Complementary feeding practices among children aged 6-23 months in Gujarat, India: patterns, predictors and barriers

Timely, adequate, and diverse complementary feeding (CF) is critical to prevent child undernutrition, a major public health concern in low- and middle-income countries, including India. Despite progress, significant disparities persist across Indian states, with Gujarat performing below the national average for several CF Indicators. This study examined infant and young child feeding (IYCF) practices, their predictors, and barriers in selected districts of Gujarat to inform targeted interventions.

A cross-sectional study was conducted in four districts, with two-stage representative sampling powered for estimating district estimates. Data were collected from 1,575 and 1,583 mothers of 6-11 and 12-23 months-old children, respectively, through structured digital interviews. Socio-demographic variables, programmatic exposures, and IYCF practices were analysed using descriptive statistics and multivariable logistic regression models.

Mothers of 12-23 month children showed higher TICF (76.5%) and MMF (95.6%) than 6-11 months (64.8, 76.7%), while 6-11 months demonstrated better MDD (50.2% vs. 42.7%) and MAD (46.5% vs. 41.9%) practices. IYCF practices were significantly better among mothers aged 25-34 years, from non-marginalized groups, with at least primary education, and from wealthier households. Maternal employment, participation in CF-day, receipt of Balshakti (take-home ration), FLW visit, and CF-counselling were positively associated with improved IYCF practices.

Socio-culturally sensitive and context-specific interventions are vital to improve IYCF practices. Tailored counselling and sustained FLW engagement can bridge awareness gaps, correct misperceptions, and enhance mothers' understanding of infants' nutritional needs. Strengthening community-based platforms and ensuring targeted outreach among marginalized groups can promote healthier feeding practices and reduce child undernutrition in Gujarat.