title: Complementary feeding practices and child growth outcomes in Haiti: an analysis of data from Demographic and Health Surveys.
abstract: The Haitian National Nutrition Policy identifies the promotion of optimal complementary feeding (CF) practices as a priority action to prevent childhood malnutrition. We analysed data from the nationally representative 2005-2006 Haiti Demographic Health Survey using the World Health Organization 2008 infant and young child feeding indicators to describe feeding practices among children aged 6-23 months and thus inform policy and programme planning. Multivariate regression analyses were used to identify the determinants of CF practices and to examine their association with child growth outcomes. Overall, 87.3% of 6-8-month-olds received soft, solid or semi-solid foods in the previous 24 h. Minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD) were achieved in 29.2%, 45.3% and 17.1% of children aged 6-23 months, respectively. Non-breastfed children were more likely to achieve MDD than breastfed children of the same age (37.3% vs. 25.8%; P < 0.001). The proportion of children achieving MMF varied significantly by age (P < 0.001). Children with overweight mothers were more likely to achieve MDD, MMF and MAD [odds ratio (OR) 2.08, P = 0.012; OR 1.81, P = 0.02; and OR 2.4, P = 0.01, respectively] than children of normal weight mothers. Odds of achieving MDD and MMF increased with household wealth. Among mothers with secondary or more education, achieving MDD or MAD was significantly associated with lower mean weight-for-age z-score and height-for-age z-score (P-value <0.05 for infants and young child feeding indicator × maternal education interaction). CF practices were mostly inadequate and contributed to growth faltering among Haitian children 6-23 months old.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Heidkamp
authors.affiliation: Nutrition Section, UNICEF Country Office, Port-au-Prince, Haiti.
authors.forename: Mohamed Ag
authors.initials: MA
authors.lastname: Ayoya
authors.affiliation: Nutrition Section, UNICEF Country Office, Port-au-Prince, Haiti.
authors.forename: Ismael Ngnie
authors.initials: IN
authors.lastname: Teta
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Stoltzfus
authors.affiliation: National Food and Nutrition Program Coordination Unit, Ministry of Public Health and Population, Port-au-Prince, Haiti.
authors.forename: Joseline Pierre
authors.initials: JP
authors.lastname: Marhone
mesh_terms: D015992:Body Mass Index; D001835:Body Weight; D001942:Breast Feeding; D002657:Child Development; D003430:Cross-Sectional Studies; D003710:Demography; D005247:Feeding Behavior; D005260:Female; D006205:Haiti; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D044342:Malnutrition / Q000517:prevention & control; D015999:Multivariate Analysis; D064167:Recommended Dietary Allowances; D012959:Socioeconomic Factors; D014944:World Health Organization
keywords: child growth; complementary feeding; health policy; infant and child nutrition; low-income countries