Complementary Feeding In Children Research Articles

Complementary feeding practices for children aged 6-23 months in early childhood education institutions in urban China: A cross-sectional study.

Appropriate infant and young child feeding (IYCF) plays a crucial role in promoting the healthy growth of children. Currently, many Chinese urban parents are seeking care of children from the early childhood education (ECE) institutions, however, little is known about the feeding practices of infants and young children in ECE institutions. This study aims to investigate the complementary feeding practices for Chinese urban children aged 6-23 months in ECE institutions and explore potential factors influencing their feeding practices. This cross-sectional study was conducted among primary caregivers of children aged 6-23 months in ECE institutions across 31 provinces in China from 1 March to 30 April 2023. Convenience sampling was used to recruit caregivers from centres of Gymboree Play & Music (an ECE institution). Self-administered questionnaires were designed using the online survey tool Sojump and distributed through WeChat platform, which collected information on 1) children's complementary feeding practices; 2) food frequency of seven food groups; 3) caregivers' feeding knowledge and practices; 4) frequency of children attended ECE classes and the primary caregivers' daily nurturing care time; 5) source of information on complementary feeding. A total of 2731 children and their caregivers were surveyed, with 416 children aged 6-11 months and 2315 children aged 12-23 months. The prevalence of minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) was 59.4, 60.6, and 39.2%, respectively. Only 17.3% caregivers believed that continued breastfeeding should be at two years or above, and 29.5% children were continuously breastfed at 12-23 months (CBF). The proportion of non-responsive feeding practices among caregivers ranged from 28 to 64%. Except for CBF, the prevalence of other key complementary feeding practices was higher among children who attending ECE classes than those not attending ECE classes (all P < 0.05). Moreover, children aged 12-23 months who received long-nursing care time (≥4h/d) had significantly higher MMF and MAD prevalence than those in short-nursing care time group (MMF = 66.2 vs. 58.8%, P = 0.0003; MAD = 44.2 vs. 38.3%, P = 0.0047). The complementary feeding practices of children aged 6-23 months in ECE institutions in urban China remained suboptimal, and non-responsive feeding practices among caregivers were common. The attendance of ECE classes and the caregivers' daily nurturing care time could be beneficial in ensuring children to comply with complementary feeding recommendations.

Personalization of Complementary Feeding in Children With Acute Food Protein–Induced Enterocolitis Syndrome

Food protein-induced enterocolitis syndrome (FPIES) is a food allergy that results in repetitive vomiting, lethargy, and pallor within 1 to 4 hours of food ingestion. One of the issues in its management is the introduction of new foods. Over the past 25 years, suggestions have been made mainly based on the likelihood that a given food family could induce an episode of acute FPIES. Thus, foods have been categorized into low, moderate, and high risk. The suggestion was always to postpone the introduction of moderate- or high-risk foods, leaving the decision whether to introduce them at home or in hospital to the doctor. These suggestions were designed for all children with acute FPIES, regardless of their geographical area. However, it is true that these suggestions are the result of expert opinion. In recent years, studies have been published that have shown that the risk category of foods varies according to geographical area and so does the prevalence of single FPIES versus multiple FPIES. For this reason, we believe that the introduction of new foods in the child with acute FPIES can and should be tailored according to the geographical area.

Understanding the Knowledge, Attitudes, and Practices of Mothers/Caretakers Regarding Complementary Feeding in Children Aged 6 Months to 2 Years Attending the Pediatrics Outpatient Department at Ishaka Adventist Hospital

