Complementary feeding practices and dietary intakes from complementary foods amongst weanlings in rural Malawi

Objective: The objectives of this study were to estimate the quantity and n utritive quality of the complementary diet in rural Malawi, and to identify feeding practices, nutrients and dietary modifiers of iron and zinc bioava ilability that may limit the quality of the diet. Design: This cross-sectional study design included an anthropometric survey , a feeding practices questionnaire, and an interactive, 24 h recall dietar y data survey. Setting: Four rural villages in Balaka district, southern Malawi. Subjects: Mothers resident in the study communities with breastfed children aged up to 24 months were eligible. Results: Stunting was prevalent among these weanlings. Maize was the predom inant food source, with limited contribution of animal foods. Deficits in d ietary energy and several nutrients were found when compared to estimated n eeds. When expressed per kg body weight, energy intakes appeared adequate. The bioavailability of zinc was low due to a high phytate:zinc molar ratio. Iron bioavailability was also low due to low intake of absorption enhancer s such as meat/fish/poultry protein and ascorbic acid. Dietary quality was poorest for 6 to 8-month-old infants. Conclusions: Iron, zinc and calcium were the most limiting nutrients to the quality of the diet, partly exacerbated by the poor bioavailability of iro n and zinc. Increased total intake and bioavailability of iron and zinc wou ld improve the complementary diets.