{"title":"A Descriptive Investigation of Infant Feeding Bottles Marketed in the UK Designed to Replicate Breastfeeding and the Evidence That Underpins Them.","authors":"Clare Maxwell, Becky Self, Kathryn Bould","doi":"10.1111/mcn.70008","DOIUrl":"https://doi.org/10.1111/mcn.70008","url":null,"abstract":"<p><p>Scant attention has been given to the marketing of infant feeding bottles and teats with claimed equivalence to breastfeeding. Such bottles are purported as having 'breast-like' qualities and to be interchangeable with breastfeeding, encouraging breastfeeding mothers to combine breast and bottle feeding. However, the introduction of bottle feeding alongside breastfeeding can have a negative impact on breastfeeding duration and lead to cessation. We investigated features of infant feeding bottles marketed in the United Kingdom to replicate breastfeeding and appraised the underpinning evidence. We searched online to identify the most popular bottles marketed for breastfeeding in the United Kingdom and captured marketing materials from the bottle brand websites, importing them into NVivo11 for data analysis. We coded data in relation to features of bottles associated with breastfeeding and used Johanna Briggs Institute (JBI) critical appraisal tools to appraise the evidence used to underpin the bottle features. We identified 10 bottle brands and 8 main advertised features of bottles aligned to breastfeeding. Features included bottles that simulated the breast, imitated breastfeeding physiology and aided combined breast and bottle feeding. Scientific evidence to support the bottle features was scarce, misleading, and inadequate, with only one study deemed to be high quality. Our findings show that infant feeding bottles are being marketed as equivalent to breastfeeding; however, the scientific evidence used to support features of these bottles is almost non-existent. Research on the impact of the marketing of bottles on breastfeeding and more effective controls of bottle company advertising are needed.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70008"},"PeriodicalIF":2.8,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valeria Aureoles-García, Mishel Unar-Munguía, Andrea Santos-Guzmán, Lizbeth Tolentino-Mayo, Rafael Pérez-Escamilla
{"title":"Digital Marketing Claims and Their Association With the Perceptions of Parents of Children Under 2 Years Old of Commercial Milk Formulas in Mexico.","authors":"Valeria Aureoles-García, Mishel Unar-Munguía, Andrea Santos-Guzmán, Lizbeth Tolentino-Mayo, Rafael Pérez-Escamilla","doi":"10.1111/mcn.70001","DOIUrl":"https://doi.org/10.1111/mcn.70001","url":null,"abstract":"<p><p>We analysed digital marketing claims for commercial milk formula (CMF) and their association with parents' perceptions of the health and nutrition benefits of this industrialised product. The study sample consisted of 1074 parents ≥ 18 years old with internet access, with children < 2 years old, living in Mexico, who responded to an online survey between December 2020 and January 2021. The most frequent health-related, nutrition, technical, and emotional claims on websites and social media of major CMF brands, online pharmacies, and supermarkets were identified and linked to parents' potential exposure. The degree of favourable perception of CMF was estimated using a Likert scale and categorised as high versus low. Adjusted logistic regressions were used to assess the association between potential exposure to CMF claims and the parents' perceptions of these products. Parents who were potentially exposed to the following CMF claims on digital media: 'No sugar added' (OR: 1.5; 95% CI: 1.14-2.0), 'Prevents diseases' (OR: 1.4; 95% CI: 1.04-1.88), and 'Information related to COVID-19' (OR: 2.1; 95% CI: 1.57-2.74) were more likely to have a positive perception of CMF compared to those not exposed to these claims. In conclusion, parents' potential exposure to health-related and nutrition claims from leading CMF brands on websites and social media in Mexico was associated with a favourable perception of these products. The results support the World Health Assembly resolutions not to allow nutrition and health claims for CMFs, as they can be used to promote these products as equivalent or superior to breastfeeding. Action is needed to ensure that prohibition of CMF claims applies to digital media, as recommended by recent global guidelines.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70001"},"PeriodicalIF":2.8,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tina G Sanghvi, Sandra Remancus, Edward A Frongillo, Rafael Perez-Escamilla, Chessa Lutter, Pooja Pandey Rana, Victor Ogbodo, Tuan Nguyen, Roger Mathisen
