Complementary Feeding Research Articles

Evaluation of Complementary Feeding Indicators Among Children Aged 6–23 Months According to the Health Literacy Status of Their Mothers

Background/Objectives: Infant and young child feeding (IYCF) practices directly affect child health, development, and survival, especially under 2 years of age and ultimately affect adult life well-being. As the primary caregivers of the children, mothers with higher health literacy may better perceive the benefits of optimal complementary feeding practices, leading to improved health outcomes for their children. In this study, we aimed to assess complementary feeding practices among children aged 6–23 months in Turkey according to 2021 World Health Organization IYCF indicators [minimum dietary diversity (MDD); minimum meal frequency (MMF); minimum acceptable diet (MAD); egg and/or flesh food consumption (EFF); sweet beverage consumption (SwB); unhealthy food consumption (UFC); zero vegetable or fruit consumption (ZVF); and bottle feeding (BoF)] and investigate their associations with sociodemographic characteristics and mothers’ health literacy. Methods: With a descriptive study design, we reached 572 mothers of children aged 6–23 months from five regions of Turkey. We used the Turkey Health Literacy Scale-32 (TSOY-32) to assess mothers’ health literacy. Results: While maternal and child age are significantly associated with more complementary feeding practices, specifically MDD, MAD, and EFF, having multiple children has negative impacts on several complementary feeding indicators, including MDD, MMF, MAD, UFC, and ZVF. The only indicator associated with mothers’ TSOY-32 scores was zero fruit and vegetable consumption. Conclusion: Raising awareness among mothers about the importance of complementary feeding practices and identification of vulnerable groups will guide practitioners and policymakers to improve child health and nutrition.

Infant Food Flours Made from Local Products to Combat Acute Malnutrition in Children Under 5 Years Old in Côte D’ivoire

In Côte d'Ivoire, recurring stock shortages and difficulties in accessing specialized food products compromise nutritional treatment. This study proposes food formulas of flours composed of locally available products capable of meeting the protein-energy needs of children aged 6 to 59 months diagnosed with moderate acute malnutrition. The methodological approach consists of formulating and determining the physicochemical, nutrient, and functional characteristics of four new formulations (1F, 2F, 3F, 4F, and 5F). The results indicate that the formulated foods have high levels of calcium (215.60-252,29 mg/100g MS), potassium (555,70-789,29 mg/100 g MS), magnesium (261,26-200,63 mg/100g MS), iron (4,86-7,03 mg/100g MS) and phosphorus (392,36 -469,36 mg/100g MS). The fat content varies from 9.66% to 23.86%. The energy value determined for all flours corresponds well to the Codex. The food formulas developed would also be able to meet more than 100% of the daily requirement of vitamins E and B1. The phytate (180.26 - 227.05 mg/100 g) and oxalate (66.00 - 88.00 mg/100 g) contents are low. The presence of phenolic compounds, including flavonoids (7.78-15.44 mg/100 g) and antioxidant activity (31.09-32.84%) would be a significant asset. The levels of deoxynivalenol (62 μg/kg) recorded in flours are below 200 μg/kg recommended for infants and young children. The proposed formulations have high-water absorption capacity (136.15 -252.94%) and high solubility index (56.84 -59.2%). The wettability time ranges from 3.66 ± 0.16 s to 33.71 ± 0.23 s. Flours (1F, 2F, 3F, 5F) have a better absorption capacity for refined palm oil (132 %, 139 %, 121 %; 115 %). The proposed new formulations have nutritional characteristics close to standard data and could therefore be recommended for children aged 6 to 59 months for complementary feeding in the context of the fight against moderate acute malnutrition.

