Complementary Feeding: Is It The Forgotten Factor of The First 1000 Days of Life?

Abstract

Abstract Background:Appropriate complementary feeding is a practice with great potential for reduction of nutrition-related diseases and mortalities in children. However, uptake of the recommended World Health Organisation (WHO) infant and young child feeding practices in Kenya remains low. Most previous studies have been done in rural or urban poor populations hence the need to provide practical guidelines for the complementary feeding period in a typical middle-class urban setting. This study investigated complementary feeding practices by caregivers of infants and young children on follow up at Aga Khan University Hospital-Nairobi (AKUH-N) well-baby clinic and the factors influencing compliance with the WHO guidelines.Methods:A total of 290 caregivers of infants and young children aged between nine and twenty-four months were interviewed using a questionnaire. Out of these, 21 were purposively sampled to participate in a qualitative study using in-depth interviews. Thematic analysis was used to analyse qualitative data while descriptive statistics, univariate and multivariate regression analysis were used for quantitative data. A convergent parallel design was used to integrate the qualitative and quantitative data.Results:Out of 290 caregivers interviewed, 125 (43.1%) complied with WHO complementary feeding guidelines. Proportions of underweight and stunting were 6.9% and 1.7%, respectively, while that of overweight was 8.6%. Factors that affected complementary feeding practices included education level of the caregiver, access to information, support from healthcare workers and fear of allergic reactions. Conclusions:Full compliance to WHO complementary feeding guidelines remained below 50%. In addition, the proportion of children who were overweight in this study was double the national average, highlighting a growing trend of obesity in childhood. Some of the factors positively associated with compliance with complementary feeding guidelines included access to multiple sources of information, and support from health workers and family members. Lack of tertiary education of the caregiver, absence of specific and practical guidelines, resource constraints and fear of allergies were found to negatively impact compliance with complementary feeding guidelines.