period of growth and development. Complementary feeding is the introduction of adequate and nutrient-dense foods to children after 6 months of age, when breastmilk alone cannot meet the energy and nutrient needs of the child [3,5]. This crucial period of transition from exclusive breastfeeding to breastfeeding in tandem with solid and soft foods is a critical window for the promotion of optimal growth, health and development of a child [5]. Findings related to MMF should be further investigated to ensure that complementary feeding programs account for the potential practice of frequent feeding with nutrient-poor foods
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