Timing of food pieces introduction and neurodevelopment: findings from a nationwide birth cohort

BackgroundWhile complementary feeding can be challenging, little emphasis has been placed on the introduction to food texture/pieces, especially in terms of neurodevelopmental outcomes. This study aims to determine the association between the timing of introduction to food pieces during infancy and neurodevelopment in early childhood. We hypothesized that late introduction to food texture/pieces relates to unfavorable neurodevelopmental outcomes.MethodsFamilies (n = 18329) were recruited from the general population during the nationwide ELFE (Étude Longitudinale Française depuis l’Enfance) birth cohort in France, and 8511 were selected for a complete case analysis. Age at introduction to food pieces was determined based on repeated assessments during the first year. A range of neurodevelopmental outcomes among children were assessed using validated instruments, i.e. composite scores at 1 and 3.5 years, and a score for language acquisition at 2 years. Risk for developmental delay at 3.5 years was defined based on a developmental quotient (DQ) below 90 according to the child’s chronological age and the respective composite score at this age. We used linear regression modelling to evaluate associations between age at introduction to food pieces and the standardised neurodevelopmental scores, while logistic regression models were used in the analyses according to the risk for developmental delay.ResultsOur findings highlight consistent associations between late introduction to food pieces (i.e., after 10 months, compared to early (before 8 months)) and lower estimates of standardised neurodevelopmental scores at ages 1, 2 and 3.5 years (-0.35 [-0.40; -0.30], -0.15 [-0.20; -0.10] and − 0.18 [-0.23; -0.13], respectively). Infants introduced to pieces late were also more likely to be at risk for developmental delay according to DQ < 90 (OR [95%CI] = 1.62 [1.36; 1.94]).ConclusionsThis study shows that late introduction to food pieces (> 10 months) is related to lower neurodevelopmental scores. Given the challenges that complementary feeding may pose, concerted efforts are required to enhance our understanding of the sensory aspects of early diets and to ultimately provide guidance.

Dietary intake and growth of HIV exposed and unexposed 6-12 months old infants in South Africa.

Factors affecting the growth of HIV-exposed-uninfected (HEU) children are multi-factorial, with limited information available on the dietary intake from 6 months. This study compared the dietary intake, micronutrient composition of breastmilk, and growth of HEU and HIV-unexposed-uninfected (HUU) infants aged 6 and 12 months in an urban setting. A repeated cross-sectional study used structured questionnaires to collect socio-demographic, dietary intake, food group data, and anthropometric measurements in the Siyakhula study. The HEU (48%) and HUU (52%) infants were included (total n = 181). At 6 months, HEU infants had lower weight-for-age z-scores (WAZ) (-0.6 ± 1.1 vs. 0.1 ± 1.2; p < 0.001), length-for-age z-scores (-0.8 ± 1.4 vs. -0.1 ± 1.2; p < 0.001), and mid-upper-arm circumference-for-age z-scores (MUACAZ) (0.5 ± 1.1 vs. 1.0 ± 0.9; p < 0.001) than HUU infants. At 12 months, HEU infants had lower WAZ, MUACAZ, and weight-for-length z-scores compared to HUU infants (p < 0.05). Stunting was found at 6 (15%) and 12 (12%) months in HEU infants. The micronutrient composition of breastmilk fed to both groups was similar. Breastfeeding rates were lower in HEU than in HUU infants at 6 (49% vs. 64%; p = 0.005) and 12 (24% vs. 46%; p = 0.002) months. Less than 3% of HEU and HUU infants achieved minimal dietary diversity scores at 12 months. Dietary intake of fat was similar in all breastfed infants, but iron and vitamin B12 were higher in non-breastfed HEU infants at 12 months. HEU infants had lower breastfeeding rates than HUU infants. A lack of dietary diversity was found in all infants. Nutrition education and counselling in the complementary feeding phase are essential for optimal growth.

