COMPLEMENTARY FEEDING PRACTICES AND ANTHROPOMETRIC STATUS OF 0-2YEARS CHILDREN IN ENUGU NORTH LOCAL GOVERNMENT AREA, ENUGU STATE.

During infancy and early childhood (birth to 2 years), adequate amount of appropriate nutrition has paramount importance for full development of children’s human potential. This period is also regarded as “critical window” for child’s health, growth, and development (World Health Organization WHO, 2003). It is also peak period for faltering in child’s growth, micronutrient deficiencies, and emergence of common childhood ailments as diarrhea. Furthermore, reversing of stunting developed during this period is very difficult after the second anniversary of the children (World Bank WB, 2006). Complementary feeding should be timely (start receiving from 6 months onward) and adequate (in amounts, frequency, consistency, and using a variety of foods). The foods should be prepared and given in a safe manner and be given in a way that is appropriate (foods are of appropriate texture for the age of the child) and applying responsive feeding following principles for psychosocial care (Monte et al., 2004). During these formative years, poor nutrition has immediate consequences of increased morbidity and mortality and delayed development of the brain and other nervous systems (Krebs et al., 2011). The latent impacts of deficits in nutrients in early ages include impaired cognitive performance and reproductive outcomes and reduced work capacity and health status during adolescence and adulthood. Furthermore, malnutrition cycle persists with intergeneration impacts. When malnourished girl child grows up, she faces greater odds of having malnourished, low birth weight infant. Muller and Krawinkel (2005) were the failure to consume additional nutritious food in low resource settings has been identified as important risk factor resulting in excess disease and death of young children (Krebs et al.,2011). It is difficult to pinpoint the ideal time for starting provision to infants of diet other than breast milk. (Lanigan et al., 2001). There is high risk of harmful effects (possibility of choking, food allergies, and decrease in breast milk intake or formula) through the early introduction of complementary foods. Delayed introduction may miss developmental readiness infants and difficulties learning to eat at later ages while risking malnutrition at the same time. United state department of Agriculture (USDA, 2009). According to pediatric nutrition authorities, developmental readiness in most infants and the ability to tolerate foods consumed would occur around 4 and 6 months of age (Issaka et al., 2015). During this period, the intestinal tract will have well-developed defense system that minimizes or averts risk of allergic reaction in infants following intake of foods containing foreign proteins, while its ability to utilize proteins, fats, and carbohydrates improves. Similarly, the infant’s kidney develops to a state where it can successfully eliminate waste products emanating from foods such as meat with characteristic high renal load. Furthermore, their neuromuscular system matures enough leading into development of abilities for recognizing food, accepting spoons, masticating and swallowing foods, and, even, distinguishing and appreciating varieties in food tastes and colors (Cohen et al., 1994).  There is no evidence for harm when safe nutritious complementary foods are introduced after 4 months when the infant is developmentally ready.

According to United Nations Children’s Fund (UNICEF) state of the world’s children report (UNICEF, 2015), over the past five years, infant and under-five mortality rates have remained steady in Nigeria, at 74 and 117 deaths per 1000 live births, respectively. At these levels, one Nigerian child of every 13 born dies before reaching age one in every eight does not survive to their fifth birthday. Although WHO, UNICEF and Nigeria’s National breastfeeding policy recommended that infants be exclusively breastfed from birth to 6 months and continue breastfeeding to 24 months and beyond, for optimal survival, growth and development, unfortunately only 17% of infants under six months of age are exclusively breastfed in a tropical rural setting in Nigeria. Hence, a study in northern Nigeria on feeding practices and nutritional status of under-five children, Awogbenja and his colleague adduced that mothers who introduced complementary food too early had high incidence of children who were under-nourished (Awogbenja et al., 2010). Since malnutrition is a significant public health problem in the nation and poor complementary feeding habits of mothers has been linked with poor nutritional status of infants (Awobgenja et al., 2010). Addressing the influence of complementary feeding practice of mothers on nutritional status of children may be an important approach towards reducing the burden of child malnutrition. Thus, the present study is aimed at assessing the complementary feeding practices and anthropometric status of children in urban area in Enugu State.

The general objectives of this study is to determine the factors influencing complementary feeding practices and anthropometric status of children in selected urban area in Enugu state  

The specific objectives include:

1. To determine the socio demographic and economic characteristics of the mothers.

2. To determine the complementary feeding practices adopted by the mothers in feeding their children. 

3. To assess the knowledge and attitude of mothers towards the recommended complementary feeding practices. 

4. To assess the anthropometric status of the children. 

The findings of the study will assist programme implementers and stakeholders make evidenced based decision in the improvement of children’s health by promoting better feeding practices to reduce and eradicate prevalence of malnutrition in Nigeria particularly the vulnerable first year of life (6-24month). This will aid to enhance the full benefit of complementary feeding practices in the study area.  

At the end of this study, recommendations will be made to assess the adequacy of complementary feeding practices of infants aged 6-24months in study area and identify the key factors influencing them. The findings will also sensitize mothers and health workers on the need and benefit of initiating complementary food for infants which should be derived from locally available food items defined by WHO and how to combine, prepare and feed them to provide adequate nutrient for child. Advice about breastfeeding and complementary feeding during antenatal checkups and postnatal visit to improve feeding practices.