Feeding Practices in Children with Severe Acute Malnutrition Presenting to MTI-Lady Reading Hospital, Peshawar

Abstract

Background: Severe acute malnutrition (SAM) in infancy is a leading cause of morbidity and mortality in low-resource settings. Inappropriate feeding practices, including early cessation of breastfeeding and reliance on unsafe alternatives, are significant contributors to SAM, yet patterns and determinants of feeding behaviors vary across regions and populations. Understanding these practices within their sociodemographic context is essential for effective intervention design. Objective: To determine the frequency and patterns of infant feeding practices and their association with sociodemographic factors among children aged 1–12 months diagnosed with severe acute malnutrition at MTI–Lady Reading Hospital, Peshawar. Methods: A cross-sectional study was conducted from September 2024 to March 2025 among 159 infants meeting WHO criteria for SAM. Data on feeding practices (breastfeeding, bottle feeding, top feeds) and maternal sociodemographic variables were collected using structured interviews and clinical assessments. Associations were analyzed using chi-square tests and logistic regression to calculate odds ratios with 95% confidence intervals. Results: Breastfeeding was reported in 59.7% of infants, while 28.3% received bottle feeds and 27.7% received top feeds. Breastfeeding was significantly more common in rural, lower socioeconomic groups and among unemployed or illiterate mothers. Bottle and top feeding were significantly associated with increased prevalence of SAM indicators (p<0.01), with odds ratios of 1.71 and 2.85, respectively, compared to breastfed infants. Conclusion: Feeding practices in infants with SAM are strongly influenced by maternal education, employment, and residence. The transition away from breastfeeding, particularly in urban and literate populations, is associated with increased risk of SAM, highlighting the need for targeted support and education during weaning.