Infant feeding practices in a South African birth cohortA longitudinal study

Childhood malnutrition is highly prevalent in low- and middle-income countries. The choices of complementary foods, which are important in infant nutrition, are poorly described in this setting. We investigated infant feeding practices in a South African birth cohort, the Drakenstein Child Health Study. Longitudinal feeding data were collected from March 2012 to March 2015. Feeding practices at birth, 6-10 and 14weeks and 6, 9, and 12months, were investigated using food frequency questionnaires. Anthropometry was measured at birth and 12months. The quality of the diet was analyzed using the World Health Organization infant and young child feeding indicators. Regression models were used to explore associations between feeding and growth outcomes at 1year. Exclusive breastfeeding for 6months was low (13%), and 19% of infants were introduced to solid foods before 4months. There was high daily consumption of processed meat (56%) and inappropriate foods such as fruit juice (82%), soft drinks (54%), and refined sugary foods (51%) at 1year. Dietary diversity and consumption of iron rich foods were low at 6months (5% and 3%, respectively) but higher by 12months (75% and 78%). Longer duration of exclusive breastfeeding was associated with a lower height-for-age z-score at 1year. Several dietary deficits and a rising trend in the consumption of inappropriate nutritionally poor foods were identified. These findings raise concern about poor dietary practices and the impact on child and long-term health.