Effect of Complementary Feeding Behaviour Change Communication Delivered through Community-level Actors on Infant Feeding Practices, Growth and Morbidity in Rural Communities of West Gojjam Zone, Northwest Ethiopia: a Cluster-randomized Controlled Trial

Abstract

It is well recognized that the age of 6-23 months is a complementary feeding period which has the most critical influence on the growth and development of an infant. The incidence of growth faltering, and micronutrient deficiencies is highest in this period as children have high demand for nutrients and there are insufficiencies in the quality and quantity of complementary foods. Improving feeding practices in this critical window of period is therefore among the most costeffective strategies to improve overall infant health and ensure their nutritional wellbeing. This could be ensured by enabling mothers/caregivers to appropriately feed their children with safe and adequate complementary foods while maintaining frequent breastfeeding. The quality of children‟s diets is more important before age two years than at any other time in life. Appropriate complementary foods and feeding practices contribute to child survival, growth and development. However, children may not receive safe and appropriate complementary foods at the right age, at the right frequency or in adequate quality. Globally, complementary feeding practice is far from the WHO recommendations. Only about 65% of infants 6-8 months of age are fed solid, semisolid, or soft foods, less than one third (29%) of the children aged 6-23 months fulfill the minimum dietary diversity, half (52%) have the minimum meal frequency, and only one in six (16%) have the minimum acceptable diet. The situation is particularly worrying for the youngest children (6-11 months). Attaining the recommended level of adequacy of an infant‟s diet remains a serious challenge in many developing countries. Complementary foods are mainly starchy-staples that lack the desired nutrient quality, amount, and density with limited consumption of animal-source foods, fruits and vegetables. In Ethiopia, inappropriate complementary feeding practices have been widely reported. Complementary foods are untimely introduced (either too early or too late), limited dietary diversity, and inadequate in calories. According to the Ethiopian Demographic Health Survey 2016, only 60% of children aged 6-8 months consumed solid, semisolid, or soft foods, 14% met the minimum dietary diversity, 45% had the minimum meal frequency, and 7% fulfilled the minimum dietary diversity.