Complementary feeding practices among children under two years old in West Africa: A review

Abstract

The burden of child malnutrition is still high in West African countries with 19.2 million stunted children and increases rapidly during the weaning period. This has been attributed to inappropriate complementary feeding practices. To our knowledge, few studies have tried to review the state of complementary feeding in the sub-region. This review aimed to provide an overview of current complementary feeding practices in West Africa in order to identify issues that should be targeted for ensuring optimal infant and young child nutrition. Articles and reports published from 2006 to 2016 were selected and reviewed. All documents were accessed through PubMed, Google scholar, and FreeFullPDF databases. Relevant and current documents focused on infant and young child (IYC) feeding from World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) were identified by using electronic searches via the Google platform. Complementary feeding practices are suboptimal in West Africa compared to the Northern Africa. Porridges and family dishes are the two main categories of complementary foods given to children and there are nutritionally inadequate. Enriched flours have been developed by using local diversity of food resources and improved food process like dehulling, fermentation, germination, malting, but their use remains low. Socioeconomic , cultural and geographical factors were the determinants influencing IYC feeding practices at mother and household levels. Besides food availability, social, cultural, economic and geographic determinants were interrelated in a complex way to affect child feeding practices. This paper contributes to a much-needed evidence-based focus on the state of complementary feeding practices. As a key component to child survival, the improvement of complementary feeding has been shown to be the most effective in enhancing child growth and reducing stunting. Stakeholders such as policy and decision-makers, development partners, the private sector, and Non-Governmental Organizations should develop strategies for making enriched flours and nutritionally dense foods more accessible and affordable. Nutritional interventions should emphasize the promotion of adequate complementary feeding practices including feeding frequency, quality and quantity of diet and food safety in order to reduce malnutrition. Ongoing national plans and strategies for optimal IYC feeding should be encouraged to reduce child malnutrition.

Nutrient Profiles of Commercially Produced Complementary Foods Available in Burkina Faso, Cameroon, Ghana, Nigeria and Senegal

“…A nutrient profiling model for this region would therefore benefit from the inclusion of micronutrient requirements, particularly for those micronutrients where there are often nutrient gaps in diets. In light of the poor nutritional quality of most CPCFs assessed in this study, parents and caregivers in West Africa will require guidance in understanding the potentially harmful effects of inappropriate CPCFs [ 14 , 57 , 58 ]. The use of nutrient profiling models for placement of front-of-pack warning signs on products with excessive sugar, sodium, and unhealthy fat content is one tool by which poor nutritional quality of such products would be clearly communicated to IYC caregivers [ 59 ].…”

Nutritional Status and Feeding Practices of Children Aged 0 to 36 Months in Thulamela Municipality, Limpopo Province

“…Introduction of uid and food before six months may increase the risk of diarrheal disease, food allergies, hamper optimal growth and development of the child [40,41]. Short-term adverse effects of undernutrition include recurring illness, weakness, delayed physical and mental development, irritability, poor appetite, low weight for age while the long-term adverse effects are short height for age, poor learning ability, poor performance at school and poor general health [42].…”

Feeding practices and micronutrient status of children aged 0–36 months in Thulamela Municipality, Limpopo province

“…High prevalence of vitamin A in the current study may be attributed to children being fed maize meal soft porridge without introducing micronutrient-rich food. Consumption of a monotonous diet based on starchy food with limited vitamin and mineral-rich food consumption is likely to increase the risk of micronutrient deficiency in children (Kavitha et al 2014;Mitchodigni et al 2018;Ntila et al 2017). Low dietary intake of vitamin A-rich food, rapid growth and repeated infections are the major causes of vitamin A deficiency, especially in early childhood (Gibson 2005).…”

“…Even though South Africa had legislated fortification of flour and maize to reduce micronutrient malnutrition, food introduced during childhood includes small amounts of iron, rich with a high content of substances such as phytates and oxalates, tannins and fibre that interfere with iron absorption (Mitchodigni et al 2018). Lack of knowledge about the importance of food groups, food insecurity, poor food choices and limited food availability may limit the inclusion of food rich in micronutrients during the introduction of complementary food (Mitchodigni et al 2018). In low-income rural villages of Africa, many people have limited access to diets that meet their daily macro-and micronutrient requirements, resulting in malnutrition, particularly underweight.…”