Factors associated with infants’ and young children’s (6–23 months) dietary diversity in Pakistan: evidence from the demographic and health survey 2012–13

BACKGROUND Optimum nutrition and good feeding practices amongst infants and young children are the key determinants of growth for a healthy life. Dietary diversity is considered to be a reliable and easy-to-measure proxy variable to assess young children's feeding practices for dietary adequacy and nutritional intake. This research aims to examine the current practices of dietary diversity amongst infants and young children aged 6-23 months in Pakistan and the various associated factors at child, maternal, household and community levels. METHODS Secondary data analysis was performed for this research using the nationally representative dataset of the Pakistan Demographic and Health Survey 2012-13. Data on the last-born infants and young children aged 6-23 months (n = 1102) was taken from their mothers' interviews, who reported on their child's consumption of 7 food groups during the 24 h immediately preceding the survey. Data was analysed, using IBM® SPSS® Complex Sample to measure the association between children's dietary diversity and various factors at child, maternal, household and community levels through multiple linear regressions. RESULTS Our research uncovered positive associations between children's dietary diversity and other sociodemographic variables. Overall, a variation was observed in consumption of 7 food groups across the youngest, middle and oldest age-groups of children. Multivariate analysis revealed that the children's Dietary Diversity Score (scale from 0 to 7) increases to 0.56 (95% CI: 0.18-0.94) amongst children in the middle age-group (12-17 months). Furthermore, the children who were still breastfeeding, with mothers who had a primary level of schooling and whose mothers also received information/services from lady health workers (LHWs) on maternal and child health were found to be a statistically significant predictor of infants' and young children's dietary diversity. Nevertheless, amongst them, the DDS had a negative association with the children's status of still breastfeeding and mothers' primary level of schooling, whereas it had a positive association with children being in the middle age-group and with mothers who received information/services from LHWs. CONCLUSION The dietary diversity of infants and young children aged 6-23 months has a modest, nevertheless statistically significant, relationship with sociodemographic characteristics in Pakistan. There is a need for practical efforts to change the behaviour of communities to encourage more diverse foods to promote the healthy growth of children.