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Compliance with Updated Infant and Young Child Feeding Indicators and Their Association with MUAC- Based Nutritional Status Among Children Aged 0–23 Months: A Hospital-Based Cross-Sectional Study in Karachi, Pakistan

Shahid S, Nawaz A, Shah W · 2 Sept 2026

Abstract

Abstract Background Infant and Young Child Feeding (IYCF) practices are essential for optimal growth and development in the first two years of life. The WHO and UNICEF have updated IYCF guidelines to include additional indicators such as consumption of unhealthy foods, sweetened beverages, and fruit and vegetable intake for a more comprehensive assessment. However, infant feeding practices in Pakistan have not yet been evaluated against these revised standards, particularly regarding unhealthy food and sweet beverage consumption. Understanding determinants of both healthy and unhealthy feeding practices is important to identify gaps and guide targeted interventions. This study, therefore, aims to assess feeding practices using the updated IYCF guidelines and to identify key gaps, particularly in the consumption of unhealthy foods among children aged 0–23 months. Methods This cross-sectional study included children from birth to 23 months of age. The study was conducted from January 2025 to June 2025 in the outpatient department of Indus Hospital. Children were screened for nutritional status through MUAC measurement and by checking for nutritional edema. Feeding details were determined through a 24-h dietary recall questionnaire. Data was recorded on SPSS and analyzed through logistic regression analysis. Results A total of 166 children were enrolled. Breastfeeding status did not show a significant association with malnutrition. Children who achieved recommended minimum dietary diversity (OR = 16.84), minimum acceptable diet (OR = 4.05), and egg and flesh food consumption (OR = 23.96) showed higher odds of being well-nourished. Those with Zero fruit/vegetable consumption had higher odds of being malnourished (OR = 0.07). Conclusion While exclusive breastfeeding provides essential nutrition during infancy, the timely introduction of diverse foods in recommended amounts is crucial for optimal growth. Children aged 6–23 months who achieved the recommended minimum dietary diversity, minimum acceptable diet, and adequate intake of eggs and flesh foods were associated with better MUAC-based nutritional status.