Feeding patterns and dietary diversity practices of caregivers with children (0 to 24 months) admitted with acute malnutrition in hospitals in Mpumalanga province, South Africa

Malnutrition is a global public health problem more prominent among infants under five years of age, and South Africa is no exception. Caregivers’ poor infant feeding practices, including lower exclusive breastfeeding rates, dietary diversity, and meal frequency, are the main causes of malnutrition during the first two years of life. Improving mother practices on infant and young children is crucial for growth and development and prevention of malnutrition. This study aimed to assess feeding patterns and dietary diversity practices of caregivers with children admitted with malnutrition in hospitals in Bushbuckridge Sub-District, Mpumalanga Province. A quantitative study design was applied. Data were collected among 151 caregiver-child pairs using an interviewer-administered questionnaire adapted from the Food Agriculture Organization publication guidelines for assessing nutrition-related knowledge, attitudes and practices using closed-ended multiple choice questions. Descriptive and ANOVA statistics were analysed using STATA 13 statistical software. The results showed that the majority, 90.0% (n=66) of infants < 6 months, were not exclusively breastfed. Most, 34.6% (n= 27) of the children aged 6-24 months had a lower dietary diversity score (DDS) (<5) and 65.0% (n=51) consumed less than the recommended meals for age (4 times a day). Analysis of variance (ANOVA) showed that the effect of continuing breastfeeding was significant for gender [F (1, 71) = 3.90, p=.05] and the diagnosis of the child [F (1, 71) = 8.19, p = .00]. The effect of minimum feeding frequency was significant for residence areas (F (3,74) = 5.23, p =.00) and caregiver education levels [F (3, 74) =3.71, p = .01]. The findings indicated that the majority (90.0%) of mothers did not practise exclusive breastfeeding, the diet lacked diversity, and the children consumed meals less than 4 times a day as recommended for age. Therefore, there is need for targeted infant feeding nutrition interventions, such as nutrition education and promotion of breastfeeding and complementary feeding practices, which will subsequently lead to an improvement of the nutritional status of infants. Key words: exclusive breastfeeding, dietary diversity, meal frequency, acute malnutrition, complementary feeding