{"title":"Evidence-Based Lessons From Two Decades of Implementation Research on Complementary Feeding Programmes.","authors":"Tina G Sanghvi, Sandra Remancus, Edward A Frongillo, Rafael Perez-Escamilla, Chessa Lutter, Pooja Pandey Rana, Victor Ogbodo, Tuan Nguyen, Roger Mathisen","doi":"10.1111/mcn.13811","DOIUrl":"https://doi.org/10.1111/mcn.13811","url":null,"abstract":"<p><p>Child nutrition has serious long-term development implications. Evidence-based frameworks and models are urgently needed to reduce deficits in infants and young children's diets on a large scale. Our paper reviews 32 publications and five impact evaluations of programmes in Bangladesh, Ethiopia, Nepal, Nigeria and Vietnam to identify what worked and why; the quality of evidence, diversity of countries and multi-level interventions on a large scale were selection criteria. Key lessons are: the need for advocacy to prioritize complementary feeding; engagement of multiple stakeholders to reach national scale and to address diverse factors such as food access, harmful marketing of unhealthy foods and beverages, knowledge gaps, social norms and maternal self-efficacy. Applying a behavioural science lens, monitoring intervention coverage, targeting to reduce inequalities, engaging community leaders, motivating frontline workers and leveraging mass media to reach multiple audiences worked synergistically to produce impacts at scale. Despite different contexts and dietary diversity levels at baseline, rigorous evaluations documented substantial improvements attributable to the interventions in all five countries. The expenditures incurred varied by programme complexity and showed that they are manageable if the interventions focus on priority issues, are streamlined to fit existing platforms and reach large populations. With evidence of impact in diverse contexts, an evidence-based conceptual framework and tools for implementation, insights into how to adapt to country contexts and knowledge of what to budget, decision-makers can invest confidently in improving complementary feeding programmes.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e13811"},"PeriodicalIF":2.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jenny Jonsdottir, Birna Thorisdottir, Kristjana Einarsdottir, Inga Thorsdottir
{"title":"An Infant Diet Score Based on Health Records Is Associated With BMI: A Nationwide Mother-Child Cohort Study in Iceland (ICE-MCH).","authors":"Jenny Jonsdottir, Birna Thorisdottir, Kristjana Einarsdottir, Inga Thorsdottir","doi":"10.1111/mcn.70010","DOIUrl":"https://doi.org/10.1111/mcn.70010","url":null,"abstract":"<p><p>Nationwide health records provide innovative research opportunities. The aim of this study was to describe infant feeding in the first year of life amongst all infants in Iceland born January 2009 to June 2015 (N = 30,623), explore the feasibility of creating a composite infant diet score (IDS) for the period 0-12 months in a subset of infants with complete records from routine nutrition monitoring (n = 12,848), and examine its associations with BMI-for-age z-score (BMIz) at 12 and 18 months, maternal and birth characteristics. Recorded dietary variables included breastfeeding (> 90% at 2-3 weeks); exclusive breastfeeding (13% at 6 months); introduction of cow's milk (26% at 12 months); introduction of porridges, fruit/vegetables, meat, and fish (> 50% received ≥ one of those at 5 months); vitamin D supplements (95% at 12 months). The newly constructed IDS consisted of: duration of (i) exclusive and (ii) any breastfeeding; age of (iii) cow's milk and (iv) semi-solids/solids introduction; (v) an estimate of food variety; (vi) vitamin D supplement use. We used multiple linear and logistic regression adjusted for relevant factors to examine associations between infant feeding, birth and maternal factors, and BMIz > +2 (WHO Growth Standards, indicative of overweight/obesity). Compared with IDS quintile 5 (alignment with nutrition recommendations) IDS quintiles 1 and 2 had higher odds of overweight/obesity, at 12 months (aOR: 1.80; 95% CI: 1.20-2.74; aOR: 1.73; 95% CI: 1.16-2.64) and 18 months (aOR: 1.46; 95% CI: 1.04-2.04; aOR: 1.69; 95% CI: 1.22-2.34). Our novel IDS was associated with overweight/obesity and maternal and birth characteristics, supporting its value as a measure of infant nutrition quality.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70010"},"PeriodicalIF":2.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Busert-Sebela, Mario Cortina-Borja, Vikas Paudel, Delanjathan Devakumar, Jonathan C K Wells, Dharma S Manandhar, Naomi M Saville