Parent-reported offering of allergen foods to infants during complementary feeding: An observational study of New Zealand infants

The prevalence of food allergies in New Zealand infants is uncertain but is believed to be similar to Australia, exceeding 10%. Current recommendations for reducing food allergy risk are to offer all major food allergens to infants from as early as six months of age (start of complementary feeding), and before 12 months of age. However, little is known regarding parental practices around introducing major food allergens. This study aimed to explore parental offering of major food allergens to infants during complementary feeding, and parent-reported food allergies. The cross-sectional study is a secondary analysis of the multi-centre (Auckland and Dunedin) First Foods New Zealand study of 625 parent-infant dyads. Participants were recruited in 2020–2022 when infants were 7–10 months of age. Questionnaires assessed sociodemographic characteristics, complementary feeding approach, infant pouch use and parental responses to five food allergy questions. All major food allergens had been offered to only 17% of infants by 9–10 months of age. Having offered egg, peanut, tree nuts, sesame, soy and seafood was more commonly associated with using a baby-led complementary feeding approach than a parent-led approach (p < 0.001). Frequent baby food pouch use was associated with a lower likelihood of offering egg and peanut (both p < 0.001). Overall, 12.6% of infants had a reported food allergy, with symptomatic response after exposure being the most common diagnostic tool. Most infants are not offered all major food allergens during early complementary feeding, with some parents actively avoiding major food allergens in the first year of life. These results provide up-to-date knowledge of parental practices, highlighting the need for more targeted advice and strategies to improve parental engagement with allergy prevention and diagnosis.

Macronutrient Intake during Complementary Feeding in Very Low Birth Weight Infants Comparing Early and Late Introduction of Solid Foods: A Secondary Outcome Analysis.

Background/Objectives: Very low birth weight (VLBW) infants may require enhanced nutrition, even during complementary feeding. However, there are limited data on macronutrient intake during this period, particularly concerning the individual timing of the introduction of solid foods in a representative VLBW infant population. Methods: This prospective observational study analyzed macronutrient intake in VLBW infants with a gestational age < 32 weeks based on whether solid foods were introduced early (<17 weeks corrected age (CA)) or late (≥17 weeks corrected age) Nutritional intake was analyzed using a 24 h recall at 6 weeks CA and 3-day dietary records at 12 weeks, 6, 9, and 12 months CA. Results: In total, 115 infants were assigned to the early and 82 to the late group. The timing of solid food introduction did not affect macronutrient intake, except for a lower fat and higher carbohydrate intake (% of energy) in the early group at 12 weeks and 6 months CA: early vs. late, fat-12 weeks: 47.0% vs. 49.0%, 6 months: 39.2% vs. 43.3%; carbohydrates-12 weeks: 44.9% vs. 43.2%, 6 months: 51.3% vs. 48.0%. Apart from docosahexaenoic acid (DHA) and arachidonic acid (AA), dietary intake recommendations were met in both groups. While nutrient intakes varied significantly between breastfed and formula-fed infants, those with comorbidities exhibited similar nutrient intake levels compared to those without. Conclusions: Our findings suggest adequate macronutrient intakes in VLBW infants irrespective of the timing of solid introduction. However, there is a notable need to enhance dietary intakes of DHA and AA. Future research is crucial to assess whether current nutrient intakes are sufficient for VLBW infants with comorbidities.

Effectiveness of early childhood education interventions to improve complementary feeding practices in children 4 to 36 months of age: a systematic review protocol.

Healthy eating habits, which start with food introduction, can influence children's growth and development. Therefore, the educational actions carried out at school for children who are beginning to eat, involving families and school staff who attend daycare centers, can serve as strategies to improve complementary feeding practices. This review will analyze the effectiveness of early childhood education interventions to improve complementary feeding practices in children aged 4 to 36 months. The review will consider randomized clinical trials, cluster-randomized clinical trials, and controlled clinical trials that evaluate the effectiveness of early childhood education interventions involving children aged 4 to 36 months, their families, or school staff to improve complementary feeding. In their absence, observational cohort, case-control, and cross-sectional studies may be considered. This review will be conducted in line with the JBI methodology for systematic reviews of effectiveness. The search for relevant studies will be conducted in PubMed, Embase (Ovid), BIREME, Scopus, the Cochrane Library (Cochrane Central Register of Controlled Trials CENTRAL and Cochrane Database of Systematic Reviews), CINAHL (EBSCOhost), and the ProQuest Databases (ProQuest Central). No date or language limitation will be applied. Two independent reviewers will select studies by screening titles, abstracts, and keywords against the inclusion criteria. This will be followed by full-text screening. Two independent reviewers will then conduct the study method quality evaluation and data extraction. GRADEpro will be used to assess the certainty in the findings, which will be reported in a systematic review, and, if possible, grouped in a meta-analysis. PROSPERO CRD42022384704.