This research aimed to evaluate the knowledge, attitudes, and practices among mothers caring for children aged 6 months to 2 years regarding Complementary Feeding (CF). Conducted over a one-month period from October to November 2020, this descriptive cross-sectional study engaged 206 Mothers/caretakers attending Ishaka Adventist Hospital OPD for various child health concerns, including immunization and growth monitoring. Participants were selected randomly based on their arrival order at the hospital during the study period. Data collection involved researcher-administered questionnaires for illiterate participants and self-administered questionnaires for literate individuals after obtaining consent. Participants' comprehension and execution of complementary feeding practices were assessed through their responses. Data entry and analysis utilized EPI-DATA and STATA 17 software. Univariate analysis determined frequency, mean, mode, and percentage of participant responses, while bivariate analysis explored the relationship between knowledge and attitude, and between knowledge and practices among mothers/caretakers at Ishaka Adventist Hospital's pediatric OPD. Findings revealed that only 4% of participants were knowledgeable about the frequency of both Complementary Feeding (CF) and Breastfeeding (BF) for infants and the ideal diet composition. However, 63% were aware of the appropriate ages to initiate CF and stop BF, along with the consequences of delayed CF initiation. Although 85.5% commenced CF at the recommended age of six months, merely 4.3% provided adequate quantity and quality of complementary feeds to their infants. The study discovered statistically significant associations between proper/poor CF practices and respondents' age, education level, socio-economic status, and number of children in the household. Despite varied practices, participants generally exhibited positive and supportive attitudes toward CF. Keywords: Breast milk, Malnutrition, Immunization, Complementary Feeding, Babies.

P24-009-23 Body Composition and Complementary Feeding in Children 6–23 Months Receiving Food and Nutritional Assistance of WFP in Northern Senegal

P24-009-23 Body Composition and Complementary Feeding in Children 6–23 Months Receiving Food and Nutritional Assistance of WFP in Northern Senegal

Fathers’ involvement in complementary feeding of children in Damot Woyde District, South Ethiopia: a community-based cross-sectional study

BackgroundIn infant and young child feeding practice parents are the primary agents for childcare activities, such as feeding. Mothers’ role in infant and young child feeding practice has been the focus of previous research. The involvement of fathers in child-feeding practice has rarely been studied. Thus, this study aimed to assess fathers’ involvement in the complementary feeding of children and identify factors associated with it in Southern Ethiopia.MethodsA community-based cross-sectional study was conducted which included a survey, in-depth interviews, and focus group discussions (FGDs). The survey was conducted with 593 fathers who have at least one child of age 6-23 months. Four FGDs were conducted with fathers, and 21 in-depth interviews were conducted with fathers, mothers, and community health workers. The survey data were entered into Epi data software version 1.4.4.0 and statistical analysis was performed using SPSS software version 20. Bivariate and multivariate logistic regression analyses were performed and statistical significance was considered at p < 0.05. All interviews and FGDs were transcribed, coded, categorized, and analyzed using open code software version 4.0.2.ResultsOf the total sample of 593, 50.9% of the fathers in the study were involved in their children’s complementary feeding practices. Fathers with better household income (AOR = 1.56; 95% CI: 1.09, 2.22) and good perception of child complementary feeding practice (AOR = 1.79; 95% CI: 1.28, 2.52) were more likely to be involved in their children’s complementary feeding practice. The majority of the fathers had better knowledge about the recommended complementary feeding practices.ConclusionsIncome-generating activities and behavioral change communication for fathers should be encouraged to improve their involvement in child feeding. Community-based nutrition programs should also give due attention to increasing the involvement of fathers.

Complementary feeding in children and its homoeopathic management

Complementary feeding in children and its homoeopathic management

Mothers’ knowledge and attitudes regarding child complementary feeding recommendations in Iraq

Mothers’ knowledge and attitudes regarding child complementary feeding recommendations in Iraq

Impact of Training Program to Nurses Regarding Complementary Feeding in Infant and Young Children: An Educational Interventional Study

Introduction: Under nutrition is an underlying cause of more than one third of global deaths in children below the age of 5 years. Nutrition education is a critical strategy of intervention to improve child complementary feeding practices which will subsequently decrease mortality and morbidity of under-5 children.&#x0D; Objective: To determine the knowledge of nurses on complementary feeding practices and also provide appropriate training and verify its effectiveness.&#x0D; Method: It is a hospital based educational interventional study. The time-series was from October 2021 to march 2022 included 24 nursing staff. The nurses underwent one-day training on complementary feeding practices in infant. They were evaluated periodically on their knowledge at four different time points. The effectiveness of training was calculated based on the change in scores, as per mean numeric scores, immediately, 1 and 6 months after the training.&#x0D; Result: The nurses showed high competence by obtaining above average scores (100%) by all participant immediately after training and remained so after 1 month. The mean test score obtained before training was 15.3 which increased to 23 after training, 21.9 after 1 month and 17.8 after 6 months of training. The differences in mean were statistically significant (p value 0.000).&#x0D; Conclusion: This training intervention improved knowledge of nurses regarding complementary feeding practices, but improvements need to be strengthened and sustained.

