Feeding Patterns of Children Under 24 Months with Severe Acute Malnutrition at Khyber Teaching Hospital, Peshawar

Wajid Ali; Abdul Khaliq; Aziz ur Rahman; Sadiq Akbar; Maarij Ullah Shah; Ibadullah

doi:10.70749/ijbr.v3i3.684

Authors

Wajid Ali Department of Pediatrics, Khyber Teaching Hospital, Peshawar, KP, Pakistan.
Abdul Khaliq Department of Pediatrics, Khyber Teaching Hospital, Peshawar, KP, Pakistan.
Aziz ur Rahman Department of Pediatrics, Saidu Group of Teaching Hospital, Swat, KP, Pakistan.
Sadiq Akbar Department of Pediatrics, Khyber Teaching Hospital, Peshawar, KP, Pakistan.
Maarij Ullah Shah Department of Pediatric Medicine, Hayatabad Medical Complex, Peshawar, KP, Pakistan.
Ibadullah Department of Pediatric Medicine, Qazi Hussain Ahmad Medical Complex, Nowshera, KP, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i3.684

Keywords:

Children, Feeding Patterns, Malnutrition

Abstract

Objectives: To determine the feeding patterns among children under 24 months presenting with severe acute malnutrition. Study design: Cross-sectional Study. Place and duration of study: Department of Pediatrics, MTI, Khyber Teaching Hospital Peshawar, from 11th of August 2024 to 11th February 2025. Methodology: A total of 325 children under 24 months of age diagnosed with severe acute malnutrition (as defined by WHO criteria) were included in this study through consecutive sampling. All the data regarding sociodemographic characteristics, feeding patterns and nutritional practices were collected through structured interviews with mothers, clinical examinations, and anthropometric measurements. Descriptive analysis was done to determine the feeding patterns among these children presenting with severe acute malnutrition. Results: The mean age of children in this study was 13.14±5.96 months. Males constituted 52% of the total study population, while females accounted for 48%. The demographics and socioeconomic characteristics showed that most of the children belonged to age group of 7-12 months (31.4%), most were rural residents (51.7%), most of the mothers had primary level of education (39%) and majority were belonging to lower income status (53%). The details of feeding patterns showed that most of the children were never breastfed/had early cessation of breastfeeding (56.3%). A notable proportion had started earlier mixed feeding (40.3%), started complementary feeding after 6 months (41%) and were having ˂3 meals/day (35%). Conclusion: Suboptimal feeding practices in shape of early cessation of breastfeeding, inappropriate mixed feeding and lack of complementary feeding significantly contribute to severe acute malnutrition in children under 24 months.

Downloads

Download data is not yet available.

References

UNICEF. (2019, April 30). Levels and trends in child malnutrition: Key findings of the 2019 edition. Unicef.org. https://www.unicef.org/reports/joint-child-malnutrition-estimates-levels-and-trends-child-malnutrition

Govender, I., Rangiah, S., Kaswa, R., & Nzaumvila, D. (2021). Malnutrition in children under the age of 5 years in a primary health care setting. South African Family Practice, 63(1). https://doi.org/10.4102/safp.v63i1.5337

Guesdon, B., Faruqi, M. I., Siddiqui, M. I., Usman, G., Ariser, K. N., Shah, R., Amin, F., Masoud, M., Tagar, Q. D., Tonon, B., Lesieur, E., & Memon, K. N. (2024). Mid-upper arm circumference only protocol in Pakistan: Missed opportunities for children suffering from severe acute malnutrition? A mixed-methods observational study. Public Health Nutrition, 1-25. https://doi.org/10.1017/s1368980024000041

Wali, N., Agho, K. E., & Renzaho, A. M. (2020). Factors associated with stunting among children under 5 years in five South Asian countries (2014–2018): Analysis of demographic health surveys. Nutrients, 12(12), 3875. https://doi.org/10.3390/nu12123875

Siddiqui, F., Salam, R. A., Lassi, Z. S., & Das, J. K. (2020). The intertwined relationship between malnutrition and poverty. Frontiers in Public Health, 8. https://doi.org/10.3389/fpubh.2020.00453