{"title":"Determinants of Infant Growth in a Birth Cohort in the Nepal Plains.","authors":"Laura Busert-Sebela, Mario Cortina-Borja, Vikas Paudel, Delanjathan Devakumar, Jonathan C K Wells, Dharma S Manandhar, Naomi M Saville","doi":"10.1111/mcn.70004","DOIUrl":"https://doi.org/10.1111/mcn.70004","url":null,"abstract":"<p><p>This study aimed to identify the determinants of infant growth in terms of length-for-age z-score (LAZ) in a birth cohort (n = 602) in the plains of Nepal. Children were enrolled within 72 h of birth and followed-up every 28 days until they were 2 years. We fitted mixed-effects linear regression models controlling for multiple measurements within individuals to examine the impact of household and maternal factors, feeding practices and infection on infant LAZ. We conducted separate analyses for the age periods 0-6 months (exclusive breastfeeding period) and 7-24 months (complementary feeding period) to check whether the importance of determinants differed by child age. Maternal factors related to both the environment in-utero and in postnatal life were the most important determinants of infant growth. The overall most important determinant of growth was low birthweight. At birth, babies born with low birthweight had a -1.21 (-1.38, -1.05) lower LAZ compared to normal birthweight babies. The difference in LAZ between low birthweight and normal birthweight babies attenuated with age but low birthweight remained the factor with the largest effect size. The second largest factor was maternal education. Infants of mothers with any level of education had a 0.22 (0.07, 0.38) higher LAZ in the 7-24 months age-period than those whose mothers had never been to school. Other relevant determinants were adolescent pregnancy, minimum dietary diversity, symptoms of respiratory infection, household food insecurity, season and maternal absence. The importance of maternal factors for infant growth calls for public health interventions targeting girls and young women.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70004"},"PeriodicalIF":2.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Why Animal-Source Foods Are not Consumed by Women and Children in the Amhara Region: A Qualitative Study.","authors":"Netsanet Fentahun, Valerie Flax, Yeshalem Mulugeta","doi":"10.1111/mcn.70006","DOIUrl":"https://doi.org/10.1111/mcn.70006","url":null,"abstract":"<p><p>This study aimed to understand the barriers and facilitators of animal source food (ASF) consumption among women and children in Wag Himra, South Gondar, and Central Gondar zones of Amhara Region, Ethiopia. Women and men with children under 2 years, grandmothers, community and religious leaders, and midwives and health workers were included. Thirty separate focus group discussions and 35 key informant interviews were conducted from July to August 2022. To ensure the quality of qualitative research findings, the criteria of trustworthiness were maintained by the following: credibility, transferability, dependability, and conformability. Qualitative thematic analysis was carried out using Qualitative Data Analysis Miner. Barriers to children's ASF consumption were poverty, age of the child, illness, high cost of ASFs, loss of parents, divorcee, and a lack of livestock. For pregnant and lactating women, the main barriers to ASF consumption were lack of animals in the household, financial constraints, illness, fear of having a big baby, religious fasting, and morning sickness. Family affluence, the availability of ASFs in the household, liking the taste of ASFs, and receiving nutrition education on ASFs were facilitators for children and pregnant and lactating women to consume ASFs. Barriers to ASF consumption in Amhara Region include factors related to livelihoods and social norms or beliefs. Programmes could offer a combination of livelihood supports and social and behaviour change communication to increase ASF consumption by women and children.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70006"},"PeriodicalIF":2.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wan Ching Ng, Karene Hoi Ting Yeung, Lai Ling Hui, Ka Ming Chow, Esther Yuet Ying Lau, E Anthony S Nelson
