Complementary Feeding Practices of Mothers Resident in South-East Nigeria and Effect on Weight of Children Aged 6-23 Months
Chinyere Ukamaka Onubogu *
Department of Pediatrics, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria.
Ebelechuku Francesca Ugochukwu
Department of Pediatrics, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria.
Kenneth Nchekwube Okeke
Department of Pediatrics, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria.
Chuka Pius Manyike
Department of Pediatrics, Ebonyi State University Teaching Hospital, Abakaliki, Nigeria.
Uchenna Ekwochi
Department of Pediatrics, College of Medicine, University of Science and Technology, Enugu, Nigeria.
Ihuoma Kathleen Ukpabi
Department of Pediatrics, Federal Medical Centre, Umuahia, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Complementary feeds have serious impact on the growth, development, well-being and long term health of individuals.
Objective: We examined the complementary feeding practices of mothers resident in southeast Nigeria.
Methods: A cross-sectional study was conducted among 1610 mother-child pairs seen at immunization clinics in southeast Nigeria.
Results: A substantial proportion of the mothers were income earners (88.0%), and completed secondary or tertiary education (95.2%). The prevalence of underweight, severe underweight and overweight were 11.2%, 3.7% and 4.5%, respectively, among the children. More than one-third (38.9%) of the mothers initiated cereal in an untimely manner. Mothers’ educational status (p=0.044), profession (p=0.020), social class (p=0.001) and exclusive breastfeeding (p<0.001) were significantly associated with timing of cereal initiation. The most commonly used cereal was locally prepared pap (97.6%) which was predominantly fortified with commercial formula (79.7%). One 400g tin of formula lasted beyond 7 days for 40.5% of children. More than half (58.2%) of the mothers were bottle-feeding, 27% did not regularly wash their hands before preparing feeds, and 32.6% were not giving the recommended daily complementary feed frequency. Bottle-feeding was mainly due to need to return to work (37.9%), convenience (36.5%) and perception that suckling mother’s nipple was inadequate (12.4%). Cereal and family foods were not given fresh by 35.5% and 50.1% of mothers, respectively. Age at complementary feed (p=0.008) or family feed (p=0.002) initiation, feeding frequency (p<0.001), type of cereal (p<0.001) or pap fortifier (<0.001), timespan one tin of formula (p<0.001) and breastfeeding status (p<0.001) were significantly associated with child’s weight-for-age. Apart from timespan of one tin of formula, these factors remained significant after binary logistic regression.
Conclusion and Recommendations: The rate of untimely complementary feed initiation, unsafe/unhygienic practices, and fortification with expensive imported formula is high in southeast Nigeria. Urgent innovative interventions are needed to address these potential barriers to optimal complementary feeding.
Keywords: Weaning food, determinants, timing, adequacy, nutritional status, South-East Nigeria