A 10-year (2014-2023) review of complementary food development in sub-Saharan Africa and the impact on child health.

Complementary foods (CFs) commonly consumed by infants and young children (IYC) in sub-Saharan Africa (SSA) are processed using either single or multi-grain ingredients through simple technologies such as fermentation, malting and roasting. Interestingly, CFs (e.g., ogi, kunu, and dabo) are prepared and fed to infants alongside breastmilk until they are completely weaned up to the infant's second birthday. The grains used for preparing CFs can be contaminated with bacterial and chemical contaminants as a result of poor harvesting, handling or storage practices. The stage at which IYC are introduced to CFs is of utmost importance as it aids in addressing malnutrition and improving their overall health and well-being. Complementary feeding practices across SSA are influenced by socio-economic, cultural and geographical factors such that improper introduction can result in dire health consequences including immune suppression, severe foodborne diseases, poor child growth and development, and sometimes death from malnutrition. Malnutrition often occurs from inadequacies of nutrient intakes and assimilation which affect the ability to maintain normal body functions such as growth, learning abilities, resistance to and recovery from diseases. In SSA, IYC malnutrition still poses an enormous concern, therefore indicating the need for intervention strategies such as the promotion of indigenous crops and elevating traditional knowledge and technologies for formulating CFs. This paper clearly highlights the diversity of CFs in SSA, ingredients utilized, processing techniques, contamination by bacteria and chemicals, and demonstrates the consequences of consuming contaminated CFs, and their influence on IYC health as well as approaches to ensuring safety and scaling up indigenous CFs.

Hygienic practice during complementary feeding and associated factors among mothers of children aged 6-24 months in Borecha Woreda, southwestern Ethiopia: a community-based cross-sectional study.

Complementary feeding is a critical transitional phase in the life of an infant, and complementary foods should be prepared, stored, and fed hygienically, with clean hands, dishes, and utensils to prevent diseases. However, the prevalence and risk factors associated with hygienic complementary feeding practice have not been well addressed in Ethiopia, especially in the study area. This study aimed to assess hygienic practices and associated factors during complementary feeding among mothers with children aged 6-24 months in Borecha Woreda, Buno Bedele Zone, southwestern Ethiopia, in 2022. A community-based cross-sectional study was conducted using a multistage sampling technique. The study was conducted on 536 mothers of children aged 6-24 months in Borecha Woreda from 1 March to 1 April 2022. Data were collected using an interviewer-administered questionnaire. The data were coded, cleaned, edited, and entered into Epi-Data version 4.6 and then exported to SPSS version 20.0 for further analysis. Both bivariate and multivariable logistic regression models were fitted. Moreover, crude (for bivariate) and adjusted (multivariable) odds ratios (AORs) with 95% confidence intervals (CIs) were computed to assess the association between independent factors and outcome variables. A p-value of <0.05 was considered statistically significant. Out of 536 respondents, 350 (65.3%) exhibited poor hygienic practices during complementary feeding. The risk of poor hygienic practices was about two times higher among women over 30 than those under 25 (AOR: 1.8; 95% CI: 1.11-2.90). Mothers whose husbands had primary education or higher had a 50% reduced risk (AOR: 0.50; 95% CI 0.31-0.83) of poor hygienic care practices during complementary feeding compared to their counterparts. The odds of poor hygiene practice among mothers with poor knowledge of hygienic care were 2.71 times higher than those with good knowledge (AOR: 2.71; 95% CI: 1.60-4.61). The prevalence of poor hygienic practices during the preparation and handling of complementary foods among mothers in Borecha Woreda is high compared to other studies. Therefore, improving hygiene practices during complementary food preparation requires the involvement and responsibility of policymakers, the community, and families.