Determinants of Complementary Feeding Indicators: A Secondary Analysis of Thailand Multiple Indicators Cluster Survey 2019.

Child complementary feeding (CF) practices meet dietary recommendations more often among educated, high-income groups. Much of the evidence for this association addresses inadequate CF for addressing child undernutrition. However, in many countries, including Thailand, child malnutrition assessments must now address under- and over-nutrition. More comprehensive data is needed to understand this complex situation. This study uses data from the Thailand Multiple Indicators Survey 2019, to identify the determinants of CF practices among 6–23-month children (n = 4125) using the newly developed WHO indicators. Logistic regression analysis was used to measure associations between sociodemographic factors and CF practices. In a fully adjusted model, child age, primary caregivers’ education, and household incomes were statistically associated with (in)appropriate CF practices. Older children aged 9–23 months, not only have better minimum dietary diversity (MDD), minimum acceptable diet (MAD), and egg and/or flesh food consumption (EFF), but also tend to consume more unhealthy foods. The proportion of inappropriate CF practices was higher among children living with caregivers other than their mothers. While maternal education and household income were positively associated with MDD and MAD, children of mothers from middle-class households consumed more sweetened beverages. Therefore, nutrition programs addressing different feeding problems should be developed specifically for different primary caregiver and demographic groups.

A Randomized Trial of Iron-Biofortified Pearl Millet-Based Complementary Feeding in Children Aged 12 to 18 Months Living in Urban Slums in India

ObjectivesTo determine the efficacy of iron-biofortified pearl millet (FePM, Dhanashakti, ICTP-8203Fe)-based complementary feeding on iron status and growth, in children living in urban slums of Mumbai, India. MethodsThis randomized controlled feeding trial of FePM was conducted among 223 children aged 12 to 18 months who were not severely anemic (hemoglobin (Hb) ≥9.0 g/dL) (Clinicaltrials.gov ID: NCT02233764). Children were randomized to receive either complementary foods prepared from FePM or conventional non-biofortified pearl millet (CPM) daily for 9 months. Iron status (Hb, serum ferritin (SF)), and anthropometric indicators (i.e., length, weight, head, mid-upper arm circumferences, triceps and subscapular skinfolds) were evaluated at enrollment and throughout the trial. World Health Organization (WHO) anthropometric Z-scores were calculated using WHO growth standards. Primary outcomes were Hb and SF concentrations, and growth, defined as WHO Z-scores. An intent to treat approach was used for analyses. We used the Hodges–Lehmann–Sen test to assess the change in primary outcomes between baseline and the last visit and report corresponding 95% confidence intervals. ResultsAt baseline, 67.7% of children were anemic (Hb < 11.0 g/dL) and 59.6% were iron-deficient (SF < 12.0 μg/L). FePM did not significantly increase iron biomarkers or improve growth, compared to CPM. In subgroup analyses, FePM improved hemoglobin concentrations in male children, and in children with iron deficiency or iron depletion (SF < 25.0 μg/L) at baseline, compared to CPM. ConclusionsDaily consumption of FePM-based complementary foods did not significantly improve iron status or growth in children living in this population. However, the intervention significantly improved hemoglobin concentrations among male children and individuals who were iron-deficient or iron-depleted at baseline. Funding SourcesHarvestPlus.

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

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.

[Study on infant and young children complementary feeding in poor rural regions in China].

