Weaning practices and nutritional value of commonly used weaning diets in peri-urban communities in Kumasi, Ghana

Abstract

The period of weaning is very important in determining the nutritional status of infants, since malnutrition in children under the age of five years starts mainly during the weaning period. International guidelines recommend exclusive breast-feeding until the infant is 4 to 6 months old, followed by introduction of suitable supplementary foods, appropriately given till the child is about 2 years, to reduce malnutrition and infection. However, in many societies the weaning practices are inappropriate. This work describes weaning practices, factors associated with it, and the nutritional value of commonly used weaning diets. Women with children 2 years or below, in peri-urban communities of Kumasi metropolis of Ghana, were interviewed in a cross-sectional survey. One hundred and seventy-two mothers were randomly sampled and questioned on weaning practices, socio-economic characteristics and the dietary intakes of their children. Composition of the commonly used weaning foods, energy and protein intakes of the children were determined. The relationship between the weaning practices and the socio-economic characteristics of the mothers, as well as the results of two focus group discussions on weaning and other practices held, are also reported. Despite the prolonged duration of breast-feeding, with mean shortest and longest periods of breast-feeding being 13.7 and 16.9 months, respectively, the frequency was low, and abrupt stoppage was a common practice. Liquid weaning diets were introduced earlier (at 1-3 months) than recommended, but semi-solids were given at the appropriate time (between 5 and 7 months). The energy and protein intakes of the children were low, meeting only 49% and 90% of their recommended daily intakes, respectively. This was attributed to the low energy and protein densities of koko, the most commonly used liquid diet, and low energy and nutrient contents of other commonly used weaning diets. The duration of breast-feeding was significantly, negatively correlated with the mothers' educational level and occupation, possibly due to the fact that the more educated mothers introduce weaning foods earlier, and are mostly employed outside the home. The breast-feeding duration was, however, positively correlated with the daily income of mothers who earned less than 2000 cedis, since a higher income could lead to a better nutrition for the mother, therefore a prolonged breast-feeding. Among the illiterate mothers and housewives, the daily energy and protein intakes of their children were significantly, positively correlated with their age, possibly because the older mothers feed the children more food as they spend more time with them. The design and implementation of a nutrition education programme, and a complete evaluation of the usefulness of home-made and recommended weaning diets is recommended to improve the weaning practices.