Appropriate feeding practices are protective against malnutrition and poor growth. We compared feeding practices and growth in HIV-exposed-uninfected (HEU) and HIV-unexposed-uninfected (HUU) between 6-12 months of age in urbanized African infants in South Africa. A repeated cross-sectional analysis was used to determine differences in infant feeding practices and anthropometric measures by HIV exposure status at 6, 9, and 12 months in the Siyakhula study. The study included 181 infants (86 HEU; 95 HUU). Breastfeeding rates were lower in HEU vs. HUU infants at 9 (35.6% vs. 57.3%; p = 0.013) and 12 months (24.7% vs. 48.0%; p = 0.005). Introduction to early complementary foods was common (HEU = 16.2 ± 11.0 vs. HUU = 12.8 ± 9.3 weeks; p = 0.118). Lower weight-for-age Z-scores (WAZ) and head circumference-for-age Z-scores (HCZ) were found in HEU infants at birth. At 6 months, WAZ, length-for-age Z-scores (LAZ), HCZ, and mid-upper-arm circumference-for-age Z-scores (MUACAZ) were lower in HEU vs. HUU infants. At 9 months, lower WAZ, LAZ, and MUACAZ were found in HEU vs. HUU infants. At 12 months, lower WAZ, MUACAZ, and weight-for-length Z-scores (−0.2 ± 1.2 vs. 0.2 ± 1.2; p = 0.020) were observed. HEU infants had lower rates of breastfeeding and poorer growth compared to HUU infants. Maternal HIV exposure affects the feeding practices and growth of infants.

Factors affecting the growth of HIV‐exposed‐uninfected (HEU) children are multi‐factorial, with limited information available on the dietary intake from 6 months. This study compared the dietary intake, micronutrient composition of breastmilk, and growth of HEU and HIV‐unexposed‐uninfected (HUU) infants aged 6 and 12 months in an urban setting. A repeated cross‐sectional study used structured questionnaires to collect socio‐demographic, dietary intake, food group data, and anthropometric measurements in the Siyakhula study. The HEU (48%) and HUU (52%) infants were included (total n = 181). At 6 months, HEU infants had lower weight‐for‐age z‐scores (WAZ) (−0.6 ± 1.1 vs. 0.1 ± 1.2; p < 0.001), length‐for‐age z‐scores (−0.8 ± 1.4 vs. −0.1 ± 1.2; p < 0.001), and mid‐upper‐arm circumference‐for‐age z‐scores (MUACAZ) (0.5 ± 1.1 vs. 1.0 ± 0.9; p < 0.001) than HUU infants. At 12 months, HEU infants had lower WAZ, MUACAZ, and weight‐for‐length z‐scores compared to HUU infants (p < 0.05). Stunting was found at 6 (15%) and 12 (12%) months in HEU infants. The micronutrient composition of breastmilk fed to both groups was similar. Breastfeeding rates were lower in HEU than in HUU infants at 6 (49% vs. 64%; p = 0.005) and 12 (24% vs. 46%; p = 0.002) months. Less than 3% of HEU and HUU infants achieved minimal dietary diversity scores at 12 months. Dietary intake of fat was similar in all breastfed infants, but iron and vitamin B12 were higher in non‐breastfed HEU infants at 12 months. HEU infants had lower breastfeeding rates than HUU infants. A lack of dietary diversity was found in all infants. Nutrition education and counselling in the complementary feeding phase are essential for optimal growth.

Background/Objectives: Undernutrition remains an important contributor to morbidity and mortality among children under five years of age, particularly in rural and low-resource settings. This study determined the proportion of children with documented readmission for undernutrition and identified associated factors at Bela-Bela District Hospital, Limpopo Province, South Africa. Methods: A retrospective analytical hospital record review covering January 2018 to December 2025 was conducted. Of 538 medical records identified, 94 were excluded, 444 remained eligible, and 222 were selected through systematic random sampling. Clinical, caregiver/household conditions, healthcare-related and post-discharge data were extracted. The primary outcome was documented readmission for undernutrition at Bela-Bela District Hospital following discharge. Multivariable logistic regression was used to identify independently associated factors. Results: Of 222 children, 54 (24.3%) had documented readmission. Previous admission for undernutrition was strongly associated with documented readmission (AOR = 4.12; 95% CI: 2.00–8.50; p < 0.001). Lack of documented caregiver nutrition education (AOR = 3.10; 95% CI: 1.40–6.90; p = 0.005), absence of a documented follow-up date (AOR = 2.20; 95% CI: 1.05–4.60; p = 0.036), and failure to attend follow-up according to schedule (AOR = 1.95; 95% CI: 1.05–3.60; p = 0.030) were also associated with documented readmission. Conclusions: Documented readmission was associated with previous admission for undernutrition and gaps in documented post-discharge care. These findings highlight the importance of strengthening post-discharge planning, documentation of caregiver nutrition education, documentation of follow-up appointments, and continuity of nutritional support.