Complementary feeding and food handling practices among caregivers in a semi-urban setting in Northern Uganda

Background: Complementary feeding practices influence the nutritional status and health of children, especially in developing countries where sub-optimal infant feeding practices are the major cause of childhood undernutrition, morbidity, and mortality. This study sought to characterize the adequacy of complimentary feeding and food handling practices among caregivers of children aged 6-23 months in a semi-urban setting. Methods: Exploratory cross-sectional study was conducted in Adyel division, Lira district in Northern Uganda among 127 child-caregiver pairs randomly selected from three villages. Caregivers were interviewed about their child-feeding practices, complementary foods used, and common practices in handling and preparation of foods used as complementary feeds. Results: Overall, children’s feeding patterns met the recommended dietary intake when assessed using the child feeding index (CFI) whereby children aged 6-8, 9-11, and 12-23 months scored 8.03, 9.17, and 7.59, respectively. However, most children were complemented with foods from the household meals and dietary diversity was limited by frequent use of food leftover from the previous meals. Conclusions: Inappropriate meal patterns and food handling practices identified are likely to compromise child nutrition and health. Nutrition education is needed to improve the caregivers’ child-feeding and food handling practices within their socio-economic and cultural context. Keywords: Complementary feeding practices; food handling; diet quality; food safety; children; Uganda.

Patterns of complementary feeding introduction and associated factors in a cohort of Brazilian infants

BackgroundUnderstanding the timing of food introduction in infants is essential for promoting optimal complementary feeding practices. However, existing studies often rely on cross-sectional data, limiting the ability to capture age-specific patterns. We aimed to describe food introduction during the first year of life by identifying patterns related to age at food introduction and associated factors in a cohort of Brazilian infants.MethodsData were collected through standardized questionnaires administered to mothers via face-to-face interviews during the infant’s first month of life and at 3, 6, 9, and 12 months of age. Additionally, two telephone interviews were conducted at 2 and 4 months of age. Information regarding food intake was assessed using a list of 48 foods, with two key aspects recorded: whether the food was introduced (yes/no) and the age at introduction. To define food introduction patterns, we employed k-means cluster analysis. Hierarchical Poisson multiple regression was employed to examine the associations between sociodemographic, biological, and healthcare factors and patterns of food introduction.ResultsThree distinct patterns were identified and named according to their main characteristics: Pattern 1 – “Low Infant Formula and Timely CF Introduction”; Pattern 2 – “High Infant Formula and Early CF Introduction”; and Pattern 3 – “High Infant Formula and Later Ultra-processed Food Introduction”. Breastfeeding at six months showed a positive association with Pattern 1 (PR = 1.40; 95% CI = 1.10–1.80), while bottle use at four months was negatively associated with Pattern 1 (PR = 0.68; 95% CI = 0.53–0.87). No variables studied exhibited an association with Pattern 2. For Pattern 3, higher prevalences were observed among children whose mothers were aged < 20 years (PR = 1.54; 95% CI = 1.13–2.01) or > 34 years (PR = 1.42; 95% CI = 1.04–1.93). Not receiving guidance on the recommended duration of breastfeeding and complementary feeding during prenatal care was associated with a higher prevalence of children in this pattern (PR = 1.35; 95% CI = 1.01–1.80).ConclusionsWe identified three distinct patterns of age at food introduction in the study population, although none perfectly aligned with Brazilian or WHO dietary recommendations. These findings underscore the need for targeted interventions to promote timely and healthy complementary feeding practices in Brazilian infants.