To analyze complementary feeding status and issues among 6-23 month infants and young children(IYC) in poor rural regions in China to figure out actions further IYC nutrition in China. Using 2018 monitoring data from Project of Children Nutrition Improvement in Poor Rural Regions, 6-23 months infants were sampled with the method of a combination of provincial stratification, multi-stage stratified cluster, PPS and random equidistant. Complementary feeding practices were collected by 24 hours diet recall method and and parental knowledge on IYC feeding was collected by KAP questionnaire. Complementary diet was analyzed according to the World Health Organization& apos; s definition of infant and young child feeding indicators. Logistic regression model was used to analyze the influencing factors of minimum acceptable diet(MAD). A total of 40 910 infants(boys 21 153, girls 19 757) completed the survey. The proportion of infants 6-8 months of age who receive solid, semi-solid foods was 83.8%, the percentage of IYC who get minimum dietary diversity(MDD), minimum meal frequency(MMF), and MAD was 67.8%, 71.4% and 39.7%, respectively. The age of months, mother& apos; s educational level and parent& apos; s nutrition and feeding knowledge had significant impact on the outcome of MAD. The OR for month& apos; s age were 1.990 and 1.905(P& lt; 0.001), OR for mother education level was 1. 545(P& lt; 0.001) and OR for parent knowledge were 1.114 and 1.346(P& lt; 0.001). Complementary feeding practices were poor in terms of the proportion of infants 6-8 months of age who introduced complementary foods, MDD, MMF and MAD in poor region of China.

Higher Energy and Zinc Intakes from Complementary Feeding Are Associated with Decreased Risk of Undernutrition in Children from South America, Africa, and Asia

BackgroundFew studies have focused on quantitatively analyzing nutrients from infant diets, compromising complementary feeding evaluation and health promotion worldwide. ObjectivesThis study aimed to describe dietary intake in infants from 9 to 24 mo of age, determining nutrient intakes associated with the risk of underweight, wasting, and stunting. MethodsUsual nutrient intakes from complementary feeding were determined by 24-h recalls collected when infants were 9–24 mo of age in communities from 7 low- and middle-income countries: Brazil (n = 169), Peru (n = 199), South Africa (n = 221), Tanzania (n = 210), Bangladesh (n = 208), India (n = 227), and Nepal (n = 229), totaling 1463 children and 22,282 food recalls. Intakes were corrected for within- and between-person variance and energy intake. Multivariable regression models were constructed to determine nutrient intakes associated with the development of underweight, wasting, and stunting at 12, 18, and 24 mo of age. ResultsChildren with malnutrition presented significantly lower intakes of energy and zinc at 12, 18, and 24 mo of age, ranging from −16.4% to −25.9% for energy and −2.3% to −48.8% for zinc. Higher energy intakes decreased the risk of underweight at 12 [adjusted odds ratio (AOR): 0.90; 95% CI: 0.84, 0.96] and 24 mo (AOR: 0.91; 95% CI: 0.86, 0.96), and wasting at 18 (AOR: 0.91; 95% CI: 0.83, 0.99) and 24 mo (AOR: 0.83; 95% CI: 0.74, 0.92). Higher zinc intakes decreased the risk of underweight (AOR: 0.12; 95% CI: 0.03, 0.55) and wasting (AOR: 0.19; 95% CI: 0.04, 0.92) at 12 mo, and wasting (AOR: 0.05; 95% CI: 0.00, 0.76) at 24 mo. ConclusionsHigher intakes of energy and zinc in complementary feeding were associated with decreased risk of undernutrition in the studied children. Data suggest these are characteristics to be improved in children's complementary feeding across countries.

Effect of Nutrition Education Videos on Mothers’ Knowledge, and Practices on Complementary Feeding of Children 6 - 23 Months in Ruaraka Sub-county, Nairobi City County

Effect of Nutrition Education Videos on Mothers’ Knowledge, and Practices on Complementary Feeding of Children 6 - 23 Months in Ruaraka Sub-county, Nairobi City County

Can parity influence infant feeding in the first six months of life?

This article aims to evaluate the influence of parity on breastfeeding and introduction of complementary feeding in children up to six months after childbirth. Longitudinal study conducted through a convenience sample of mother-child pairs, selected at postpartum and accompanied until the sixth month of infant's life, between 2011 and 2016, in Porto Alegre, Brazil. There was an analysis of the time taken in the first feeding after birth, practice and time of breastfeeding, consumption of other types of milk and introduction of complementary feeding. The sample consisted of 161 dyads, with 74 primiparous and 87 multiparous. Multiparous women breastfed their babies sooner in the first 24 hours post-partum (p = 0.019). The offering of other kinds of milk showed no difference in relation to parity, as the moment of introduction to infant nutrition, although both primiparous and multiparous did it before the age of four months. Parity seemed to influence the timing of first breastfeeding offer, but not the introduction of complementary feeding, although this occurred in an early way. In this sense, it is necessary to disseminate more information about breastfeeding and infant feeding during prenatal and childcare, to improve maternal and child health.

