Abstract
Bangladesh has experienced steady socio‐economic development. However, improvements in child growth have not kept pace. It is important to document complementary feeding (CF) practices—a key determinant of children's growth—and their trends over time. The study aims to examine trends in CF practices in children aged 6–23 months using data from Bangladesh Demographic and Health Surveys conducted in 2004, 2007, 2011, and 2014. Multilevel logistic regression models were applied to identify independent predictors of four CF practice indicators among children 6–23 months, namely, timely introduction of complementary foods, minimum meal frequency, minimum dietary diversity, and minimum acceptable diet. Introduction of complementary foods was achieved among 64–71% of children between 2004 and 2014. The proportion meeting minimum meal frequency increased from 2004 to 2007 (71–81%) and declined and held steady at 65% from 2011 to 2014. The proportion meeting minimum dietary diversity in 2011 and 2014 was low (25% and 28%), and so was minimum acceptable diet (19% and 20%). From 2007 to 2014, child dietary diversity decreased and the most decline was in the consumption of legumes and nuts (29% to 8%), vitamin A‐rich fruits and vegetables (54% to 41%), and other fruits and vegetables (47% to 20%). Young child age (6–11 months), poor parental education, household poverty, and residence in the Chittagong and Sylhet independently predicted poorer feeding practices. Dietary diversity and overall diet in Bangladeshi children are strikingly poor. Stagnation or worsening of feeding practices in the past decade are concerning and call for decisive policy and programme action to address inappropriate child feeding practices.
Highlights
Child malnutrition remains a serious problem in Bangladesh
minimum dietary diversity (MDD) and minimum acceptable diet (MAD) were achieved in higher proportions in both 2011 and 2014 among children whose mothers had better education, who lived in wealthier households, and in communities with better access to health and nutrition care
There were other predictors that were consistently associated with MDD and MAD but not Intro or Minimum meal frequency (MMF), including 33–36% lower odds of meeting MDD and MAD among children who were firstborn, 24–26% lower odds among children whose fathers had no education, and 5–8%, 28–33%, 42–43%, 45–48% lower odds among children living in the progressively poorer household wealth quintiles
Summary
Child malnutrition remains a serious problem in Bangladesh. A national survey in 2014 indicated that the proportion of children under five who were stunted, underweight, or wasted was 36%, 33%, and 14%, respectively (National Institute of Population Research and Training, Mitra and Associates, & ICF International, 2016). Understanding the status of CF, how it is changing, and what factors predict poor CF practices will help identify unmet needs and populations at risk, informing the design and implementation of policies, programmes, and intervention strategies. The objective of this analysis is to document trends and predictors. Young child age (6–11 months), poor parental education, household poverty, and residence in the Chittagong and Sylhet regions independently predicted poorer feeding practices, underscoring the need for policy and direct programme efforts to promote complementary feeding practices, especially for the youngest and most vulnerable children. Of CF practices in Bangladesh using repeated national survey data over a 10‐year period (2004–2014)
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