Dissimilarities across age groups in the associations between complementary feeding practices and child growth:
Justine Briaux1,2, Sonia Fortin1, Yves Kameli1
1UMR 204 Nutripass, Institut de Recherche pour le Développement (IRD), University of Montpellier, Montpellier SupAgro, Montpellier, France.
Insights
Complementary feeding (CF) practices in Togo were suboptimal, with varying impacts on child growth across age groups. Current WHO indicators may not fully capture the complex relationship between CF and child development.
Area of Science:
- Child Nutrition and Development
- Public Health and Epidemiology
- Global Health Research
Background:
- Optimal complementary feeding (CF) is crucial for child growth but difficult to measure comprehensively.
- Suboptimal CF practices are prevalent in many low-resource settings, impacting child development outcomes.
- Existing infant and young child feeding indicators may not fully reflect the nuances of CF practices and their effects.
Purpose of the Study:
- To describe complementary feeding (CF) practices in rural Northern Togo among children aged 6-23 months.
- To investigate the associations between various CF indicators and child growth, specifically length-for-age z-score (LAZ) and stunting.
- To evaluate the utility of current World Health Organization (WHO) infant and young child feeding indicators in capturing these associations.
Main Methods:
- Cross-sectional study of 2,034 children aged 6-23 months in rural Northern Togo (May-July 2014).
- Computation of WHO infant and young child feeding indicators, alongside feeding style and food introduction timing.
- Analysis of associations between CF indicators and LAZ/stunting using regression models, stratified by age and adjusted for covariates.
Main Results:
- CF practices were suboptimal across the study population.
- Positive associations were found between minimum dietary diversity/acceptable diet and LAZ in 6-11 month olds.
- Consumption of iron-rich foods linked to better LAZ and reduced stunting in 18-23 month olds; late introduction of family foods and untimely porridge introduction were associated with stunting.
- Helping a child eat showed an unexpected negative association with linear growth across all age groups.
Conclusions:
- Complementary feeding practices in the studied population were inadequate.
- The associations between specific CF practices and child growth indicators (LAZ, stunting) are age-dependent.
- Current WHO infant and young child feeding indicators may require refinement to better reflect the complex relationship between CF and child growth across different developmental stages.
Abstract:
Adequate complementary feeding (CF) practices are essential for achieving optimal growth but challenging to measure comprehensively. This paper describes CF practices in 2,034 children aged 6-23 months and investigates their relationships with length-for-age z-score (LAZ) and stunting, using cross-sectional data collected from May to July 2014 in rural Northern Togo. The World Health Organization infant and young child feeding indicators were computed, along with ancillary indicators on feeding style and timing of introduction of complementary foods. The associations between those indicators and children's LAZ and stunting were assessed using linear and logistic regressions after stratification by age group and adjustment for children, maternal, and household characteristics. CF practices were suboptimal, and their associations with child's growth varied across indicators and age groups. In children aged 6-11 months, reaching the minimum dietary diversity and the minimum acceptable diet was associated with higher LAZ (p < .05). In 18- to 23-month-old children, only the consumption of iron-rich food was associated with both LAZ (p = .02) and stunting (p = .05). The late introduction of family foods was associated with higher odds of being stunted and lower LAZ in children aged 12-17 months (p < .001). The untimely introduction of porridge was associated with higher odds of stunting in children aged 9-23 months (p < .05). Unexpectedly, helping the child to eat was negatively associated with linear growth in all age groups. These findings nurture the ongoing process of review of the World Health Organization infant and young child feeding indicators showing that, in their current version, they hardly capture the links between CF and child's growth at different ages.
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