Association between iron deficiency anaemia and complementary feeding in children under 2 years assisted by a Conditional Cash Transfer programme.

To evaluate the association between Fe deficiency anaemia (IDA) and complementary feeding in children under 2 years old assisted by the Conditional Cash Transfer programme, Bolsa Família (BFP). Cross-sectional study. Data were obtained through a standardised form, questionnaire to assess the eating habits of children under 2 years of age, capillary Hb (HemoCue®) and the Brazilian Household Food Insecurity Measurement Scale. Associations were calculated using hierarchical Poisson regression, adjusted at the last level by socio-economic, demographic and environmental variables from previous hierarchical levels. Six municipalities from the State of Alagoas, Brazil. Children aged 6-24 months assisted by BFP. A total of 1604 children were evaluated, among whom 58·1 % had anaemia. A higher number of food groups consumed (prevalence ratio (PR) = 0·97; 95 % CI 0·95, 0·99; P = 0·009), the consumption of dairy (PR = 0·86; 95 % CI 0·79, 0·84; P = 0·001) and meat (PR = 0·90; 95 % CI 0·83, 0·99; P = 0·030) in addition to bottle feeding (PR = 0·88; 95 % CI 0·82, 0·96; P = 0·004) were associated with a lower prevalence of IDA. IDA is still a serious public health problem in children under 2 years old assisted by BFP in Alagoas. We highlight the importance of promoting complementary feeding based on a diversified dietary intake, as well strengthening prophylactic supplementation programmes to increase children's adherence in conjunction with the implementation of food and nutrition education to help reduce the prevalence of this condition.

Aleitamento materno e introdução da alimentação complementar: uma análise de povos indígenas

A população indígena no Brasil vem crescendo nos últimos anos, estima-se que o alcance dessa população seja maior que 900 mil nativos declarados e situem-se em 305 etnias e 274 idiomas. É recomendável o aleitamento materno exclusivo até os 6 meses de idade e que a alimentação complementar saudável seja introduzida a partir dos 6 meses. No entanto, entende-se que os povos indígenas apresentam uma complexa circunstância de saúde que está relacionada diretamente com as mudanças sociais, econômicas e ambientais, processo histórico que agravou as condições de saúde. Este estudo teve como objetivo analisar por meio de uma revisão da literatura os impactos do aleitamento materno e introdução da alimentação complementar em crianças de até 2 anos de povos indígenas. A pesquisa bibliográfica foi realizada utilizando a bases de dados BIREME, LILACS, SCIELO, MEDLINE e foram selecionados artigos publicados nos últimos dez anos e nacionais. Após a revisão da literatura, ficou evidente que o tempo de aleitamento materno nas populações indígenas é bem menor que o recomendado pela OMS. Portanto, impactando não só na saúde das crianças indígenas, mas também na relação de vínculo, acolhimento, admiração entre mãe e filho.

Minimum Diet Diversity and Minimum Meal Frequency – Do They Matter Equally? Understanding IYCF Practices in India

Abstract Objectives Infant and Young Child Feeding practices, mainly, complementary feeding in children between 6 months and two years of age, is found to be sub-optimal and emerge as the weakest link in improving child nutrition outcomes in India. Minimum Acceptable Diet (MAD), comprising of two sub-indicator – Minimum Dietary Diversity (MDD) and Minimum Meal Frequency (MMF), serves as an essential indicator to understand the diet adequacy pattern in children. The objective of this study was thus to investigate the role of MDD-MMF dyad in influencing the nutritional outcomes in children and its pattern across regions in India. Methods Data was obtained from the National Family Health Survey – 4 (NFHS-4) from the DHS Program website. The prevalence of MMF and MDD was calculated for 640 districts in India. The MMF and MDD were classified into three categories - high, medium and low based on equal percentile distribution of their prevalence range. Districts with high MMF and high MDD formed one cohort. Similarly, eight other cohorts were created based on their performance on MMF and MDD indicator. The prevalence of Stunting (St), Wasting (Wa) and Underweight (Uw) in children between 6 months and two years of age was then calculated for each of the nine cohorts. The districts were also mapped based on their cohort category to study the variation across regions in India. Results All three anthropometric indicators – stunting, wasting and underweight showed significant decline moving across low MMF- low MDD cohort (40% St; 26.2% Wa; 37.1% Uw) to medium MMF – medium MDD cohort (38.6% St; 23.8% Wa; 35.4% Uw) to high MMF – high MDD cohort (29% St; 15.5% Wa; 19.2% Uw). Second, the importance of minimum dietary diversity in improving nutritional outcomes was revealed, as opposed to minimum meal frequency, which shows improvement only when it reaches a certain threshold. Third, mapping revealed sharp differences across various regions in MMF-MDD pattern, especially in the states like Odisha, Assam and Andhra Pradesh. States in the central region performed poorly on complementary feeding indicators, specifically diet diversity. Conclusions The study highlights the importance of optimal complementary feeding practices in improving nutrition outcomes and the need to consider the regional heterogeneities while promoting IYCF practices in India. Funding Sources None.

