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Session: Milk to Meals: Feeding From Birth to Childhood (Oral 5)

(OR05-05-23) Trends in Complementary Feeding Practices in Jordan: An Analysis of Children Aged 6–23 Months Using Demographic Health Surveys 1990 Through 2017/18

Sunday, July 23, 2023
8:48 AM – 9:00 AM ET
Location:  Constitution B

    Presenting Author(s)

  • Robin Shrestha, Researcher

    Research and Capacity Building Manager
    Tufts University
    Worcester, Massachusetts, United States

    Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Shibani Ghosh, PhD

    Research Associate Professor
    Tufts University
    Boston, Massachusetts, United States

  • Yanlin Ren, MS

    Researcher
    Tufts University
    Boston, Massachusetts, United States

  • KS

    Karuna Salve

    Friedman School of Nutrition Science and Policy at Tufts University; Feed the Future Jordan Nutrition Innovation Lab

  • PW

    Patrick Webb, PhD

    Professor
    Tufts University
    Boston, Massachusetts, United States

Disclosure(s):
Robin Shrestha, Researcher: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: Complementary feeding addresses a critical growth period yet continues to be a challenge, as foods used often lack in diversity and adequate nutrient quality, in optimal amounts. This study assessed trends in complementary feeding practices in Jordan from 1990 to 2017 for children aged 6-23 months and factors associated with the consumption of micronutrient-rich food (MNFs) groups, infant formula, and sugar-sweetened beverages (SSBs).

Methods: We used a series of six Demographic and Health Survey (DHS) data collected between 1990 and 2017 (n=15,735 children). IYCF indicators were computed, including minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) for both breastfed and non-breastfed infants. Diet quality was assessed at the food group and individual food item levels. Trend analyses were conducted using logistic regression models in STATA 17. Outcome variables included MDD, MMF, MAD, and consumption of MNFs, SSBs, and infant formula.

Results: From 2012 to 2017, the proportion of children of 6-23 months that met MAD declined from 28% to 15%, while MDD declined from 33% to 26%, and MMF declined from 77% to 48%. Consumption of infant formula increased between 1990 to 2017 (12% to 44%), as did juice (21% to 51%). After adjusting for covariates, compared to 2002, children were 65% less likely (p < 0.001) to achieve MMF in 2018. Compared to 2007, children were 81% less likely (p < 0.001) to achieve MDD in 2017. In 2017, Jordanian children were 52% less likely (p < 0.001) to achieve MAD compared to 2012. IYCF indicators were positively associated with wealth status and maternal education. Compared to 2007, children were significantly less likely to consume MNFs: 60% less likely to consume vitamin A-rich foods and vegetables, 61% less likely to consume eggs, poultry, and meat, 75% less likely for fish and 79% less likely for dairy, and 58% less likely for legumes (all p< 0.001).

Conclusions: There is a growing use of infant formula and juices alongside decreasing quality of the diet and complementary feeding practices starting at 6 months of age in Jordan. The findings from this study highlight a significant need for research on the underlying factors that drive the decreasing trend in complementary feeding practices in infants and young children in Jordan.

Funding Sources: United States Agency for International Development (USAID) in Jordan