Correlates of Sub-Optimal Feeding Practices among under-5 Children amid Escalating Crises in Lebanon: A National
Maha Hoteit1,2,3, Carla Ibrahim2,3,4, Danielle Saadeh1,5,6
1Faculty of Public Health, Section 1, Lebanese University, Beirut 6573, Lebanon.
Insights
Malnutrition affects Lebanese children under 5, with low exclusive breastfeeding rates and early introduction of solids amid crises. Hospital and husband support positively impact breastfeeding, while mother
Area of Science:
- Pediatrics and Child Health
- Public Health and Epidemiology
- Nutrition Science
Background:
- Sub-optimal feeding practices are primary drivers of malnutrition in children under 5.
- Lebanon faces concurrent COVID-19 pandemic, economic, and political crises impacting child nutrition.
- Understanding feeding practices is crucial for mitigating malnutrition in vulnerable populations.
Purpose of the Study:
- To assess malnutrition prevalence in Lebanese children under 5.
- To identify factors influencing exclusive breastfeeding, bottle feeding, and complementary feeding practices.
- To analyze these practices amidst Lebanon's crises and the COVID-19 pandemic.
Main Methods:
- Nationally representative stratified random sample of 511 mother-child dyads.
- Data collected via surveys on infant feeding and complementary feeding practices.
- Multivariate logistic regression used to determine factors associated with feeding practices.
Main Results:
- Malnutrition rates: 0.5% underweight, 8.4% stunting, 6.7% wasting, 16.8% overweight, 8.9% obese.
- Exclusive breastfeeding prevalence was 59.1%; 25.8% received bottle feeding at birth.
- Hospital breastfeeding support and husband's support increased breastfeeding odds; mother's occupation inversely associated.
Conclusions:
- Significant malnutrition rates and low exclusive breastfeeding prevalence observed.
- High rates of early formula and solid food introduction noted among Lebanese children.
- Contextual factors like hospital support and spousal involvement significantly influence infant feeding practices.
Abstract:
Sub-optimal feeding practices among under-5 children are the major drivers of malnutrition. This study aims to assess the prevalence of malnutrition and the factors affecting exclusive breastfeeding, bottle feeding, and complementary feeding practices among under 5 children amid the COVID-19 pandemic as well as the economic and the political crises in Lebanon. A nationally representative stratified random sample of mother-child dyads (n = 511) was collected from households using a stratified cluster sampling design. The survey inquired about infant's feeding and complementary feeding practices using a valid questionnaire. Anthropometric measurements of the mother and child were collected. Multivariate logistic regression was conducted to explore the determinants associated with under-5 children's practices. The prevalence of underweight, stunting, wasting, overweight and obese children was 0.5%, 8.4%, 6.7%, 16.8% and 8.9%, respectively. In total, among under-5 children, the prevalence of ever breastfeeding, exclusive breastfeeding, and bottle feeding at birth was 95.1%, 59.1% and 25.8%, respectively. Half the children in this study started solid foods between 4 and 6 months. Regression analysis showed that supporting breastfeeding at hospital (aOR = 8.20, 95% CI (3.03-22.17)) and husband's support (aOR = 3.07, 95% CI (1.9-4.92)) were associated with increased breastfeeding odds. However, mother's occupation (aOR = 0.18, 95% CI (0.55-0.58)) was inversely associated with breastfeeding practices. Male children (aOR = 2.119, 95% CI (1.37-3.27), mothers diagnosed with COVID-19 (aOR = 0.58, 95% CI (0.35-0.95)), and bottle feeding at hospital (aOR = 0.5, 95% CI (0.32-0.77)) were more likely to induce early initiation of solid foods at 4 months of age. This study demonstrated non-negligible rates of malnutrition, low prevalence of exclusive breastfeeding, and high rates of early introduction of formula feeding and solid foods among Lebanese under-5-children amid escalating crises.
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