Shahid, M., Ahmed, F., Ameer, W., Guo, J., Raza, S., Fatima, S., & Qureshi, M. G. (2022). Prevalence of child malnutrition and household socioeconomic deprivation: A case study of marginalized district in Punjab, Pakistan. PLOS ONE, 17(3), e0263470. https://doi.org/10.1371/journal.pone.0263470

Harrison, L., Padhani, Z., Salam, R., Oh, C., Rahim, K., Maqsood, M., Ali, A., Charbonneau, K., Keats, E. C., Lassi, Z. S., Imdad, A., Owais, A., Das, J., & Bhutta, Z. A. (2023). Dietary strategies for complementary feeding between 6 and 24 months of age: The evidence. Nutrients, 15(13), 3041. https://doi.org/10.3390/nu15133041

Kocagozoglu, S. G., Sengelen, M., & Yalcin, S. S. (2024). Evaluation of complementary feeding indicators among children aged 6–23 months according to the health literacy status of their mothers. Nutrients, 16(20), 3537. https://doi.org/10.3390/nu16203537

Na, M., Aguayo, V. M., Arimond, M., & Stewart, C. P. (2017). Risk factors of poor complementary feeding practices in Pakistani children aged 6–23 months: A multilevel analysis of the demographic and health survey 2012–2013. Maternal & Child Nutrition, 13(S2). https://doi.org/10.1111/mcn.12463

Waghmare, H., Chauhan, S., & Sharma, S. K. (2022). Prevalence and determinants of nutritional status among women and children in Pakistan. BMC Public Health, 22(1). https://doi.org/10.1186/s12889-022-13059-2

Gebremaryam, T., Amare, D., Ayalew, T., Tigabu, A., & Menshaw, T. (2022). Determinants of severe acute malnutrition among children aged 6—23 months in bahir DAR city public hospitals, northwest Ethiopia, 2020: A case control study. BMC Pediatrics, 22(1). https://doi.org/10.1186/s12887-022-03327-w

World Health Organization. WHO Child Growth Standards and the Identification of Severe Acute Malnutrition in Infants and Children: A Joint Statement by the World Health Organization and the United Nations Children's Fund [Internet]. Geneva: WHO; 2009 [cited 2025]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK200776/

Zong, X., Wu, H., Zhao, M., Magnussen, C. G., & Xi, B. (2021). Global prevalence of WHO infant feeding practices in 57 LMICs in 2010–2018 and time trends since 2000 for 44 LMICs. eClinicalMedicine, 37, 100971. https://doi.org/10.1016/j.eclinm.2021.100971

Asim, M., & Nawaz, Y. (2018). Child malnutrition in Pakistan: Evidence from literature. Children, 5(5), 60. https://doi.org/10.3390/children5050060

Ayub, F., Anjum, M., Bibi, S., Khan, A., Soomro, S., & Sardar, A. (2023). Nutritional status and its association with breastfeeding and complementary feeding practices among children visiting tertiary care health centre. Pakistan Armed Forces Medical Journal, 73(4), 1028-1032. https://doi.org/10.51253/pafmj.v73i4.7895

Khalil, H. A., Hawi, M., & Hoteit, M. (2022). Feeding patterns, mother-child dietary diversity and prevalence of malnutrition among under-five children in Lebanon: A cross-sectional study based on retrospective recall. Frontiers in Nutrition, 9. https://doi.org/10.3389/fnut.2022.815000

Mehmood, R., Humayun, K. N., Saleem, A. F., Sherazi, S. A., & Ali, N. A. (2023). Complementary Feeding Pattern and Nutritional Status of Children. Journal of the College of Physicians and Surgeons--Pakistan: JCPSP, 33(7), 775–778. https://doi.org/10.29271/jcpsp.2023.07.775

Deepak, D. H. (2022). Inappropriate feeding practices as a risk factor for severe acute malnutrition in children aged between one month to five years: a case control study. Int J Contemp Pediatr 9, 167-72. https://dx.doi.org/10.18203/2349-3291.ijcp20220088