{"title":"A Content Analysis of Digital Marketing Strategies of Formula Companies and Influencers to Promote Commercial Milk Formula in Hong Kong.","authors":"Wan Ching Ng, Karene Hoi Ting Yeung, Lai Ling Hui, Ka Ming Chow, Esther Yuet Ying Lau, E Anthony S Nelson","doi":"10.1111/mcn.70007","DOIUrl":"https://doi.org/10.1111/mcn.70007","url":null,"abstract":"<p><p>This study examines the compliance of the digital marketing strategies used by formula companies and social media influencers in promoting commercial milk formula (CMF) for infants and young children with the International Code of Marketing of Breast-milk Substitutes (International Code) and the Hong Kong Code of Marketing of Formula Milk and Related Products, and Food Products for Infants & Young Children (HK Code). Content analyses on influencers' posts, websites and social media sites of five major formula companies were conducted to identify the digital marketing strategies used, evidence of product cross-promotion, and compliance with the International and HK Codes. Statistical analyses were performed to assess the associations between marketing strategies and social media interactions (likes/comments/shares). The findings revealed widespread noncompliance to the two codes by both influencers and formula companies. Of 1036 influencer (n = 493) and formula company (n = 543) materials mentioned products covered by the Codes, all influencer materials and 95% of company materials violated at least two provisions of the Codes. Persistent brand promotion and cross-promotion strategies were observed in CMF marketing in Hong Kong, with tactics such as parents' sharing, showing images of happy children and families, and celebrity endorsements leading to higher social media interactions. The extensive CMF promotion by influencers and the covert cross-promotion and brand promotion are of particular concern given the lack of regulation in this area. The study calls for a comprehensive review and introduction of legalisation in Hong Kong to govern CMF marketing, ensuring enforcement as outlined in the Convention on the Rights of the Child.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70007"},"PeriodicalIF":2.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hannah Gardner, Atma Prakash, Shweta Rawal, Said M Yaqoob Azimi, William Joe, Zivai Murira, Vani Sethi
{"title":"Factors Associated With Complementary Feeding Practices in Afghanistan: Analysis of the Multiple Indicator Cluster Survey 2022-2023.","authors":"Hannah Gardner, Atma Prakash, Shweta Rawal, Said M Yaqoob Azimi, William Joe, Zivai Murira, Vani Sethi","doi":"10.1111/mcn.70003","DOIUrl":"https://doi.org/10.1111/mcn.70003","url":null,"abstract":"<p><p>Children between the ages of 6 and 23 months require the age-appropriate introduction of complementary foods alongside breastfeeding to meet their nutritional needs, but in humanitarian settings children frequently do not receive appropriate diets. Using data from 9193 children aged 6-23 months in the Afghanistan Multiple Indicator Cluster Survey 2022-2023, this paper provides nationally representative estimates of the percentage of children meeting key IYCF indicators and assesses the child, maternal and household determinants of receiving minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD) using multivariable logistic regression. Results showed that 85%, 65% and 93% of children were not fed a diet that met MDD, MMF or MAD criteria, respectively. Older children (18-23 months) had significantly higher odds of meeting all three criteria compared to younger children (6-11 months) (MDD aOR = 2.46, 95% CI: 1.93-3.12; MMF aOR = 1.29, 95% CI: 1.11-1.50; MAD aOR = 2.00, 95% CI: 1.51-2.65), as did children from the richest households (vs. poorest) (MDD aOR = 2.85, 95% CI: 1.72-4.70; MMF aOR = 1.82, 95% CI: 1.35-2.46; MAD aOR = 3.88, 95% CI: 2.14-7.04). There was substantial variation in the odds of all outcomes by region. Rural residence (vs. urban) was also associated with higher odds of receiving MMF (aOR = 1.60, 95% CI: 1.25-2.05) and MAD (aOR = 1.69, 95% CI: 1.18-2.42) but not MDD. Overall, alarmingly few children in Afghanistan are receiving appropriate complementary diets amidst a context of concurrent political, economic and environmental crises. Reversals to funding reductions are vital to ensure proven interventions responding to the determinants identified here continue to be delivered to support nutrition among Afghanistan's infants and young children.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70003"},"PeriodicalIF":2.