To describe the status of, and to identify the factors associated with, complementary feeding among infants and young children aged 6- 23 months in poor rural areas of Hunan Province, China.

A total of 8 735 infants and young children aged 6- 23 months from 30 poor rural counties in the Wuling and Luoxiao Mountains in Hunan Province were selected by township-level probability-proportional-to-size sampling in August 2015. Questionnaires were used to collect information on the feeding status of the infants in the previous 24 hours, along with personal/family information. The qualified rate of minimum dietary diversity (MDD), the minimum meal frequency (MMF) and the minimum acceptable diet (MAD) were calculated according to the WHO indicators for assessing infant and young child feeding practices. Multi non-conditional logistic regression models were used to analyze factors associated with complementary feeding among infants and young children aged 6- 23 months.

The findings indicated that 73.9% (6 452/8 735) of infants and young children aged 6-23 months received the minimum dietary diversity, 81.6% (7 124/8 735) of infants and young children aged 6- 23 months received the minimum meal frequency and 49.0% (4 276/8 735) of infants and young children aged 6- 23 months received an acceptable diet. Compared with the boys, the OR for the MMF and MAD for the girls were 1.15 and 1.11, respectively. Compared with the 6-11 month group, the OR for the MDD for the 12-17 month and 18-23 month groups were 0.41 and 0.38, respectively; the OR for the MMF for the 12-17 month and 18-23 month groups were 1.53 and 2.46, respectively; and the OR for the MAD for the 12-17 month and 18-23 month groups were 0.60 and 0.60, respectively. Compared with the Han ethnic group, the OR for the MDD, MMF and MAD for the Miao ethnic group were 1.43, 1.72 and 1.56, respectively; for the Tujia ethnic group were 2.21, 2.02 and 2.11, respectively; and for the Dong ethnic group were 0.62, 0.61 and 0.64, respectively. When analyzing data related to the children's mothers, compared with women who gestated at the age of 25- 29, the OR for the MMF for women who gestated at less than 20 years of age was 1.59 and at greater than or equal to 35 years of age was 1.33. Compared with women with primary school education or below, the OR for the MDD, MMF and MAD for women with junior high school education were 0.77, 0.74 and 0.80, respectively; for women with senior high school education were 0.67, 0.65 and 0.68, respectively; and for women educated to university level or above were 0.66, 0.47 and 0.60, respectively. Compared with the normal birth weight group, the OR for the MMF for the low birth weight group was 0.71, and for the high birth weight group was 1.30. Compared with the caregivers who provided qualified feeding knowledge, the OR for the MDD, MMF and MAD for the caregivers who provided unqualified feeding knowledge were 1.45, 1.30 and 1.40, respectively. Compared with the breastfed group, the OR for the MDD and the MMF for the non-breastfed group were 0.53 and 0.36, respectively. All P values were <0.05.

Most infants and young children aged 6-23 months in poor rural areas of China met the MDD and MMF requirements, but fewer met the MAD requirements. The risk factors in infants and young children for complementary feeding included being of female gender, lower in age (months), of Miao or Tujia ethnicity, being born to a mother who gestated at less than 20 or ≥35 years of age, being born to a mother of low education, having a high birth weight, having a caregiver who provided unqualified feeding knowledge and being breastfed.

Infant; Cross-sectional studies; Porerty areas; Complementary feeding