Peer-reviewed article
Determinants of sub-optimal complementary feeding practices among caregivers of children aged 6-23 months in low-and middle-income countries: scoping review.
Maishataba Solomon Makwela, Reneilwe Given Mashaba ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This scoping review examined factors that lead to poor complementary feeding practices among caregivers of children aged 6-23 months in low- and middle-income countries. The review analysed 109 studies covering over one million mother-child pairs and identified multiple interconnected determinants of sub-optimal feeding, including socioeconomic factors, maternal characteristics, cultural influences, and health service availability. The findings show that feeding practices are influenced by different factors in different locations, suggesting that interventions need to be tailored to local contexts. Poor feeding practices during this critical period can cause irreversible harm such as stunting and cognitive delays.
Key points
- 109 manuscripts were included, covering data from over 1 million caregiver-child pairs across low- and middle-income countries
- Key determinants identified include socioeconomic factors, maternal and caregiver characteristics, child-specific factors, cultural and societal influences, health services, and environmental conditions
- The review found that determinants of sub-optimal complementary feeding are interconnected and vary by location
- Sub-optimal feeding practices in children aged 6-23 months are associated with irreversible damage including stunting and cognitive delays
- The evidence base suggests need for location-specific intervention models rather than one-size-fits-all approaches
Limitations
This is a scoping review that consolidates existing literature rather than conducting new research or evaluating a specific intervention. The review does not assess the strength of evidence or report effect sizes for individual factors, so it cannot quantify the relative importance of different determinants or provide detailed guidance on which interventions would be most effective.
Abstract
BACKGROUND/OBJECTIVES: Low to middle income countries are burdened by undernutrition and malnutrition mostly affecting children aged < 2 years due to inappropriate feeding practices. Inappropriate feeding practices have been associated with irreversible damage such as stunting and cognitive delays. Therefore, this scoping review aimed to investigate factors that influence sub-optimal complementary feeding practices among caregivers of children aged 6-23 months in low- and middle-income countries. A holistic view of these factors may assist in developing models to prevent inappropriate feeding practices. METHODS: The scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. RESULTS: One hundred and eight (109) manuscripts were included in the review with a sample size of 1,000,028 caregiver/mother child pairs. Several themes were identified relating to factors that contribute to sub-optimal complementary feeding practices. These included social economic factors, maternal and caregiver's characteristics, child specific factors, cultural and societal influences, health and nutritional services, environment and living conditions, as well as barriers to optimal CF practice. CONCLUSIONS: This scoping review consolidated evidence from a substantial sample of more than one million mother-child pairs from different low- and middle-income countries. The sample size and diversity provide a strong, representative foundation for informing policy, practice, and future research directions. The present study highlighted that feeding practices are affected by multiple factors and that there are interlinks between determinants of sub-optimal CF. These factors of sub-optimal CF and their respective interlinks are different for different locations and should inform future intervention studies and preventative models to better address sub-optimal CF in low to middle income countries.