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. 2021 Apr 3:11:08003.
doi: 10.7189/jogh.11.08003.

Trends in complementary feeding practices and caregivers' feeding knowledge among children aged 6-23 months: Repeated cross-sectional surveys in rural Qinghai China 2012-18

Qiong Wu  1 , Yiwen Huang  1 , Michelle Helena van Velthoven  2 , Wei Wang  1 , Yanfeng Zhang  1
Affiliations

Trends in complementary feeding practices and caregivers' feeding knowledge among children aged 6-23 months: Repeated cross-sectional surveys in rural Qinghai China 2012-18

Qiong Wu et al. J Glob Health. .

Abstract

Background: Appropriate infant and young child feeding is the basis for child survival, growth and development. The aim of this study was to investigate trends in complementary feeding practices and caregivers' feeding knowledge among children from 2012 to 2018 in Huzhu County, Qinghai Province, China.

Methods: This study took place during and after a controlled interventional evaluation trial in Qinghai Province, China, which aimed to evaluate the effectiveness of community-based nutrient-dense complementary food supplements (YingYangBao) combined with dietary counseling on improving 6-23 month-old children's health status. We conducted four representative cross-sectional surveys on caregivers of children aged 6-23 months in Huzhu County, Qinghai Province, China (baseline survey for the trial (N = 1804) in August 2012, end-line survey for the trial (N = 2186) in August 2014, follow-up survey 1 (N = 496) in January 2016, and follow-up survey 2 (N = 754) in July 2018). In all surveys we used the same questionnaire to collect household information, infant feeding practices and caregivers' feeding knowledge.

Results: During the trial period (2012-2014), the proportion of children aged 6-8 months that introduced (semi-) solid food increased from 86.1% to 96.3% (P < 0.0001), however, there was a downward trend from 2014 to 2018 (P = 0.0014 for trend). The prevalence of minimum dietary diversity also increased from 51.4% at 2012 baseline survey to 57.5% at 2014 endline survey (P = 0.0004), but the upward trend did not maintain from 2014 to 2018 (P = 0.7863 for trend). The minimum dietary frequency, the minimum acceptable diet, and continued breastfeeding at one year were nearly unchanged from 2012 to 2018 (P = 0.9529, P = 0.7602 and P = 0.6013 for trend, respectively), remaining around 30%, 10% and 20% respectively in the four surveys. Caregivers' feeding knowledge on the duration of exclusive breastfeeding and introduction of semi or solid foods at 6-8 months increased from 2012 to 2018 (18.6% to 39.5%, 43.2% to 64.3%, respectively).

Conclusion: This study showed that the sustainability of community-based YYB and dietary counseling program was suboptimal. We suggest that multiple information delivery channels such as smartphones and the Internet should be explored as a supplement to existing channels for delivering counseling information.

Trial registration: ChiCTRPRC12002444.

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Conflict of interest statement

Competing interests: The authors completed the ICMJE Unified Competing Interest form (available upon request from the corresponding author), and declare no conflicts of interest.

Figures

Figure 1
Figure 1
Trends in complementary feeding practices from 2012 to 2018. Panel A. Introduction of solid, semi-solid or soft foods: baseline 2012 vs endline 2014, P < 0.0001; trend P = 0.7979 from 2012 to 2018; trend P = 0.0014 from 2014 to 2018. Panel B. Minimum dietary diversity: baseline 2012 vs endline 2014, P = 0.0004; trend P = 0.5831 from 2012 to 2018; trend P = 0.7863 from 2014 to 2018. Panel C. Consumption of meat: baseline 2012 vs endline 2014, P < 0.0001; trend P = 0.5327 from 2012 to 2018; trend P = 0.4446 from 2014 to 2018. Panel D. Minimum meal frequency: baseline 2012 vs endline 2014, P = 0.2753; trend P = 0.9529 from 2012 to 2018; trend P = 0.8524 from 2014 to 2018. Panel E. Continued breastfeeding at one year: baseline 2012 vs endline 2014, P = 0.7642; trend P = 0.6013 from 2012 to 2018; trend P = 0.8450 from 2014 to 2018. Panel F. Minimum acceptable diet: baseline 2012 vs endline 2014, P = 0.4267; trend P = 0.7602 from 2012 to 2018; trend P = 0.8587 from 2014 to 2018.
Figure 2
Figure 2
Trends in caregivers’ feeding knowledge from 2012 to 2018. Panel A. Knowing the duration of exclusive breastfeeding: trend P = 0.004 from 2012 to 2018. Panel B. Knowing introduction of semi or solid foods at 6-8 months: trend P = 0.0008 from 2012 to 2018. Panel C. Believing children should be given meat at 6-8 months: trend P = 0.7223 from 2012 to 2018. Panel D. Believing continued BF at one years or above: trend P = 0.1711 from 2012 to 2018.
Figure 3
Figure 3
Source of caregivers' information on complementary feeding.
See this image and copyright information in PMC

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