Knowledge, attitudes, and practices regarding complementary feeding among mothers of infants aged 9-12 months attending well-baby clinics in tertiary care hospitals in the Kandy district, and their correlation with growth

Introduction: Transitioning from breastfeeding to family diet is considered complementary feeding (CF). Introduction of nutritious complementary foods along with appropriate CF practices supports a child’s physical and cognitive development.
Objectives: To assess mothers’ knowledge, attitudes, and practices (KAP) regarding CF and their correlation with infants’ growth rates, and to determine the association between factors influencing CF (maternal educational level, monthly family income and parity) and infant growth.
Method: This is an analytical cross-sectional study conducted from August to December 2024 in tertiary care hospitals in Kandy, Sri Lanka. Data were collected through self-administered questionnaires distributed among 246 mothers of infants attending well-baby/immunization clinics. Statistical analysis used SPSS version 26.
Results: Mothers’ mean scores for KAP regarding CF were 78.8±19.20, 87.23±11.3 and 89.3±11.10 respectively. Maternal knowledge (p=0.003), attitudes (p<0.001), practices (p<0.001) and total KAP score (p<0.001) strongly correlated with infants’ normal weight achievement. CF was introduced at 6 months for 222 (90.2%) infants. More than 80% of infants in all age groups consumed foods of animal origin daily, 82% was not introduced to sugar and 77.6% was not introduced to salt during CF. Association of maternal age to practice (p<0.05) and attitudes (p<0.05) was significant, and infants’ birth weight significantly affected mothers’ knowledge (p=0.008) and practice (p=0.001). More than 80% infants in all age groups received Minimum Dietary Diversity (MDD). Maternal knowledge (p=0.009), attitudes (p<0.001), and practice (p<0.001) significantly correlated with MDD.
Conclusions: Mothers of infants in the study population had satisfactory KAP regarding CF, irrespective of their educational level and socio-economic background. Infants’ growth rate strongly correlated with mothers' KAP regarding CF. Most mothers adhered to World Health Organization CF guidelines and used trusted sources to gain knowledge regarding CF.