Bibliometric Analysis of Research on Nutrition Interventions in Toddlers: A Focus on the Role of Mothers and the Impact of Supplementary Feeding Programs on Stunting Prevention

ABSTRACT Stunting is a significant public health problem in many developing countries, including Indonesia. It affects not only children's physical growth but also their cognitive development and learning ability, ultimately impacting the quality of future human resources. Effective and timely nutrition interventions are essential to prevent stunting and ensure children reach their full potential. This bibliometric study aims to analyze the trends and focus of research related to nutritional interventions in children under five, with an emphasis on the role of mothers and the impact of supplementary feeding programs in stunting prevention. Using the Publish or Perish and VOSviewer applications, this study examined publications from Google Scholar between 2018 and 2024, identifying keywords, journal distribution by year, journal type, number of citations, and country of origin. The results revealed important findings regarding the central role of mothers, the importance of maternal nutrition knowledge, and complementary feeding practices in stunting prevention. The analysis identified four main clusters in the literature, showing a strong focus on the role of mothers, nutrition knowledge and complementary feeding practices. The study also highlighted the trend of increasing publications over the years and the dominant contribution of Indonesian researchers. Overall, the findings suggest that interventions targeting improved maternal knowledge and skills in complementary feeding are essential for effective stunting prevention. This study provides a comprehensive understanding of current research trends and identifies potential research gaps that can be further explored to improve the effectiveness of nutrition interventions and stunting prevention programs. Keywords: Stunting, Nutrition Interventions, Maternal Role, Complementary Feeding, Bibliometric Analysis

Caregivers’ perceptions of feeding practices and diet diversity among children aged 12–59 months in a rural district of South India: an analytical cross-sectional study

ObjectiveThe primary objective of this study was to assess caregivers’ perceptions of feeding practices (breastfeeding and complementary feeding) and diet diversity among children aged 12–59 months in a rural district...

Assessment Of Nutritional Status Of Under Five Children In Sokoto North Local Government Area, Sokoto State

Background: Malnutrion is an imbalance between the intake of calorie and the body’s requirement. When the body’s requirement supersedes the intake, it is under nutrition and when the intake is more than the body’s requirement, it leads to overweight or obesity. Both instances are forms of malnutrition. The study aim to determine prevalence of under nutrition among the study subject , age variation in relation to under nutrition and compare results of malnutrition obtained from Mid-Upper-Arm circumference and other methods of determining Nutritional status (weight-for-Age and height-for-Age Materials and Methods: a descriptive cross-sectional study was conducted among 112 under five children in Sokoto North LGA. Multi stage sampling technique was used for selection where 3 districts were randomly selected from the 11 districts in Sokoto North LGA, and 4 areas where the study was carried out were randomly selected from the 3 districts. Results: The prevalence of stunting was 53.6% among which 22.3% were mildly stunted , 15.3% were moderately stunted, and 16.1% were severely stunted. The prevalence of wasting was 53.6% of which 14.28% had Grade 1 wasting, 9.8% of the subjects were moderately wasted (grade 2), 12.5% were severely wasted(grade3) and 17% had very severe wasting. Majority of the children (80.4%) had suffered from one form of illness or the other. Mean of under 5 years Feeding practices showed that 98.2% were breastfed, 12.9% of those who breastfed were stopped abruptly, majority of the study subject were introduced to complementary feeding at 6 months of age (50.9%) and majority (79.4%) have received one form of immunization or the other. Determinants of malnutrition were maternal level of education, time of introduction of complementary feeding as well as the type, frequency and quality of food introduced, childhood illness, immunization status, parents’ occupation among others. Conclusion: The results showed that there is high prevalence of malnutrition among under-five children in Sokoto North Local Government Area of Sokoto State We recommended that mothers should be educated and encourage for exclusive breastfeeding

Community service initiative: Empowering Mothers in Wongsorejo, Banyuwangi, East Java to Prevent Stunting Through Education and Complementary Feeding Circle Demonstrations

The challenge of stunting in Indonesia remains critical, with the National Basic Health Research of 2018 indicating a high prevalence rate of 30.8%. Addressing stunting effectively requires targeted interventions and behavior change strategies. This community service project aimed to tackle stunting in Wongsorejo, Banyuwangi, East Java, through a comprehensive approach focused on nutrition and complementary feeding practices. The initiative was structured around three main activities: a seminar on stunting, counseling on complementary feeding, and a cooking demonstration. The seminar aimed to enhance understanding of stunting, including its causes, consequences, and preventive measures, with a specific focus on the role of mothers. The counseling sessions were designed to educate mothers about the implementation of complementary feeding circles to ensure their infants receive adequate nutrition. The cooking demonstration provided practical guidance on preparing nutritious complementary foods using local ingredients. This community service project targeted mothers in the Wongsorejo area, along with representatives from local health centers and community leaders. The objective was to improve knowledge and practices related to stunting prevention, nutrition, and healthy feeding habits. Methods included educational seminars, interactive counseling, and practical demonstrations. Overall, this project seeks to empower mothers with the necessary knowledge and skills to combat stunting, thereby contributing to improved child health and nutrition in the Wongsorejo community. The effectiveness of these activities was evaluated through pre- and post-intervention assessments.

