Tendência temporal dos indicadores da alimentação infantil e sua associação com fatores sociodemográficos entre crianças de 6 a 23 meses de idade em países da América Latina e do Caribe nas décadas de 2000 e 2010

Abstract

Introduction: Infant and young child feeding indicators were primarily developed to monitor progress toward established targets and to assess the impact of public policies on infant and young child nutrition. Objectives: To analyze temporal trends in infant and young child feeding indicators during the 2000s and 2010s and to examine their association with sociodemographic factors among children aged 6–23 months living in Latin America and the Caribbean in the 2010s. Methods: This cross-sectional study used data from the Demographic and Health Surveys (DHS), Multiple Indicator Cluster Surveys (MICS), and the Brazilian National Survey on Child Nutrition (ENANI), conducted during the 2000s and 2010s among children aged 6–23 months living in Latin American and Caribbean countries. To describe the prevalence of infant and young child feeding practices across the two decades, indicators proposed by the World Health Organization (WHO, 2021) were used: continued breastfeeding (CBF); introduction of solid, semi-solid, or soft foods (ISSSF); minimum dietary diversity (MDD); minimum meal frequency (MMF); consumption of eggs and/or flesh foods (EFF); and zero consumption of fruits or vegetables (ZFV). The sociodemographic variables analyzed included child sex and age; maternal age and education; marital status; number of children; household wealth index; and area of residence. Temporal trends were assessed using prevalence estimates and 95% confidence intervals (95% CI) by country and survey year. Associations between sociodemographic factors and feeding indicators were examined using multilevel logistic regression models, with calculation of the intraclass correlation coefficient (ICC). Results were expressed as odds ratio (OR) and 95% CI. Results: Continued breastfeeding showed a declining trend in Haiti, Honduras, and the Dominican Republic, with reductions ranging from −9.2 to −35.2 percentage points. The prevalence of ISSSF exceeded 80% in the most recent surveys, with increases observed in Haiti and Peru. Both MDD and MMF increased in Peru (+6.5 percentage points) and the Dominican Republic (+29.5 percentage points). The EFF indicator increased in Honduras, Peru, and the Dominican Republic, reaching prevalences above 80%, while ZFV decreased in Peru and the Dominican Republic. Older children had lower odds of continued breastfeeding (OR=0.15; 95% CI=0.12–0.19) and higher odds of meeting ISSSF (OR=2.71; 95% CI=2.01–3.64), MDD (OR=1.66; 95% CI=1.23–2.24), MMF (OR=2.71; 95% CI=2.01–3.64), and EFF (OR=2.41; 95% CI=1.97–2.94), as well as lower odds of ZFV (OR=0.70; 95% CI=0.59–0.83). Older mothers had higher odds of meeting CBF (OR=2.29; 95% CI=1.60–3.27), ISSSF (OR=2.01; 95% CI=1.02–3.97), MDD (OR=3.19; 95% CI=1.40–6.90), and MMF (OR=5.10; 95% CI=2.89–8.98), and lower odds of ZFV (OR=0.49; 95% CI=0.36–0.48). Mothers with higher education had lower odds of continued breastfeeding (OR=0.53; 95% CI=0.37–0.76) and higher odds of meeting the EFF and ZFV indicators. A higher number of children and rural residence were associated with lower odds of meeting ISSSF, MMF, EFF, and ZFV. The proportion of variance in feeding indicators explained by the contextual level ranged from 19% for ZFV to 55% for MDD. Conclusion: Continued breastfeeding showed a declining trend between the 2000s and 2010s; however, an overall improvement was observed in other infant and young child feeding indicators. Children older than 12 months and those whose mothers were older and more educated had higher odds of meeting infant and young child feeding recommendations. In contrast, children living in rural areas and those whose mothers had a higher number of children were less likely to meet these indicators.