Considerations for improving complementary feeding practices among infants of 6-11 months in Northern Uganda
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Kitgum and Pader districts in Northern Uganda have had series of child nutrition programs, however; malnutrition in infants 6-11months still remains a major challenge. This study therefore sought to assess the current practices, challenges and opportunities of improving complementary feeding. The study was cross sectional and descriptive employing both qualitative and quantitative methods. Community leaders, mothers of infants 0-11 months old, fathers and Village Health Teams (VHT) were purposively selected for the Focus Group Discussions (FGDs) and in-depth interviews. The FGD captured information on Infant and young child feeding aspects like; age at introduction of other foods than breast milk, feeds recipes and modifications, diet diversity, decision making and general perception of infant feeding within the communities. Mothers and caretakers of 100 infants (6-11months) were randomly selected for the Gibson multi-pass 24 hr recall dietary assessment. A sub-sample of 15 of the participants was selected based on observations to participate in Trials for Improved Practices (TIP) which included; increased infant eating frequency, increased nutrient density and hygiene practices. Qualitative and data were analyzed using Atlas-Ti version 6.1.1 and quantitative data was analyzed using Statistical Package for Social Scientists version 12 (SPSS). Pearson’s bivariate correlation was done to establish how the different variables namely; age groups of the infants, feeding frequency, dietary diversity and nutrients intake relate to one another. The results showed that the average age of the infants was 8.7 months. Fifty percent of the mothers initiated breastfeeding within two hours of delivery; however, more than half of the babies received pre-lacteals within 1-2 days of birth. Other foods/fluids than breast milk were introduced between 3-5 months. The mean frequency of feeding infants in 24 hours was 3.9 for age groups 6-8 months and 4.2 for infants aged 9-11 months. Seventy nine percent of the infants 9-11 months met their calorie and protein needs with mean intake of 620kcal/day and 18g/day, respectively. However, only 20% of the infants met their micronutrient needs. For vitamin A and iron intake, 60% and 40%, respectively of infants 9-11 months old met the recommended intake. Fifty four percent of the mothers are not in position to practice the recommended Infant and Young Child Feeding (IYCF) practices. Older infants had higher energy intake than younger infants (p=0.01 at 99%). The high energy intake is probably due to increased feeding frequency on high energy dense foods by the older infants. The intakes of protein, zinc and iron in relation to the infants’ ages were at (p=0.031, 0.05 and 0.031, respectively). The results of this work suggest that micronutrients intake is still a problem for infants 6-11 months old in the area. There is need to integrate time saving and work load reduction interventions in IYCF programs.