Abstract
Inappropriate complementary feeding is a major contributor to child malnutrition. Previous studies have described complementary feeding practice using single indicators but a combination of indicators is needed to better explain the role of complementary feeding practices in child growth. To adequately quantify appropriate complementary feeding, we used a composite indicator comprising three of the World Health Organization (WHO) core infant and young child feeding (IYCF) indicators that relate closely to complementary feeding. A community-based cross sectional cluster survey was carried out in November 2013. The study population comprised mothers/primary caregivers and their children selected using a two-stage cluster sampling procedure. A total of 778 children aged 6–23 months were involved. Of the children aged 6–23 months; 57.3 % met the minimum meal frequency, 35.3 % received minimum dietary diversity (≥4 food groups), 25.2 % had received minimum acceptable diet and only 14.3 % received appropriate complementary feeding. Multivariable logistic regression adjusted for cluster sampling showed that children aged 12–23 months were 26.6 times more likely [AOR 26.57; 95 % CI (3.66–193.12)] to receive appropriate complementary feeding compared to children aged 6–8 months. Children who were not bottled-fed were 2.5 times more likely to have been appropriately fed [AOR 2.51; 95 % CI (1.98–6.42)] compared to children who were bottle-fed in the last 24 h prior to study. Findings from this study demonstrate appropriate complementary feeding and caring practices by caregivers remain a challenge for most households in Northern Ghana.
Highlights
Inappropriate complementary feeding is a major contributor to child malnutrition
Given the strong links between diet diversity and nutritional outcomes [11,12,13,14], this study sought to assess the prevalence of appropriate complementary feeding practices and its determinants among children aged 6–23 months who reside in rural areas of Northern Ghana where child malnutrition is a serious concern
Multiple logistic regressions analysis showed three variables were significantly associated with appropriate complementary feeding practice
Summary
Study area The nutrition survey covered five programme districts of Northern Ghana comprising the Northern Region (NR), Upper East Region (UER) and Upper West Region (UWR). A brief description of main independent and dependent variables is as follows: Assessment of infant and young child feeding (IYCF) practices Infant and young child feeding indicators including minimum meal frequency, minimum dietary diversity and minimum acceptable diet were estimated by recall of food and liquid consumption during the previous day of the survey as per WHO/UNICEF guidelines [15]. To adequately quantify appropriate complementary feeding, we used a composite indicator comprising three of the WHO core IYCF indicators that relate closely to complementary feeding These are timely introduction of solid, semi-solid or soft foods at 6 months, minimum meal frequency, and minimum dietary diversity. Median deviant child was defined as having either HAZ or WHZ < −2 Statistical data analyses Both bivariate and multivariate analyses were done to identify the determinants of appropriate feeding practices and minimum dietary diversity (MDD). Participation was voluntary and each woman signed (or provided a thumb print if she was illiterate) a statement of an informed consent after which she was interviewed
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