Complementary Feeding Practices of Mothers Resident in South-East Nigeria and Effect on Weight of Children Aged 6-23 Months

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.