Persistent Inadequacies in Infant and Young Child Feeding Practices and Their Determinants

Background: Malnutrition is a major public health problem and is directly associated with poor infant and young child feeding (IYCF) practices. The study aimed to identify the inadequacies in the feeding practices for children aged 0-23 months through a cross-sectional KAP survey. Methods: Data was collected on demographic indicators, IYCF practices, 24 hours dietary recall, childhood illnesses and anthropometrics and compared with WHO guidelines. Results: Only 44.8% mothers timely initiated breastfeeding, 57% fed colostrum and 32.9% practiced exclusive breastfeeding. Only 63.2% children were breastfed beyond first year and 42.2% up to second year. Nearly half of the children were introduced to complementary feeding at 6-8 months. Minimum meal frequency (MMF) was offered to 57.5%, minimum dietary diversity (MDD) to 53.2% and minimum acceptable diet (MAD) to 37.1%. Prevalence of childhood illnesses was high. Prevalence of stunting, wasting and underweight was 19.1%, 4% and 11.4%, respectively. Mother’s working status was positively associated with timely initiation of breastfeeding (OR 1.82; 95% CI 1.17, 2.83) and MDD (OR 1.53; 95% CI 0.93, 2.51) but inversely associated with exclusive breastfeeding (OR 0.52; 95% CI 0.16, 1.66). Colostrum was given by mothers with better socioeconomic status (OR 1.3; 95% CI 0.84, 2.04) and higher education level (OR 1.22; 95% CI 0.71, 2.08). Socioeconomic status directly affected MDD (OR 2.32; 95% CI 1.40, 3.83) and MAD (OR 1.51; 95% CI 0.90, 2.54). The health status of children was positively impacted by exclusive breastfeeding (OR 2.33; 95% CI 0.89, 6.14), timely introduction of complementary feeding (OR 1.39; 95% CI 0.86, 2.26), MMF (OR 1.38; 95% CI 0.82, 2.32) and MAD (OR 1.30, 95% CI 0.77, 2.20) and negatively impacted by bottle feeding (OR 0.79; 95% CI 0.50, 1.27). Conclusions: The mothers showed moderate to low compliance to WHO IYCF indicators despite high educational status. The inadequacies in IYCF practices demand for immediate awareness interventions.