Infant feeding practices and determinant variables for early complementary feeding in the first 8 months of life: results from the Brazilian MAL-ED cohort site

Public Health Nutr. 2018 Sep;21(13):2462-2470. doi: 10.1017/S136898001800099X. Epub 2018 Apr 26.

Abstract

Objective: The present study aimed to describe breast-feeding, complementary feeding and determining factors for early complementary feeding from birth to 8 months of age in a typical Brazilian low-income urban community.

Design: A birth cohort was conducted (n 233), with data collection twice weekly, allowing close observation of breast-feeding, complementary feeding introduction and description of the WHO core indicators on infant and young child feeding. Infant feeding practices were related to socio-economic status (SES), assessed by Water/sanitation, wealth measured by a set of eight Assets, Maternal education and monthly household Income (WAMI index). Two logistic regression models were constructed to evaluate risk factors associated with early complementary feeding.

Results: Based on twice weekly follow-up, 65 % of the children received exclusive breast-feeding in the first month of life and 5 % in the sixth month. Complementary feeding was offered in the first month: 29 % of the children received water, 15 % infant formulas, 13 % other milks and 9·4 % grain-derived foods. At 6 months, dietary diversity and minimum acceptable diet were both 47 % and these increased to 69 % at 8 months. No breast-feeding within the first hour of birth was a risk factor for the early introduction of water (adjusted OR=4·68; 95 % CI 1·33, 16·47) and low WAMI index a risk factor for the early introduction of other milks (adjusted OR=0·00; 95 % CI 0·00, 0·02).

Conclusions: Data suggest local policies should promote: (i) early breast-feeding initiation; (ii) SES, considering maternal education, income and household conditions; (iii) timely introduction of complementary feeding; and (iv) dietary diversity.

Keywords: Dietary diversity; Minimum acceptable diet; WAMI index; WHO core indicators.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brazil
  • Breast Feeding / statistics & numerical data
  • Cohort Studies
  • Diet / statistics & numerical data*
  • Feeding Behavior*
  • Female
  • Humans
  • Infant
  • Infant Food / statistics & numerical data*
  • Infant Nutritional Physiological Phenomena
  • Infant, Newborn
  • Male
  • Poverty / statistics & numerical data*
  • Socioeconomic Factors
  • Time Factors
  • Urban Population / statistics & numerical data*