Feeding practices, nutrient adequacy and nutritional status of children 12-23 months in Kwania and Apac districts, northern Uganda

Abstract

Sub-optimal feeding practices is responsible for one third of all cases of child malnutrition. The effects are more severe in children between the ages of 12-23 months since this is a crucial period for development with irreversible effects of poor nutrition. The high prevalence of malnutrition among children in rural areas in Uganda, along with a dearth of insight on feeding practices and the nutrient adequacy of local foods, is proving to be a major concern. To determine the association between feeding practices, nutrient adequacy and nutritional status of children 12-23 months in Apac and Kwania district. This was part of an ongoing study which adopted quantitative cross‐sectional and descriptive study design. Based on the 11.5% of children in Lango meeting a minimum dietary diversity, a sample size of 156 children was used. Multi stage simple random sampling was used to select households with the index child 12-23 months. Structured interviews, weighed food record and anthropometric assessment were used for data collection. Nutri-Survey (Version 2007), IMAPP (Version 1.0) and WHO Anthro softwares (Version 3.1) were used to analyze nutrient adequacy and categorize nutritional status respectively. Chi-square test and multinomial regression test were used to establish associates and predictors of nutritional status outcomes respectively. This was performed at a 95% confidence interval (p <0.05). About 18.6% of the children met the minimum dietary diversity (MDD), 28.2% met the minimum meal frequency (MMF) and 9.6% of the children met the minimum acceptable diet (MAD). The children’s diet was inadequate in dietary fibre, vitamin B1, B2, vitamin E, calcium, iron, and zinc. 19.3% of the children were stunted, 12.2% of the children were underweight and 2.5% of the children were wasted. Wasting was significantly associated with bottle feeding (p=0.019, χ2=5.47) practice and late initiation of breastfeeding (p=0.05, χ2=3.606). Stunting was significantly associated with dietary diversity and meeting a minimum acceptable diet (p=0.037, χ2=5.552) and (p=0.042, χ2=3.591), respectively. Children with adequate calcium intake were 0.301 times less likely to be stunted (AOR=0.301, 95% CI: 0.113-0.803, p=0.016). Children who had inadequate intake of vitamin A were 7.9 times more likely to be underweight compared to those who took adequate amounts (AOR=7.967, 95% CI: 1.169-54.309, p=0.034). In conclusion, this study highlights significant concerns regarding the sub-optimal feeding practices and inadequate nutritional content in the foods examined. The findings indicate a pressing need for improved dietary practices and increased attention to essential nutrients, including energy, niacin, iron, zinc, calcium, dietary fiber, and vitamins.