Feeding practice and its association with nutritional status of infants aged 0–6 months in Endumeni sub-district, South Africa

Abstract

BACKGROUND : Inappropriate infant feeding practices contribute significantly to malnutrition, which underlies approximately 54% of global infant mortality. This study examined feeding practices and their association with nutritional status among infants aged 0–6 months attending well-baby clinics in Endumeni, KwaZulu-Natal, South Africa. METHODOLOGY : A cross-sectional study was conducted in 2023 involving 329 mothers or primary caregivers (aged 18–40 years) of infants aged 0–6 months from nine clinics. Data were collected using structured questionnaires and analyzed using Stata. Associations between feeding practices and infant nutritional status were assessed using Chi-square tests. RESULTS : Among the infants, 49.9% were male and 50.1% female. Most (49.5%) were between 1–4 months old. Breastfeeding was reported in 72.0% of infants, with 36.8% exclusively breastfed. Formula feeding occurred in 28.0% (22.7% exclusively and 5.3% mixed-fed). Among those introduced to complementary feeding, common first foods included soft porridge (39.5%), commercial baby foods (10.9%), and water (3.0%). Nutritional assessments indicated that 59.3% had normal weight-for-age, while 26.8% were overweight, 4.6% obese, 4.6% underweight, and 4.3% severely underweight. A significant association was found between feeding practices and nutritional status (P < 0.05). Notably, 82.6% of breastfed infants had normal weight, whereas non-breastfed infants were overrepresented in both undernutrition and overweight categories. CONCLUSION : Breastfeeding was positively associated with optimal anthropometric outcomes in early infancy, suggesting a protective effect against both under- and overnutrition. Strengthening caregiver education and breastfeeding support should be prioritized in infant nutrition interventions and policy.

HIGHLIGHTS • 63.5% of infants were currently breastfed; 36.8% exclusively breastfed. • Exclusive breastfeeding and formula feeding were nearly equally prevalent. • 56.5% of infants received early complementary foods, mainly porridge and water. • Non-breastfed infants showed higher rates of severe underweight or obesity. • 19.5% of caregivers lacked knowledge of appropriate complementary foods.