Evaluation of feeding practices in the first 12 months of life and nutritional status in an urban setting of a low resource country -Beira, Mozambique

Serena Calgaro^1*Irene Avagnina¹Anna Vettor²Cristian Girotto³Bonifacio Rodriguez Cebola⁴Arlindo Rosario Muhelo⁴Isabella Rosato⁵Liviana Da Dalt⁶PUTOTO GIOVANNI⁷Giovanna Verlato⁸

• ¹Doctor with Africa CUAMM, Beira, Mozambique
• ²University of Padua, Padua, Veneto, Italy
• ³Azienda Ospedale Università Padova, Padua, Italy
• ⁴Beira Central Hospital, Beira, Mozambique
• ⁵Department of Cardio-Thoraco-Vascolar Sciences and Public Health, Unit of Biostatistics, Epidemiology and Public Health, University of Padua, Padua, Veneto, Italy
• ⁶Department of Woman’s and Child’s Health,, Azienda Ospedale Università Padova, Padua, Italy
• ⁷Doctors with Africa CUAMM, Padova, Italy
• ⁸Pediatric Nutrition Service, Neonatal Intensive Care, Department of Woman’s and Child’s Health, University Hospital of Padova, Padua, Italy

Background: Stunting is a major public health problem, especially in the developing countries. In 2020, 37.5% of children under 5 years in Mozambique were stunted.Objectives of the study are to describe the nutritional practices in a cohort of Mozambican children and to compare them with international recommendations. Secondary objective to find differences between chronic malnourished (M) vs non-malnourished (NM) children and to detect factors related to malnutrition.Methods:a retrospective study was conducted including children admitted to Beira Central Hospital in Mozambique, using a questionnaire focusing on early nutritional and complementary feeding (CF) practices.We compared the clinical and feeding characteristics of M and NM children and conducted logistic regression to identify factors associated with chronic malnutrition. Data management was performed using Microsoft Excel Office 365 R and statistical analysis with Jamovi (version 2.3).Results: 103 children were studied (median age 19 months); 70% were exclusively breast fed, 56% continued breastfeeding even during CF but only 8% until 2 years of age.The introduction of CF occurred at a median age of 6 months, with the main reason being the baby's crying. Sugar/salt and sugary drinks were introduced before 1 year of age. At survey's time, 42% of children's diet were adequately varied. Statistical analysis showed that M children had statistically significant differences in birth weight percentile, had been less breastfed, consumed fewer dairy products compared to NM children.Multivariate logistic regression showed that risk factors for chronic malnutrition were HIV infection of both mother and child (OR 7.5, 95% CI: 1.6-35.09), unaware initiation of CF (OR 4.35, 95% CI: 1.45-13.05) and birth weight below 10 th percentile (OR 3.26, 95% CI: 1.02-10.47).In contrast, early and frequent dairy consumption and ongoing maternal breastfeeding during complementary feeding were found to be protective factors.In our population the percentage with a minimally acceptable diet was low, feeding with human milk could be increased and CF mistakes corrected.Our findings highlight the need to raise awareness of the importance of breastfeeding and timely and appropriate complementary feeding composition.The attention on children suffering from HIV, with a lower birth weight, less breastfeeding and dairy product consumption should be increased to prevent malnutrition.