Maternal Social Support Is Associated with Child Complementary Feeding, and Household Food Security in the Vakinankaratra Region, Madagascar

Abstract Objectives There is limited research on the associations between maternal social support and household food security and child feeding practices in Madagascar. Our study examined the association between maternal social support, household food security, and feeding practices among mothers of children 6 - 24 months in the Vakinankaratra region, Madagascar. Methods This cross-sectional study included 344 mother-child dyads. The Medical Outcomes Study (MOS) Social Support Index was used for maternal social support scores. A mean score of &amp;gt;4 was considered optimal social support with ≤2 as none or little support. Food insecurity scores were determined using the Household Food Insecurity Access Scale (HFIAS). Complementary feeding practices were assessed using the World Health Organization (WHO) IYCF guidelines. Logistic and linear regression models tested the association between social support, complementary feeding practices, and household food insecurity. The models were adjusted for household, maternal and child confounders. Statistical significance was set at P &amp;lt; 0.05. Results Almost half of the mothers (49.1%) were supported by their spouses, although only 37.8% of mothers had optimal social support. Less than half of infants (36.34%) met minimum dietary diversity (≥4 of 7 food groups). Mothers with optimal social support had lower household food insecurity (b = −0.85, P = 0.016, R,2 = 0.10) in the adjusted models. Furthermore, children of mothers with higher social support were more likely to meet minimum dietary diversity scores (AOR = 2.36 [1.21–4.56], P = 0.021) and to achieve the minimum adequate diet (AOR = 2.32 [1.17–4.61], P = 0.018). Although maternal social support was significantly associated with child minimum meal frequency in the bivariate analysis, it became nonsignificant in the final adjusted model (AOR = 1.70 [0.93–3.11], P = 0.387). Conclusions Increased maternal social support was significantly associated with household food security, child dietary diversity, and diet adequacy. Integrating parental peer support in nutrition interventions may be effective in improving food security, and child feeding practices in the Vakinankaratra region of Madagascar. Funding Sources This study was funded by Oklahoma State University.

Predictors of complementary feeding in infants aged 6 to 18 months: An application of Health Belief Model

Introduction: Complementary feeding plays a vital role in growth and development of children and prevention of malnutrition. Objective: To determine the predictors of complementary feeding in 6 to 18-month-old infants and young children based on the Health Belief Model (HBM). Method: This cross-sectional study was performed on 270 mothers of children aged 6 to 18 months who were randomly selected from those referred to six health centres in Andimeshk city, Iran. Data were gathered using a 53-item questionnaire based on the HBM and were analysed by SPSS statistical software, descriptive statistics, Pearson correlation and multiple regression tests. Results: Mean age of the mothers was 29.8 ± 5.08 years and most of them were homemakers (88.5) and had an under-diploma education (62.2). The HBM constructs predicted a total of 28.9 of the variance of mothers' behaviour in relation to complementary feeding in children. Perceived selfefficacy (p = 0.001) and perceived barriers (p = 0.011) significantly predicted the behaviour. Conclusions: Perceived barriers and perceived self-efficacy are the most important determinants of mothers' behaviour in relation to complementary feeding in children. © 2020, Sri Lanka College of Paediatricians.