Association of Novel Complementary Feeding Indicators with Length-for-Age Z-Scores in Rural Malawi

BackgroundInadequate complementary feeding (CF) from 6–24 months contributes to growth failure in many low income settings. However, recommended indicators of CF are inconsistently associated with length-for-age z-scores (LAZ). ObjectiveTo assess the relationship between novel indicators of CF, including consistency and meal volume, with LAZ in rural Malawi. Methods1,331 households with a child aged 6 to 17 months were sampled from 53 communities in Mchinji district, Malawi using a single stage cluster sampling approach based on caregivers’ participation in community women’s groups. Data were collected on household sociodemographics, CF practices, and child anthropometry using WHO recommended methods. To assess food consistency, caregivers selected from a series of photographs that which most closely resembled their child’s food. Caregivers estimated meal volume using uncooked rice which was then measured; meal volume was then classified as either below or above the age-specific median for the following a...