Infant and young child feeding practices and nutritional status in urban and rural area of South Kivu, Democratic Republic of Congo: a descriptive study

Background and objectives: The optimal infant and young child feeding practices (IYCF) are crucial to improving children's health and nutritional status. In the Democratic Republic of the Congo (DRC), 43% of preschool children were stunted (Demographic Health Survey 2019). This study aimed at assessing the feeding practices and nutritional status of children aged 6-23 months from two areas, Kadutu (urban) and Miti-Murhesa (rural), in South Kivu, eastern DRC. Method: A descriptive cross-sectional study conducted from August to September 2021 on randomly selected 530 children aged 6 to 23 months and their mothers in Kadutu and Miti-Murhesa. Socio-demographic characteristics were collected and IYCF practices were assessed using 24-hour recall. Nutritional status was determined according to the World Health Organization 2006 standards. Results: Median (IQR) age was 13 months (9-17, n=522) and sex ratio 1.05. Overall, 97.1% of children were ever breastfed between 0-24 months and 85.4% within the first hour of birth. However, only 60.6% of children were exclusively breastfed to 6 months. The median age of introduction of liquid, semi-solid, solid complementary food was 4, 6 and 8 months respectively. The median age for weaning was 12 months. Overall, 68.8%, 10.8%, 8.7%, 12.9% of children, received water, sugar water, tea+soy, tea+milk respectively, in addition to breastfeeding the day before the survey (n=388). In both areas, complementary feeding was poor in food of animal origin, fruits and vegetables. Most children (88.5%) consumed porridge consisting only of grain, roots, tubers (sorghum, soybeans, plantains and maize) and water. Among these children, only 42% met minimum dietary diversity, 19% a minimum meal frequency and 10% reached a minimum acceptable diet. Stunting and wasting affected 36.6% and 4.9% respectively, without any difference between urban (38.6% and 3.7%) and rural areas (34.2% and 6.6%). Conclusion: Majority of mothers breastfeed, however many introduce complementary food very early in their child's life. The diversity of complementary foods in the study area was found to be sub-optimal and could explain at least partly this high prevalence of stunting. Upgrading nutritional composition of the cereals complementary foods should be of highest priority for improving the young child nutrition.