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The aim of this study was to review the factors associated with stunting in the northern province of Rwanda by assessing anthropometric status, dietary intake, and overall complementary feeding practices. This was a cross-sectional study with 138 children 5 to 30 mo of age. A structured questionnaire was used to collect information on sociodemographic characteristics of each mother and child and breastfeeding and complementary feeding practices. Anthropometric status was assessed using height-for-age z-scores for children and body mass index for caregivers. Dietary intakes were estimated using a 24-h recall. Multiple linear and logistic regression models were performed to study the predictors of height-for-age z scores and stunting. There was a 42% stunting prevalence. Prevalence of continued breastfeeding and exclusive breastfeeding were 92% and 50%, respectively. Most children (62%) fell into the low dietary diversity score group. The nutrient intake from complementary foods was below recommendations. The odds of stunting were higher in children >12 mo of age (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.08–1.29). Exclusive breastfeeding (OR, 0.22; 95% CI, 0.10–0.48) and deworming tablet use in the previous 6 mo (OR, 0.25; 95% CI, 0.07–0.80) decreased significantly the odds of stunting in children. Also, the body mass index of the caretaker (β = 0.08 kg/m2; 95% CI, 0.00–0.17) and dietary zinc intake (β = 1.89 mg/d; 95% CI, 0.29–3.49) were positively associated with the height-for-age z scores. Interventions focusing on optimal nutrition during the complementary feeding stage, exclusive breastfeeding, and the use of deworming tablets have the potential to substantially reduce stunting in children in the northern province of Rwanda.

To assess infant and young child feeding (IYCF) practices in Lebanon and investigate their associations with socio-demographic and lifestyle factors. A cross-sectional national survey was conducted in 2012-2013. In addition to a socio-demographic and lifestyle questionnaire, a 24-h dietary recall for the children was collected, with mothers as proxies. IYCF practices were assessed based on the 2021 indicators of the WHO. Lebanon. Children aged 0-23 months and their mothers ( 469). While the majority of infants were ever breastfed (87·6 %), the prevalence of exclusive breast-feeding (BF) in those under 6 months of age was 11·0 %. Early initiation of BF was 28 %. A greater child's birth order, partner's support for BF, higher parental education, maternal BF knowledge and non-smoking were associated with higher odds of meeting BF recommendations. As for complementary feeding, 92·8 % of children (6-23 months) met the minimum meal frequency indicator, 37·5 % met the minimum dietary diversity (MDD) and 34·4 % met the minimum adequate diet (MAD). The consumption of unhealthy food was observed amongst 48·9 % of children, with nearly 37 % consuming sweet beverages. Older maternal age and maternal overweight/obesity were associated with lower odds of meeting MDD and MAD, while child's age and partner's support for BF were associated with higher odds. The results documented suboptimal IYCF practices amongst Lebanese children and identified a number of factors associated with these practices. Findings from this study will help guide the development of culture-specific programmes aimed at improving IYCF practices in Lebanon.

