Effect of inappropriate complementary feeding practices on the nutritional status of children aged 6-24 months in urban Moshi, Northern Tanzania: Cohort study

Abstract

Introduction Childhood undernutrition is a major public health problem especially in low and middle-income countries (LMIC). The prevalence of early introduction of complementary feeding, low meal frequency, and low dietary diversity are frequent in LMICs. The effect of inappropriate complementary feeding practices on the nutritional status of children is not well documented in East African countries including Tanzania. Therefore, this study aimed at determining the effect of inappropriate complementary feeding practices on the nutritional status of children aged 6–24 months in urban Moshi, Tanzania. Methodology A retrospective cohort study was done using the Pasua and Majengo cohorts of mother-child pairs in urban Moshi who were enrolled from 2002 to 2017. About 3355 mother-child pairs were included in the analysis. Appropriate complementary feeding practices were assessed using WHO IYFP indicators such as age at introduction of solid, semi-solid, or soft foods, minimum dietary diversity, and minimum meal frequency. Nutritional status (stunting, wasting, and underweight) was determined. Multilevel modeling was applied to obtain the effect of inappropriate complementary feeding practices on the nutritional status of children and to account for the clustering effect of mothers and children and the correlation of repeated measures within each child. Results Majority of the children (91.2%) were given soft/semi-solid/solid foods before six months of age, 40.3percent had low meal frequency, and 74percent had low dietary diversity. Early introduction of complementary food at age 0–1 month was statistically significantly associated with higher risks of wasting and underweight (ARR 2.9, 95%CI 1.3–6.3; and ARR 2.6, 95% CI 1.3–5.1 respectively). Children with low minimum meal frequency had higher risks of stunting, wasting, and underweight (ARR 2.9, 95%CI 2.3–3.6; ARR 1.9, 95%CI 1.5–2.5 and ARR 1.9, 95%CI 1.5–2.4 respectively). Children with low minimum dietary diversity were more likely to be stunted than is the case with their peers who received the minimum dietary diversity (ARR 1.3, 95% CI 1.01–1.6). Conclusion There were a high proportion of children, which were fed inappropriately; Inappropriate complementary feeding practices predisposed children to undernutrition. Our study supports the introduction of complementary feeding, providing minimum dietary diversity, and minimum feeding frequency at six months of age as important in improving the nutritional status of the children.

Complementary feeding practices and associated factors among mothers of children aged 6-23 months in Ethiopia: Secondary data analysis of Ethiopian mini demographic and health survey 2019

“…The result of this study revealed that the proportion of children who consumed solid, semi-solid or soft foods at least the minimum number of times (minimum meal frequency) during the prior day of the survey was found to be 53.72%. This figure is lower than findings from studies conducted in Ethiopia [ 25 , 39 , 43 ], Northern Tanzania [ 41 ], and Northern Ghana [ 29 ]. However, the current study finding is higher than studies conducted in Ethiopia (33.8, 47.1%) [ 31 ], [ 20 ], Sub-Saharan Africa (29.8, 41.9%) [ 40 , 44 ] and Pakistan 38% [ 23 ].…”

“…The proportion of minimum dietary diversity in our study was 11.74%. This result is lower than the findings from the studies done in different parts of Ethiopia [ 34 , 38 , 39 ], Sub-Saharan Africa [ 29 , 40 , 41 ] and Asia [ 23 , 42 ]. This difference could be attributed to variation in the measurement of minimum dietary diversity.…”

Infant feeding, growth monitoring and the double burden of malnutrition among children aged 6 months and their mothers in KwaZulu‐Natal, South Africa

“…Community health workers are deployed in communities in South Africa and are ideally placed to support breastfeeding at the household level. Similar reasons and findings have also been detected in other sub‐Saharan countries (Maonga et al, 2016 ; Masuke et al, 2021 ). Although there is strong support for breastfeeding provided during antenatal care and most mothers intended to breastfeed, most women fail to breastfeed exclusively or sustain breastfeeding (Horwood et al, 2020 ; Richard et al, 2021 ).…”

Dietary Diversity and Undernutrition in Children Aged 6–23 Months in Sub-Saharan Africa

“…A major factor for explaining this finding is that, when children have an adequate dietary diversity, it means they receive foods from a minimum of four of the seven groups of foods-namely grains, roots, and tubers; legumes and nuts; dairy products; flesh foods (meat, fish, poultry, and organ meats); eggs; vitamin-A rich fruits and vegetables; other fruits and vegetables [5,14]. Receiving foods from these groups provides children with sufficient nutrients needed to reduce the risk of stunting [47] as found in this study.…”