Understanding infant and young child feeding (IYCF) practices among Muslim mothers/caregivers: A qualitative study in the Bangsamoro Autonomous Region in Muslim Mindanao, Philippines

BackgroundThe study focused on understanding infant and young child feeding practices (IYCF) among Muslim mothers in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM), Philippines.ObjectiveRecognizing the cultural and religious sensitivities associated with these practices, the research aimed to identify influencing factors and assess the influence of advertisements on maternal decisions regarding infants' and children's diets.MethodsA total of 74 Muslim mothers with infants 6-23 months old were recruited and participated in the focus group discussions (FGD). Ten FGD sessions were conducted in Maguindanao Province, Philippines from July to August 2021. Verbatim transcriptions of audio-recorded discussions were transcribed into Microsoft Word files and QSR NVivo version 12 was used in the coding and analysis of the transcripts.ResultsMothers exhibited limited awareness of such important complementary feeding issues as preferring fruits and vegetables while avoiding junk food as chips. IYCF information came primarily from health workers and other mothers - their own mothers, mothers-in-law, and midwives. Television commercials were identified as particularly influential in shaping maternal feeding decisions.ConclusionsThere was a diversity of breastfeeding practices and limited knowledge, especially of complementary feeding among these Muslim mothers. Both traditional beliefs and marketing were said to influence feeding choices. This underscores the need for culturally-sensitive interventions and targeted educational initiatives to enhance maternal knowledge and advocate for optimal infant feeding practices within Muslim communities, as well as regulation of the marketing of commercial infant foods.

The Influence of Household and Family Factors, Inadequate Complementary Feeding, Breastfeeding, and Infections on the Occurrence of Stunting in Toddlers

The Influence of Household and Family Factors, Inadequate Complementary Feeding, Breastfeeding, and Infections on the Occurrence of Stunting in Toddlers

SISTEM REKOMENDASI KEBUTUHAN NUTRISI MAKANAN PENDAMPING AIR SUSU IBU (MPASI) MENGGUNAKAN METODE FUZZY TAHANI SEBAGAI UPAYA PENCEGAHAN STUNTING

Stunting is a significant child health issue in Indonesia, where children experience impaired growth, resulting in weight and height below their age average. In 2022, the World Health Organization (WHO) and the Indonesian Nutrition Status Survey (SSGI) reported a stunting prevalence of 21.6%, exceeding the WHO target of 20%. Stunting is caused by chronic malnutrition from pregnancy through the first thousand days of life, a crucial period for brain and cognitive development. Proper complementary feeding (MPASI) after 6 months is essential to meet infants' nutritional needs and prevent developmental delays in children under two. This study aims to develop a mobile web-based system that recommends MPASI according to infants' nutritional needs using the Fuzzy Tahani method. This method was chosen for its ability to handle uncertainty and provide personalized solutions. The developed system achieved 94.5% accuracy, with a precision of 33.1%, recall of 27.4%, and specificity of 85.9%. The system met the research objectives despite lower precision and recall due to imbalanced training data. User Acceptance Testing (UAT) results indicated that 77.73% of users strongly agreed with the system, while 1.86% disagreed. This system is expected to assist in preventing stunting by providing more accurate MPASI recommendations tailored to each infant's needs.

Micronutrient Intake during Complementary Feeding in Very Low Birth Weight Infants Comparing Early and Late Introduction of Solid Foods: A Secondary Outcome Analysis.