Introduction Malnutrition is a public health problem in sub-Saharan Africa with an increased morbidity and mortality rate than in other parts of the world. Poor complementary feeding practices are one of the major causes of malnutrition during the first two years of life. Therefore, this study aimed to determine the prevalence and associated factors of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan African countries. Methods A multilevel mixed-effect analysis was carried out using recent demographic health survey data from 19 sub-Saharan African countries, which were conducted between 2015 and 2020. A total weighted sample of 60,266 mothers of children aged 6 to 23 months were included in the study. The demographic health survey employs a stratified two-stage sampling technique. Data extracted from the recent DHS data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with complementary feeding practice. Variables with a p -value less than 0.05 and adjusted odds ratio (AOR) with a 95% confidence interval (CI) were reported as statistically significant variables associated with appropriate complementary feeding practices. Results The prevalence of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan African countries was 13.02% (95% CI: 12.75–13.29%). Maternal educational level [AOR = 0.69, 95% CI (0.64, 0.74)] and [AOR = 0.52, 95% CI (0.47, 0.57)], marital status of the mother [AOR = 0.85, 95% CI (0.74, 0.96)], sex of household head [AOR = 1.78, 95% CI (1.09, 1.27)], total children ever born [AOR = 1.52, 95% CI (1.18, 1.96)], [AOR = 1.43, 95% CI (1.14, 1.81)], and [AOR = 1.31, 95% CI (1.04, 1.64)], media exposure [AOR = 0.74, 95% CI (0.69, 0.79)], ANC visits attended during pregnancy [AOR = 0.73, 95% CI (0.63, 0.80)] and [AOR = 0.67, 95% CI (0.62, 0.74)], place of delivery [AOR = 0.92, 95% CI (0.85, 0.98)], currently breastfeeding [AOR = 1.12, 95% CI (1.01, 1.23)], PNC checkup [AOR = 0.75, 95% CI (0.70, 0.80)], the current age of the child [AOR = 0.26, 95% CI (0.24, 0.28)] and [AOR = 0.14, 95% CI (0.13, 0.16)], birth order [AOR = 1.31, 95% CI (1.09, 1.58)], number of under 5 children in the household [AOR = 0.76, 95% CI (0.59, 0.97)], community illiteracy [AOR = 1.09, 95% CI (1.02, 1.18)], and country category [AOR = 1.62, 95% CI (1.18, 2.22)] were significantly associated with appropriate complementary feeding practices. Conclusion The prevalence of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan Africa was relatively low. Higher maternal educational level, female household head, having media exposure, attending more ANC visits, health facility delivery, currently breastfeeding, having PNC follow-up, low community illiteracy, and living in the West Africa region increase the odds of appropriate complementary feeding practices. Women empowerment, increasing maternal health services accessibility, promoting breastfeeding behavior, increasing media exposure of the household, and improving the proportion of health facility delivery are strongly recommended.

The purpose of this study was to determine the prevalence of iron-rich food (IRF) consumption and its related characteristics among children aged 6–23 months in South Asian countries. This cross-sectional study utilized data from the most recent nationally representative demographic and health surveys (DHS) from six South Asian nations. The sample included 84,234 children aged 6–23 months who lived with their mothers. Eating iron-rich foods was the main outcome variable. India had the lowest IRF use at 17.4%, while the Maldives had the highest at 71.9%. Bangladesh followed with 69.6%, then Pakistan at 38%, Nepal at 35.3%, and Afghanistan at 30%. Overall, 21.5% of children from South Asian backgrounds consumed IRF. Additionally, male children, those who were still being breastfed, those who had experienced diarrhea in the past two weeks, mothers who were older and had less education, those with more than two children under five in the household, and those living in rural areas had lower odds of consuming the iron-rich food. This study demonstrates that a mother’s education and adequate prenatal care (ANC) visits have a significant impact on her child’s consumption of iron-rich foods. Overall, the consumption of IRF among children aged 6–23 months in South Asia remains low. Therefore, a focused communication program is needed to improve mothers’ awareness and practices regarding child nutrition, particularly to increase the intake of iron-rich foods during this critical growth stage.

Although recommended infant and young child feeding (IYCF) practices have been found to be protective against undernutrition in some settings, there is no finality yet due to inconsistencies in the literature. A cross-sectional survey of 581 mother-child pairs was conducted in northern Ghana in June 2018. The association between IYCF indicators and child undernutrition (stunting and wasting) were assessed. The descriptive analysis showed that 66.4% of the children (6–23 months) were introduced to complementary feeding in a timely manner, 69.4% met the minimum meal frequency, and 38.9% met the minimum acceptable diet daily. The prevalence of stunting, wasting, underweight and overweight was 33.2%, 14.1%, 27% and 2.6%, respectively. From the multivariable binary logistic regression, child gender, child age group and source of power for lighting the household were significantly associated with wasting. Intake of iron-rich foods, child age group, and maternal height were significantly associated with stunting after adjusting for confounders. The prevalence of the compliance with IYCF indicators was relatively high. None of the individual IYCF indicators showed significant association with undernutrition, except intake of iron-rich foods for stunting. Nutrition-specific interventions targeted at improving IYCF practices, dietary diversification and intake of nutrient-rich meals, should be adopted and scaled up to address undernutrition in northern Ghana.

