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Impact of Complementary Feeding Education on Infant Feeding Practices among Mothers in Nigeria

Abstract

Appropriate complementary feeding is essential for the growth, development, and survival of infants and young children. After the period when breast milk alone is no longer sufficient to meet all nutritional requirements, infants require timely, adequate, safe, and nutritionally appropriate complementary foods alongside continued breastfeeding. In Nigeria, inappropriate complementary feeding practices, including delayed or early introduction of complementary foods, inadequate dietary diversity, insufficient meal frequency, poor food consistency, unsafe food preparation, and inadequate responsive feeding, may contribute to childhood undernutrition, micronutrient deficiencies, impaired growth, and increased susceptibility to infections. Complementary feeding education provides mothers with information about the appropriate timing of introducing complementary foods, dietary diversity, meal frequency, food consistency, portion sizes, food hygiene, responsive feeding, continued breastfeeding, locally available nutritious foods, and age-appropriate feeding practices. Infant feeding practices refer to the behaviours mothers adopt in feeding infants and young children, including timely introduction of complementary foods, dietary diversity, meal frequency, food preparation and hygiene, continued breastfeeding, and responsive feeding. In Nigeria, inadequate nutrition knowledge, household food insecurity, cultural beliefs, limited access to nutritious foods, and misconceptions about infant feeding may influence the adoption of appropriate complementary feeding practices. Effective complementary feeding education may improve mothers' knowledge and encourage appropriate infant feeding behaviours. Against this background, this study investigates the impact of complementary feeding education on infant feeding practices among mothers in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice framework. The Health Belief Model explains health-related behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding mothers' decisions regarding appropriate infant feeding. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping feeding behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from complementary feeding education may influence infant feeding practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how complementary feeding education may influence infant feeding practices among mothers in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from mothers or primary female caregivers of infants and young children in selected communities in Nigeria using a structured interviewer-administered questionnaire and an infant feeding-practice assessment tool. A multistage sampling technique will be employed to select states, local government areas, communities, households, and eligible mothers. Where feasible, selected communities or participant groups will be assigned to intervention and comparison groups. Mothers in the intervention group will receive structured complementary feeding education covering the appropriate timing of introduction of complementary foods, continued breastfeeding, dietary diversity, meal frequency, age-appropriate food consistency and portion sizes, locally available nutritious foods, food preparation and hygiene, safe storage, responsive feeding, and practical strategies for improving infant diets using affordable household foods. Infant feeding practices will be assessed using indicators such as timely introduction of complementary foods, minimum dietary diversity, appropriate meal frequency, acceptable food consistency, continued breastfeeding, food hygiene, responsive feeding, and appropriate use of locally available nutrient-rich foods. Descriptive statistics will be used to summarize mothers' sociodemographic characteristics, complementary feeding knowledge, exposure to education, and infant feeding practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the impact of complementary feeding education on infant feeding practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that complementary feeding education has a significant positive impact on infant feeding practices among mothers in Nigeria. Mothers exposed to structured complementary feeding education are expected to demonstrate improved knowledge of appropriate complementary feeding and greater adoption of recommended feeding behaviours. Education may encourage timely introduction of complementary foods, increased dietary diversity, appropriate meal frequency, continued breastfeeding, improved food hygiene, responsive feeding, and greater use of locally available nutrient-rich foods. However, education alone may not guarantee optimal feeding practices because mothers may continue to face barriers such as household food insecurity, high food prices, limited access to diverse nutritious foods, cultural beliefs, family influences, limited time, and inadequate cooking and storage facilities. Consequently, complementary feeding education is expected to be most effective when supported by improved household food security, access to affordable nutritious foods, maternal and child health services, community nutrition programmes, and appropriate social support. The study is expected to contribute to the literature on infant and young child feeding, maternal nutrition education, child nutrition, health promotion, maternal and child health, and public health in Nigeria by providing empirical evidence on the impact of complementary feeding education on infant feeding practices among mothers. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), National Agency for Food and Drug Administration and Control (NAFDAC), state ministries of health, primary healthcare facilities, nutrition programmes, community health workers, healthcare professionals, development partners, and policymakers regarding strategies for improving infant feeding practices. The study will also provide evidence-based recommendations for strengthening community-based complementary feeding education, promoting dietary diversity, improving access to affordable nutritious foods, strengthening maternal and child health services, addressing harmful feeding misconceptions, and promoting appropriate infant feeding practices among mothers across Nigeria.

Keywords: Complementary feeding education, infant feeding practices, mothers, infant nutrition, dietary diversity, meal frequency, child nutrition, maternal and child health, breastfeeding, responsive feeding, nutrition education, public health, Nigeria.