Background/Objectives: The complementary feeding period is crucial for addressing micronutrient imbalances, particularly in very low birth weight (VLBW) infants. However, the impact of the timing of solid food introduction on micronutrient intake in a representative VLBW population remains unclear. Methods: This prospective, observational study investigated micronutrient intake during complementary feeding in VLBW infants categorized based on whether solids were introduced early (<17 weeks corrected age (CA)) or late (≥17 weeks CA). Nutritional intake was assessed using a 24 h recall at 6 weeks CA and with 3-day dietary records at 12 weeks and at 6, 9, and 12 months CA. Results: Among 218 infants, 115 were assigned to the early group and 82 to the late group. In total, 114-170 dietary records were valid for the final analysis at each timepoint. The timepoint of solid introduction did not affect micronutrient intake, except for a higher iron and phosphorus intake at 6 months CA in the early group (early vs. late: iron 0.71 vs. 0.58 mg/kg/d, adjusted p-value (p-adj.) = 0.04; phosphorus 341 vs. 286 mg/d, p-adj. = 0.04). Total vitamin D, calcium, zinc, and phosphorus greatly met intake recommendations; however, dietary iron intake was insufficient to equalize the iron quantity from supplements during the second half year CA. While nutrient intakes were similar between infants with and without comorbidities, breastfed infants had lower micronutrient intakes compared with formula-fed infants. Conclusions: This study suggests that micronutrient intakes were sufficient during complementary feeding in VLBW infants. However, prolonged iron supplementation may be necessary beyond the introduction of iron-rich solids. Further research is essential to determine micronutrient requirements for infants with comorbidities.

The potential effectiveness of community health and nutrition volunteers on mothers’ infant and young children feeding knowledge and practice in remote areas, Hajjah, Yemen

BackgroundThe Infant and young child feeding (IYCF) practices directly affect the health, development and nutritional status of children under two years of age. However, IYCF counseling is one of the Community Health and Nutrition Volunteers (CHNVs) activities provided, which may contribute to improving the IYCF knowledge and practice among mothers. Since establishment of the CHNVs program in Yemen, its outcome has never been evaluated. Therefore, the aim of this study was to evaluate the role of CHNVs in improving the IYCF knowledge and practice among mothers in Hajjah governorate.MethodsA comparative cross-sectional study design was conducted in Bani Qais and Al-Maghrabah districts, Hajjah governorate between January and April 2023. A three-stage cluster sampling method was used to select districts, volunteer villages and households. A total of 926 mothers were interviewed. A pre-tested structured questionnaire was used to collect data. SPSS 26 was used for data analysis. The multinomial logistic regression and Chi-Square test were used to compare the IYCF knowledge and practices among mothers between the volunteer and non-volunteer villages. Odds Ratio (OR) with 95% Confidence Interval (CI) were calculated. A p-value < 0.05 was considered statistically significant.ResultsThe mothers in volunteer villages had significantly better breastfeeding and complementary feeding (CF) knowledge than mothers in non-volunteer villages. The OR of having good and moderate knowledge of breastfeeding were 3.5 (95%CI: 2.4–5.2) and 1.6 (95% CI: 1.2–2.2), respectively. The OR for good and moderate knowledge of CF were 1.7 (95% CI: 1.1–2.7) and 2.2 (95% CI: 1.5-3.0), respectively. Moreover, there is a statistically significant association in prevalence of Exclusively breastfed for the first two days after birth (EBF2D), Mixed milk feeding under six months (MixMF) and Bottle feeding 0–23 months (BoF) between volunteer and non-volunteer villages [(OR = 1.4, 95% CI: 1.0-1.8), (OR = 0.4, 95% CI: 0.2–0.8) and (OR = 0.5, 95% CI: 0.4–0.7), respectively].ConclusionsThe study found that CHNVs play a significant effect in improving the breastfeeding and CF knowledge, and prevalence of EBF2D, MixMF and BoF practices among mothers in their villages compared to non-volunteer villages. Future follow-up study and expansion to other settings in different governorates is recommended.