Determinants of Complementary Feeding Indicators: A Secondary Analysis of Thailand Multiple Indicators Cluster Survey 2019

Abstract

Child complementary feeding (CF) practices meet dietary recommendations more often among educated, high-income groups. Much of the evidence for this association addresses inadequate CF for addressing child undernutrition. However, in many countries, including Thailand, child malnutrition assessments must now address under- and over-nutrition. More comprehensive data is needed to understand this complex situation. This study uses data from the Thailand Multiple Indicators Survey 2019, to identify the determinants of CF practices among 6–23-month children (n = 4125) using the newly developed WHO indicators. Logistic regression analysis was used to measure associations between sociodemographic factors and CF practices. In a fully adjusted model, child age, primary caregivers’ education, and household incomes were statistically associated with (in)appropriate CF practices. Older children aged 9–23 months, not only have better minimum dietary diversity (MDD), minimum acceptable diet (MAD), and egg and/or flesh food consumption (EFF), but also tend to consume more unhealthy foods. The proportion of inappropriate CF practices was higher among children living with caregivers other than their mothers. While maternal education and household income were positively associated with MDD and MAD, children of mothers from middle-class households consumed more sweetened beverages. Therefore, nutrition programs addressing different feeding problems should be developed specifically for different primary caregiver and demographic groups.

Complementary Feeding: Food Group Diversity and Probability of Nutrient Adequacy among 6-12-Month-Old Infants in Southern Thailand

“…The common food groups of complementary foods in this study found that the Thai mothers first gave to their infants after 6 months of age were grain (rice congee) mixed with vitamin A-rich fruits or vegetables (pumpkin, carrots), which could explain the high vitamin A intake in Thai infants. This is similar to the findings of the previous by mentioned studies from Thailand 14,23 . Mashed banana was also the favorite fruit the Thai mothers gave their infants after the age of 6 months.…”

“…Also, the MPA of the infants confirmed that the infants that were fed with <4 food groups daily had a very low average MPA: 0.2-0.3, while infants who were fed with >4 food groups had a high average MPA: 0.7-0.9. In this study, complementary feeding was introduced at the ages of 6-7 months, which was a later age than in a national study of 2019, and a study from Pathum Thani in which both found that complementary feedings were introduced at the ages of 4-5 months 14,23 . The common food groups of complementary foods in this study found that the Thai mothers first gave to their infants after 6 months of age were grain (rice congee) mixed with vitamin A-rich fruits or vegetables (pumpkin, carrots), which could explain the high vitamin A intake in Thai infants.…”

“…A national survey, the Multiple Indicators Cluster Survey (MICS) of 2019, in 17 of 77 provinces in the five regions of Thailand (Bangkok, Central, North, South, and Northeast), conducted among 4,125 children aged 6-23 months, found that 92% of infants aged 6-8 months were given complementary food; with an adequate minimum meal frequency (MMF) per day of 88.8%. However, only 42.4% of them reached the minimum dietary diversity (MDD) of 5 food groups 14 .There have been a limited number of studies from southern Thailand concerning infant feeding after 6 months of age, including the number of food groups and meal frequencies of complementary foods. This present study was performed with an aim to examine the complementary feeding practices of the mothers of 6-12-month-old infants in terms of nutrient intake, the number of food groups as assessed by the MDD, the number of feedings or MMF; and the mean probability of micronutrient adequacy (MPA).…”

Associated Factors of Dietary Patterns among Adolescents in the Rural Northern Region of Thailand: A Community-Based Cross-Sectional Study

“…The impact of residential environments on dietary practices and diversity in infants and young children has been extensively studied, yielding varied results. A recent study in Thailand [ 14 ], drawing on secondary data from the 2019 Thailand Multiple Indicators Cluster Survey [ 15 ], found no notable correlation between living in rural or urban areas and DD. However, when considering the minimum acceptable diet, a composite measure encompassing both dietary variety and meal frequency [ 16 ], analysis across multiple countries in South Asia including Afghanistan, Bangladesh, India, Maldives, Nepal, and Pakistan revealed a higher percentage of urban children (15.6%) meeting the standard compared to their rural counterparts (11.8%) [ 17 ].…”