Effect of a nutrition education intervention on mothers´ complementary feeding practices: a longitudinal study in two sub-county hospitals in Nyeri County, Kenya.

INTRODUCTION: sub-optimal complementary feeding remains a major contributor to child undernutrition during the first 1,000 days of life in low- and middle-income countries. Nutrition education is widely promoted to improve infant and young child feeding practices, but evidence from longitudinal facility-based interventions in Kenya is limited. METHODS: a longitudinal intervention study was conducted among 451 mothers (intervention n = 220; control n = 231) of children aged 6-23 months attending two level-IV hospitals in Nyeri County, Kenya. The study sites were randomly selected using a simple randomization procedure involving an unbiased coin toss, ensuring each of the two eligible sites had an equal probability of selection. The "head" and the "tail" were assigned to the intervention and control sites, respectively. Participants meeting the inclusion criteria were then recruited from the site that was randomly assigned during their specified clinic visits. Mothers attending Karatina Sub-County Hospital received quarterly nutrition education sessions reinforced with cooking demonstrations over nine months, while those attending Othaya Sub-County Hospital received routine health education. Complementary feeding practices were assessed using World Health Organization/United Nations Children´s Fund infant and young child feeding indicators. Data were collected at baseline and at 3, 6, and 9 months. Data were collected using structured questionnaires and analyzed using the Statistical Package for Social Sciences (SPSS) v24. Proportions, percentage change, net effect of intervention, odds ratios (OR) with 95% confidence interval (CI), and Chi-square (χ2) tests were used; significance was set at P ≤ 0.05. RESULTS: at three months, the intervention group showed significantly greater improvements in egg and flesh food consumption, breastfeeding, minimum meal frequency, and minimum dietary diversity compared with the control group. The net effect of intervention for egg and flesh food consumption was +51.6% (odds ratio 6.17; 95% confidence interval 4.02-9.46; P < 0.001). Improvements in egg and flesh food consumption, breastfeeding, and minimum meal frequency were sustained at six and nine months. Reduction in zero vegetable and fruit consumption was greater in the control group at later follow-up points. CONCLUSION: a structured nutrition education intervention reinforced with cooking demonstrations improved several key complementary feeding practices over nine months. Integrating such interventions within routine maternal and child health services may contribute to improved infant and young child feeding outcomes.