Purpose: This paper aims to investigate breastfeeding and complementary feeding practices among children less than five years old and living in a rice surplus area in Demak Regency, Central Java.Design/methodology/approach: From December 2014 to February 2015, a cross-sectional survey was carried out in Demak, which had a high proportion of undernourished children despite high rice production. In total, 384 mothers having children below five years old from farmer family background were interviewed using a structured questionnaire about sociodemographic parameters and child feeding practices. Food habits were also investigated among these women during two focus group discussions in two selected sub-districts.Findings: Only 10.9 per cent of the children were exclusively breastfed for six months. About 60 per cent of the mothers practiced supplementary feeding in addition to breastfeeding and started complementary feeding too early. Duration of exclusive breastfeeding practice and child’s age at onset of complementary feeding were positively correlated (p= 0.04). The main reasons of supplementary feeding and too early introduction of complementary food were based on the elderly women’s opinions, and the very short duration of maternity leave for employed mothers. Mothers with a low education level had a higher chance of not reaching the optimum score of complementary feeding practices (p= 0.012).Originality/value: Despite a high level of food security in the project area, inadequate knowledge of young child feeding practices has contributed to sub-optimal breastfeeding practices. Higher educated women were more likely to follow optimal complementary feeding practices. Therefore, promotion of breastfeeding and complementary feeding practices targeting all key actors should be implemented in the study area to prevent undernutrition among infants.

Maternal nutrition is impacted by personal and environmental factors including dietary intake, knowledge, food availability, and affordability. This cross-sectional analysis aimed to evaluate nutrition-related knowledge, attitudes, practices, and associations with hemoglobin concentration among lactating mothers in the Bukavu region, Democratic Republic of the Congo. In 444 lactating mothers, nutrition-related knowledge and practice were assessed by questionnaires and translated into knowledge and practice scores ranging from 0 to 1, attitudes and drivers of food choice were assessed, the Dietary Diversity Score (DDS) was assessed with 24 h dietary recalls in a potential range from 0 to 10, and hemoglobin (Hb) was measured in mothers and their infants. Anemia prevalence was 28.2% among mothers and 74.3% among infants aged 3–8 months. Nutritional knowledge and practice were limited (the median total knowledge score was 0.39, median DDS was 3.0). While there were slight positive correlations between knowledge and maternal Hb, DDS did not significantly correlate with either knowledge or Hb. Although half of the mothers stated a perception about their own susceptibility to anemia or vitamin A deficiency (56.4%, 47.4%), less than half of those could justify their estimation (40.9%, 44.2%). Taste (68.1%), appearance (42.5%), availability (29.0%), and health effects (25.6%) were important drivers of food choice. In conclusion, interventions on the different influencing factors including nutrition education strategies are needed.

Aim: This research aimed to evaluate health and nutritional practices of mothers during pregnancy and birth outcomes of their newborns in Bukavu, Democratic Republic of the Congo (DRC), comparing semi-urban and rural areas.Background: Health and nutrition during pregnancy are crucial for adequate development of the fetus. Health care plays an important role but is often poor in rural areas of developing countries.Methods: A baseline survey of a nutritional follow-up study was conducted in two semi-urban and one rural hospital in the vicinity of Bukavu, DRC. In total, 471 mother-child pairs were recruited after delivery. Data collection included socio-demographic parameters, nutrition and health measures during pregnancy, and anthropometric parameters. Semi-urban and rural study locations were compared and predictors of birth weight evaluated.Findings: Semi-urban and rural mothers differed significantly in nutrition and health practices during pregnancy, as well as birth outcomes. In the rural area, there was a higher rate of newborns with low birth weight (10.7%) and lower rates of antimalarial medication (80.8%), deworming (24.6%), consumption of nutritional supplements (81.5%), and being informed about nutrition by medical staff (32.8%) during pregnancy as well as practicing family planning (3.1%) than in the semi-urban areas (2.7%, 88.6%, 88.3%; 89.3%, 46.5%, and 17.1%, respectively). Birth weight was positively predicted by increasing maternal MUAC, age, and gestational age and negatively by rural location, being primipara, being a farmer, and female newborn sex.Conclusion: The findings highlight the importance of strengthening antenatal care activities especially in rural areas in order to ameliorate both maternal and infantile health and ensure appropriate development.

Background: Amelioration of maternal nutrition is crucial in the Democratic Republic of the Congo (DRC), that experiences political instability and malnutrition. This study aimed to evaluate the impact of nutrition-specific interventions on nutritional knowledge, dietary practices, and hemoglobin (Hb) status among lactating mothers in the Bukavu region, DRC. Methods: A randomized, controlled trial was conducted with 416 mother–infant pairs from 3–6 to 6–9 months postpartum. The mothers were classified according to their mid-upper-arm circumference (MUAC) and subsequently assigned to the following intervention and control groups by block randomization: low MUAC–nutrition education, low MUAC–lipid-based nutrient supplements, low MUAC–control; normal MUAC–control; high MUAC–nutrition education, high MUAC–control. The pre- and post-intervention assessments included questionnaires on nutritional knowledge and practice to calculate scores (range 0–1); 24 h dietary recalls to calculate the Dietary Diversity Score (DDS, range 0–10); and measurement of maternal Hb. Changes of these parameters from pre- to post-intervention were analyzed by linear mixed models. Results: The change of total knowledge score from pre- to post-intervention was significantly positively affected by reception of nutrition education with a model-based mean difference of 0.161 between mothers with nutrition education compared to those without ( p = 0.000). The change in DDS was not affected, but there was a positive impact of nutrition education on the modification of complementary feeding practices (OR 2.930, p = 0.030). Change in maternal Hb was not different between the intervention and control groups with higher increases among mothers with anemia compared to all mothers. Conclusion: Nutrition education can positively influence knowledge and potentially complementary feeding, while further measures may be required for beneficial effects on anemia. Trial registration: The study was registered prospectively at the German Clinical Trials Register (DRKS; DRKS-ID DRKS00012842) on November 27, 2017.