Feeding Practices in Children with Severe Acute Malnutrition Presenting to MTI-Lady Reading Hospital, Peshawar

Abstract

Background: Severe acute malnutrition (SAM) in infancy is a leading cause of morbidity and mortality in low-resource settings. Inappropriate feeding practices, including early cessation of breastfeeding and reliance on unsafe alternatives, are significant contributors to SAM, yet patterns  and  determinants  of  feeding  behaviors  vary  across  regions  and  populations. Understanding these practices within their sociodemographic context is essential for effective intervention design.

Objective: To determine the frequency and patterns of infant feeding practices  and  their  association  with  sociodemographic  factors  among  children  aged  1–12 months diagnosed with severe acute malnutrition at MTI–Lady Reading Hospital, Peshawar.

Methods: A cross-sectional study was conducted from September 2024 to March 2025 among 159 infants meeting WHO criteria for SAM. Data on feeding practices (breastfeeding, bottle feeding, top feeds) and maternal sociodemographic variables were collected using structured interviews and clinical assessments. Associations were analyzed using chi-square tests and logistic  regression  to  calculate  odds  ratios  with  95%  confidence  intervals. 

Results: Breastfeeding was reported in 59.7% of infants, while 28.3% received bottle feeds and 27.7% received  top  feeds.  Breastfeeding  was  significantly  more  common  in  rural,  lower socioeconomic groups and among unemployed or illiterate mothers. Bottle and top feeding were significantly associated with increased prevalence of SAM indicators (p<0.01), with odds ratios  of  1.71  and  2.85,  respectively,  compared  to  breastfed  infants. 

Conclusion:  Feeding practices in infants with SAM are strongly influenced by maternal education, employment, and residence.  The  transition  away  from  breastfeeding,  particularly  in  urban  and  literate populations,  is  associated  with  increased  risk  of  SAM,  highlighting the  need  for  targeted support and education during weaning.