Factors Affecting Complementary Feeding Pattern in Alexandria

The nutritional needs of infants and young children change rapidly and their eating pattern progresses from breast milk and formula to more varied diets initiated by complementary feeding. Inappropriate feeding pattern is a major cause of the onset of malnutrition. The mother is responsible for the initiation, timing, and composition of complementary foods. This study was carried out to evaluate the impact of maternal factors on complementary feeding in Alexandria. The sample included 360 mothers of children in the age group 6-24 months attending the well baby Clinic in 3 MCH centers in Alexandria. Each mother was privately interviewed using a structured questionnaire to collect the needed data. The results show that 50-60% of the mothers derived their information about complementary feeding from family and friends, while 32.2% relied on the health team. More than 60% of the infants received complementary feeding before the age of 4 months, dairy products were the major complementary food (51.9%) followed by cereals (23.3%). The majority of the children (45.0%) were given 3 meals daily while 21.9% were given two meals only. The foods were prepared for every meal (68.6%), once daily (25.3%) or every two days (6.1%). Spicy, fatty, and sweetened foods are omitted from the infants’ food. The results show that maternal factors such as the level of education of the mother, her employment status, and age had a clear significant effect on the source of information regarding complementary feeding, age at introducing food and the type used, meal frequency, and types of foods omitted. INTRODUCTION Nutrition is an important component of the child's health. A child’s physical, cognitive, and emotional growth and development depend largely on the quantity, type of foods eaten, and the timing of introducing different food items. During the first two years after birth, the nutritional needs of infants and toddllers change rapidly, and their eating patterns progress from simple diets of breast milk and formula to more varied diets that include juices, cereals, and solid foods. During this time, they form eating habits that may affect their later nutrition and health. (1) Inappropriate feeding practices are a major cause of the onset of 933 Bull High Inst Public Health Vol.37 No.4 [2007] malnutrition in infants and young children who are at increased risk of malnutrition from six months of age onwards; when breast milk alone is no longer sufficient to meet all nutritional requirements. (2) Malnutrition is responsible, directly or indirectly, for over half of all childhood deaths. It is estimated that 25% of all childhood deaths could be prevented by intervention to improve breast feeding and complementary feeding. (3,4) In 2003, the WHO and PAHO jointly defined complementary feeding as the process starting when breast milk alone is no longer sufficient to meet the nutritional requirements of infants, and therefore other foods and liquids are needed along with breast milk. (5) Complementary foods should be started when the baby can no longer get enough energy and nutrients from breast milk alone. For most babies this is at six months of age. This is also the age when nerves and muscles in the mouth are developed sufficiently to let the baby munch, bite, and chew. (6) Formula may provide all nutrients needed for the first year of life, but it does not provide flavors, textures, and the opportunity to learn eating skills, which are important for formula fed as well as breast fed infants. (7) A child receives less protective factors than in breast milk, so the risk of illness especially diarrhoea increases because complementary foods may not be as clean as breast milk. Types of food given instead of breast milk are often thin, watery porridge or soup as they are easier for babies to eat. These foods fill the stomach but provide fewer nutrients than breast milk, and so the child’s needs are not met. (6) During the period of transition from exclusive breast feeding to the cessation of breast feeding, infants gradually become accustomed to eating family foods until they entirely replace breast milk. Children are physically capable of consuming family foods by one year of age, after which