Complementary feeding in the WHO Multicentre Growth Reference Study

Abstract

Aim: To describe complementary feeding practices in the Multicentre Growth Reference Study (MGRS) sample. Methods: Food frequency questionnaires and 24-h dietary recalls were administered to describe child feeding throughout the first 2 y of life. This information was used to determine complementary feeding initiation, meal frequency and use of fortified foods. Descriptions of foods consumed and dietary diversity were derived from the 24-h recalls. Compliance with the feeding recommendations of the MGRS was determined on the basis of the food frequency reports. Descriptive statistics provide a profile of the complementary feeding patterns among the compliant children. Results: Complementary feeding in the compliant group began at a mean age of 5.4 mo (range: 4.8 (Oman)-5.8 mo (Ghana)). Complementary food intake rose from 2 meals/d at 6 mo to 4-5 meals in the second year, in a reverse trend to breastfeeding frequency. Total intake from the two sources was 11 meals/d at 6-12 mo, dropping to 7 meals/d at 24 mo. Inter-site differences in total meal frequency were mainly due to variations in breastfeeding frequency. Grains were the most commonly selected food group compared with other food groups that varied more by site due to cultural factors, for example, infrequent consumption of flesh foods in India. The use of fortified foods and nutrient supplements was also influenced by site-variable practices. Dietary diversity varied minimally between compliance groups and sites. Conclusion: Complementary diets in the MGRS met global recommendations and were adequate to support physiological growth.