Quality Assessment of Complementary Feeding (CF) Practices Using CF Index and Determining Its Association With Sociodemographic Factors Among Children Aged 6-23 Months in District Etawah, Uttar Pradesh, India: A Community-Based Cross-Sectional Study.

BACKGROUND

Achieving nutritionally sufficient and well-timed supplementary feeding is central to sustaining physical growth, brain maturation, and immunological competence in infants and toddlers from 6 through 23 months. The Complementary Feeding Index (CFI) functions as an integrated multi-component instrument designed to quantify the overall adequacy of young child nutrition at the household level.

OBJECTIVE

This investigation sought to appraise complementary feeding adequacy via the CFI and explore its associations with sociodemographic characteristics among children between 6 and 23 months of age in Etawah district, Uttar Pradesh, India.

METHODS

This community-based cross-sectional analytical study recruited 416 children aged 6-23 months across rural and urban localities of Etawah district between January 2024 and February 2026. Household data were obtained through a validated, pre-piloted structured interview tool. CFI sub-indicators were evaluated: breastfeeding continuation, bottle use, age-appropriateness of complementary food introduction, dietary variety, food group coverage, and meal frequency. Anthropometric indices were measured with calibrated instruments, and all data were processed in Statistical Product and Service Solutions (SPSS, version 26.0; IBM SPSS Statistics for Windows, Armonk, NY).

RESULTS

Breastfeeding was ongoing in 70.9% of children; 35.6% were bottle-fed. Supplementary foods at the recommended six-month milestone were given in 52.2% of cases. Minimum dietary diversity (MDD) was met by 22.1%, minimum meal frequency (MMF) by 59.4%, and minimum acceptable diet (MAD) by only 13.9%. Overall, CFI classification placed 43% of children in the appropriate and 57% in the inappropriate feeding category.

CONCLUSION

Supplementary feeding quality in Etawah district is far below recommended thresholds, with 57% the children unable to achieve adequate dietary diversity or a MAD. Sustained investment in nutrition counselling, frontline workforce skill-building, and locally tailored community programmes is essential to reverse these deficits and improve child nutrition.