Dissimilarities across age groups in the associations between complementary feeding practices and child growth: Evidence from rural Togo

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.

Maternal Factors and the Utilization of Maternal Care Services Associated with Infant Feeding Practices among Mothers in Rural Southern Nepal

“…The timely initiation of CF at six months similarly protects against childhood illnesses and promotes health and nutritional wellbeing [16]. It has been shown by recent studies that the initiation of CF too early is associated with undernutrition [17], overweightness in children [18], as well as obesity and overweightness in later life [19], and that the delayed introduction of CF increases the risk of celiac disease in children [20], lower child growth velocity and increases childhood infections [21,22]. For these reasons, the World Health Organization (WHO) recommended EIBF followed by EBF for six months and then the introduction of CF at six months with breastfeeding [4].…”

Evaluation of an unconditional cash transfer program targeting children’s first-1,000–days linear growth in rural Togo: A cluster-randomized controlled trial

“…Evidence of CT programs' impact on individual dietary indicators is limited, probably because intrahousehold allocation of foods may not be favorable to all members in several contexts. Furthermore, in our study we used qualitative indicators to reflect individuals' diets, which may not be sensitive enough to detect significant changes [42,43].…”

Maternal Factors in Stunting Among Vulnerable Children

“…The dependent variable was stunting that is defined as WHO HAZ scores below -2 SD, according to sex (Aryastami et al, 2017;Briaux et al, 2019;Manggala et al, 2018;World Health Organization, 2006). The Z-scores were calculated using WHO anthropometry software (Aryastami et al, 2017;Blössner et al, 2011).…”