Background Appropriate complementary feeding practices (CFPs) play a key role for ensuring optimal health, growth and development for children 6–23 months. The purpose of this study was to determine the prevalence and associated factors of CFPs of mothers or primary caregivers having children 6–23 months in Thanh Phu rural district of Ben Tre province, Vietnam. Methods Three hundred fifty eight child-mother pairs participated in a cross-sectional study. Weight and height of children were measured by trained nutritionists using standard measurement tools and procedure. Mothers or primary caregivers were interviewed about maternal, child, and household characteristics, awareness of the food environment, household food insecurity (HFI), and CFPs using a structured questionnaire. Chi square test, Fisher exact test, t -test, and multivariate logistic regression were used to evaluate associations between CFPs and independent variables. Results The percentages of children with appropriate minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) were 71.5%, 40.8%, and 31.6%, respectively. MDD was negatively associated with younger child, the child’s sickness in the last 2 weeks, caregivers being fathers, not breastfeeding, lower monthly household income, and use of untreated drinking water after controlling for covariates ( p  < 0.05). Factors associated with poorer MMF included older child, not breastfeeding, and maternal biological status. Conversely, purchasing foods at the street vendors and appropriate MDD was positively associated with better MMF ( p  < 0.05). Maternal biological status, marital status of mothers, breastfeeding, and HFI were all associated with MAD ( p  < 0.05). Conclusions These results revealed that inappropriate complementary feeding practices among children aged 6–23 months in rural disadvantaged areas of Southern region remained a significant challenge for nutrition improvement of young children in Vietnam. Child age, HFI, use of untreated drinking water, lower monthly income, mother’s marital status, not breastfeeding, and source of purchased foods were associated with poor CFPs. Solutions for improving CFPs for children should address these underlying causes.

Background The WHO sets evidence-based guidelines for infant feeding. Adhering to the WHO guidelines ensures that infants receive the proper nutrition and thus is associated with healthy growth and development. Aim To describe breastfeeding and complementary feeding practices (CFPs) for infants and young children and identify determinants of appropriate feeding practices. Methods This cross-sectional study was performed via structured interviews with mothers living in Saudi Arabia’s Eastern Province who had children aged 6–24 months. To evaluate their adherence to the recommended WHO practices, a scoring method was applied (0–9). Results 395 mothers were interviewed. The rate of breastfeeding within the first hour, and exclusively breastfeeding for six months was both 25%. Multivariate analysis showed that exclusive breastfeeding for at least six months was less likely in middle-income mothers were less likely to exclusively breastfeed for six months than high-income mothers (OR = 0.32; 95% CI: 0.18–0.57; p  < 0.001). Mothers without domestic help were also less likely to exclusively breastfeed (OR = 3.0; p  < 0.001), as were those not living with their husbands (OR = 2.1; p  = 0.007). Multiparous mothers and those with higher education were more likely to breastfeed than high school graduates (OR = 2.3, p  = 0.02; OR = 4.4, p  = 0.015, respectively). Timely breastfeeding initiation within the first hour was more common in term infants than preterm infants (OR = 5.3; p  = 0.033), and infants born through normal delivery were four times more likely to initiate breastfeeding early (OR = 4.0; p  < 0.001). For CFPs, 42% of participants introduced solid food at six months. 55% of mothers reported poor CFPs, primarily due to inappropriate timing of solid food introduction, choking hazards, and delayed introduction of family meals. Good CFPs were positively associated with higher maternal education, increased income, and living with a husband. Conclusion Partial compliance with WHO CFP standards need improvement. Interventions should raise awareness of factors leading to poor compliance and support early breastfeeding initiation and continuation. Low-income and less educated families appear to be most in need of support.