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Engaging South Asian Communities in the United Kingdom to Explore Infant Feeding Practices and Inform Intervention Development: Application of the REPLACE Approach.","authors":"Kayleigh Kwah, Maxine Sharps, Naomi Bartle, Kubra Choudhry, Jacqueline Blissett, Katherine Brown","doi":"10.1111/mcn.70009","DOIUrl":"https://doi.org/10.1111/mcn.70009","url":null,"abstract":"<p><p>Breastfeeding in UK Pakistani and Bangladeshi communities is positively and negatively influenced by cultural beliefs and practices. The LIFT (Learning about Infant Feeding Together) project aimed to understand the determinants of infant feeding in these target communities and to engage them in the development of a culturally specific and acceptable infant feeding intervention to support breastfeeding. Reported here is phase one of the LIFT project guided by the REPLACE approach (a framework for the development of community-based interventions). The project involved an initial lengthy period of engagement with the target communities, using methods such as a community outreach event and identification of community peer group champions to help build trust. This was followed by iterative community workshops used to explore and build an understanding of infant feeding practices and the social norms and beliefs underlying these, and to assess community readiness to change. Consistent with previous research, the six key practices and beliefs identified from the workshops were: (1) Disparities between personal views versus cultural and normative barriers, (2) Family relationships and the influence on infant feeding decisions, (3) Pardah (modesty) and being unable to breastfeed in front of others, (4) Discarding colostrum (first breast milk), (5) Pre-lacteal feeds (feeds within a few hours of birth and before any breast or formula milk has been given) and complementary feeding before the baby is 6 months old, and (6) The belief that bigger babies are better and that formula helps babies to grow. Participants perceived that Pakistani and Bangladeshi communities would be amenable to intervention that aimed to change some but not all of the infant feeding behaviours identified. Findings informed the co-development of a culturally appropriate intervention toolkit to optimise infant feeding behaviour.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70009"},"PeriodicalIF":2.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Time to Recovery From Severe Acute Malnutrition to Normal Nutritional Status and Its Predictors Among Children Aged 6-59 Months in North-East Ethiopia.","authors":"Temesgen Gebeyehu Wondmeneh, Amarech Giruma","doi":"10.1111/mcn.13808","DOIUrl":"https://doi.org/10.1111/mcn.13808","url":null,"abstract":"<p><p>Malnutrition is a major disease burden in developing countries, particularly in recurrently drought-affected areas. Despite the Ethiopian government's initiatives to set up stabilization centers in different hospitals to tackle severe acute malnutrition, there is limited data on the time to recover from severe acute malnutrition and its determinants among under-five children in northeast Ethiopia. The objective of the study is to determine time to recovery of under-five children from severe acute malnutrition to normal nutritional status and its predictors in northeast Ethiopia. A facility-based retrospective record review was carried out from March 1-20, 2023. The tools for the data extraction format were adapted from the national guidelines for the management protocol for severe acute malnutrition. The Kaplan-Meier survival curve was used to compare different categorical variables. The time-varying covariate Cox-proportional hazards regression model was fitted due to the violation of the Cox proportional hazard assumption (p = 0.007). A p-value < 0.05 was a cutoff point to declare statistical significance. In the final analysis, a total of 372 children aged 6-59 months with severe acute malnutrition were included, 58.1% of whom were recovered. The incidence rate of recovery from severe acute malnutrition was 4.43 per 100 child days. Children living in rural areas (AHR = 0.7, 95% CI: 0.5-0.94) and those without F-100 supplement (AHR = 0.85, 95% CI: 0.79-0.91) had a lower recovery rate from severe acute malnutrition. Children lacking IV antibiotics (AHR = 1.4, 95% CI: 1.03-2.0) and those HIV-free (AHR = 1.76, 95% CI: 1.1-3.3) were more likely to recover from severe acute malnutrition. The percentage of recovery in the study area was found to be lower than the sphere standard. F-100 supplements should be mandatory to improve and speed up the recovery rate. Special attention should be given to children from rural areas, those receiving IV antibiotics, and those living with HIV/AIDS.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e13808"},"PeriodicalIF":2.8,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}