Complementary feeding indicators and determinants of poor feeding practices in Indonesia: a secondary analysis of 2007 Demographic and Health Survey data

Objective: The present study aimed to assess complementary feeding practices and identify the potential risk factors associated with inappropriate complementary feeding in Indonesia for a nationally representative sample of births from 2004 to 2007. Design: The data source for the analysis was the 2007 Indonesia Demographic and Health Survey. Multiple logistic regression was performed to analyse the factors associated with complementary feeding, using individual-, household-and community-level determinants. Setting: Indonesia. Subjects: Children (n 4604) aged 6-23 months. Results: Multivariate analysis revealed that infants from poor households were significantly less likely to be introduced to complementary feeding (adjusted odds ratio, AOR=4.32; 95% CI 1.46, 12.80) and meet the minimum dietary diversity (AOR=1.76; 95% CI 1.16, 2.68). Mother's education (AOR for no education in dietary diversity = 1.92; 95% CI 1.09, 3.38; AOR for no education in meal frequency = 2.03; 95% CI 1.13, 3.64; AOR for no education in acceptable diet = 3.84; 95% CI 2.07, 7.12), residence and decreased age of the infant were negatively associated with minimum dietary diversity, minimum meal frequency and an acceptable diet. Infants aged 6-11 months were also significantly less likely to meet minimum dietary diversity (AOR = 6.36; 95% CI 4.73, 8.56), minimum meal frequency (AOR = 2.30; 95% CI 1.79, 2.96) and minimum acceptable diet (AOR = 2.27; 95% CI 1.67, 3.09). All geographical regions compared with Sumatra were more likely to give the recommended meal frequency and an acceptable diet to breast-fed children. Conclusions: Public health interventions to improve complementary feeding should address individual-, household-and community-level factors which significantly influence the introduction of complementary feeding. Complementary feeding intervention programmes in Indonesia should ensure that restraints on families with low socio-economic status are addressed. Infants aged 6-11 months and mothers with low education levels may also need special focus. Promotion strategies should also target the health-care delivery system and the media.