Levels and determinants of complementary feeding based on meal frequency among children of 6 to 23 months in Bangladesh.
Information concerning complementary feeding (CF) practice during infancy and early childhood is still scarce in Bangladesh. Therefore, this study aimed to estimate the level of CF among children of 6-23 months and identify individual, household and community level determinants in Bangladesh.



Secondary data from the Bangladesh Demographic Health Survey (BDHS) 2011 was used. A total of 2,373 children aged 6-23 months were selected. A simplified index called "dimension index" was used to estimate the level of CF. The score of this index was used either as continuous or categorical dependent variables. The highest score based on dimension index is associated to an adequate CF. Statistical analyses and tests were guided by types of variables. Finally, multivariable logistic regression (binary and multinomial) analyses were performed to identify the significant determinants of CF.



The overall level of CF among children of 6-23 months was low. More than 90 % of children experienced either no (2.9 %) or inadequate CF (92.7 %). According to bivariable analyses, mean levels of CF as well as percentages of no/inadequate CF were significantly lower among children of the youngest age group, uneducated parents, unemployed/laborer fathers, socio-economically poor families, food insecure families and rural areas. No weekly exposure to mass media (namely watching TV and reading newspapers/magazines) also revealed significant associations with CF. However, only few variables remained significant for adequate CF in the multivariable logistic regression analysis. For example, the likelihood of experiencing adequate CF was significantly lower among children of 6-11 months (OR: 0.22, 95 % CI: 0.10-0.47), children of illiterate fathers (OR: 0.32, 95 % CI: 0.11-0.95) and socio-economically middle-class families (OR: 0.28, 95 % CI: 0.09-0.86) as compared to their reference categories.



A high level of inadequate CF leading to malnutrition may cause serious health problems among children of 6-23 months in Bangladesh. Vulnerable groups of children (e.g., the children aged 6 to 11 months and children of illiterate fathers), who received low levels of adequate CF, should be targeted by government and other stakeholders while developing strategies and interventions in order to improve overall situation of CF in Bangladesh.
Department of Public Health, Faculty of Health Science, First Capital University of Bangladesh, Chuadanga, Bangladesh.
Mohammad Rocky Khan
MR
Chowdhury
Department of Public Health, Faculty of Health Science, First Capital University of Bangladesh, Chuadanga, Bangladesh.|Department of Global Health Policy, School of International Health, University of Tokyo, Tokyo, Japan.
Md Shafiur
MS
Rahman
Department of Public Health Medicine, School of Public Health, Bielefeld University, Bielefeld, Germany. mobarak.khan@uni-bielefeld.de.|Department of Public Health, College of Applied Medical Sciences, King Faisal University, Hofuf, Saudi Arabia. mobarak.khan@uni-bielefeld.de.
Md Mobarak Hossain
MM
Khan
D001459:Bangladesh; D005191:Family Characteristics; D005247:Feeding Behavior; D005260:Female; D005523:Food Supply; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000209:etiology; D007227:Infant Nutritional Physiological Phenomena; D016015:Logistic Models; D008297:Male; D062407:Meals; D012111:Residence Characteristics; D012959:Socioeconomic Factors
Bangladesh; Children; Complementary feeding; Determinants; Dimension index