Background Access to various affordable and nutritious foods is considered a challenging factor for households with limited resources affecting the proper weaning practices. In order to motivate communities to adhere to the right and proper weaning practices, the social aspect should be considered through close communication with the targeted communities. This study aimed to evaluate how impactful the use of the principles of Communication for Development (C4D) that respect parents’ beliefs and their cultural norms is in improving the weaning practices and growth of infants in an Egyptian village. Methods An interventional three-phase study was conducted for three years. The intervention targeted 464 mothers of infants up to 2 years of age. C4D interventions encouraged each mother to provide her baby with nutritious and varied options through age-appropriate introduction and diversification of nutrient-rich complementary foods under the slogan “ enjoy meals like a baby”. The effectiveness of the approach was measured by five essential weaning practices: Introduction of solid, semi-solid, or soft foods, Minimum dietary diversity, minimum meal frequency, Minimum acceptable diet, and consumption of iron-rich foods. Results There was marked and significant improvement in the awareness and of the majority of the weaning practices’ indicators as a result of the interventions. This was noticed for the timely introduction of complementary foods which increased from 36.7% to 82.0%, the minimum meal frequency indicator (3–5) which increased from 25.3% to 67.3%, iron-rich or fortified food (68.0% to 82%) as well as a regular checkup for baby health at the health unit (71.3%). Indicators that were improved but failed to achieve the target were the “Minimum Dietary Diversity” (reached 32%) and the minimum acceptable diet (reached 22.0%). A significant effect on linear growth especially for females is evidenced by the remarkable decrease in wasting (from 31.5% to 11.1%) and obesity (from 12.0% to 0%) associated with a considerable decrease in underweight (from 40% to 16.7%). Conclusion Targeting caregivers through the C4D approach have succeeded in providing them with the support required for the provision of adequate nutrition for their infants that had significantly marked improvement in growth indices of their infants.

The introduction of complementary foods is a crucial stage in the development and determination of infants’ health status in both the short and longer-term. This study describes complementary feeding practices among infants and toddlers in Spain. Also, relationships among sample characteristics (both parents and their child), feeding practices (timing, type of complementary food), and parental pressure to eat were explored. Cognitive interviewing with 18 parents was used to refine the survey questions. Responses from a national random sample of 630 parents, who were responsible for feeding their infants and toddlers aged 3–18 months, were obtained. Solids, often cereals and/or fruits first, were introduced at a median age of five months. Fish and eggs were introduced around the age of nine and ten months. Almost all children were fed with home-prepared foods at least once per week (93%), and in 36% of the cases, salt was added. Interestingly, higher levels of parental pressure to eat were found in female infants, younger parents, parents with a full-time job, the southern regions of Spain, and in infants who were not fed with home-prepared foods. Our insights underline the importance of clear feeding recommendations that can support health care professionals in promoting effective strategies to improve parental feeding practices.

Background/Objectives: Optimal infant and young child feeding (IYCF) practices are crucial to addressing the double burden of malnutrition (DBM), encompassing undernutrition (including micronutrient deficiencies) and overnutrition. This study examined the demographic and socioeconomic determinants of IYCF practices, and their impacts on the DBM among 2039 Vietnamese children aged 6–23 months from the General Nutrition Survey 2020. Methods: Thirteen IYCF indicators recommended by the WHO/UNICEF were evaluated. Associations between IYCF indicators and outcome variables were assessed using logistic regressions. Results: The prevalence of stunting, underweight, and overweight subjects was 10.9%, 5.6%, and 3.1%, respectively. Low serum zinc affected 56.7% of children, while 14.3% had low serum retinol, 31.2% had anemia, and 34.6% had iron deficiency (ID). Only 36.7% of children achieved minimum dietary diversity (MDD), and 29.0% achieved the minimum acceptable diet (MAD). Children from the younger age group (6–11 months), ethnic minorities, those living in rural/mountainous regions, and poorer wealth quintiles had reduced odds of meeting IYCF criteria, including MDD and MAD. Infants meeting MDD had reduced odds of stunting [adjusted odds ratio (95% confidence intervals): 0.61 (0.41, 0.92)], and ID [0.69 (0.54, 0.88)]. Children meeting MAD had reduced odds of anemia [0.72 (0.57, 0.91)], ID [0.66 (0.52, 0.84)], and low serum retinol [0.63 (0.41, 0.99)]. Continued breastfeeding (12–23 months) reduced the odds of being underweight [0.50 (0.27, 0.92)] and of having low serum zinc [0.70 (0.52, 0.96)]. Adequate minimum milk feeding frequency had increased odds of being overweight [3.33 (1.01, 11.09)]. Conclusions: Suboptimal IYCF practices were significant predictors of the DBM among Vietnamese children, with evident age-specific, geographical, and socioeconomic disparities.