Initiation of complementary feeding is often delayed in Bangladesh and likely contributes to the high burden of infant undernutrition in the country. Pregnant women at 28–32 weeks’ gestation were recruited for a cohort-based evaluation of a community-based nutrition education program. To identify predictors of the timing of introduction of solid/semi-solid/soft foods (complementary feeding initiation), we prospectively interviewed 2078women (1042 from intervention area, 1036 from control area) at time of recruitment and at child age 3 and 9 mo. Maternal knowledge and attitudes towards complementary feeding, nutritional importance and cost of complementary foods were assessed at child age 3 months. Two scales were created from the sum of correct responses. Tertiles were created for analysis (Knowledge: 0–7, 8–9, 10–15; Attitudes: 18–25, 26, 27–34). Infant age at complementary feeding initiation was characterized as early (≤4 months), timely (5–6 months) or late (≥7 months), based on maternal recall at child age 9 mo. We used stratified polytomous logistic regression, adjusted for socioeconomic status, infant gender, maternal age, literacy and parity to identify predictors of early or late vs. timely complementary feeding initiation. Complementary feeding initiation was early for 7%, timely for 49%, and late for 44% of infants. Only 19% of mothers knew the WHO recommended age for complementary feeding initiation. The knowledge score was not associated with timely complementary feeding initiation. Mothers with the most favorable attitudes (highest attitudes score tertile) were more likely to initiate late complementary feeding compared to those with the lowest attitudes score tertile (adjusted OR = 2.2, 95% CI: 1.1–4.4). Late introduction of complementary foods is still widely prevalent in Bangladesh. Improved maternal knowledge or favorable attitudes towards complementary feeding were not associated with timely introduction of complementary foods, indicating other factors likely determine timing of complementary feeding initiation. This presents an avenue for future research.

中文翻译：

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孟加拉国农村地区母亲对补充喂养的知识和态度与启动时间有关

在孟加拉国，开始补充喂养常常被推迟，这可能导致该国婴儿营养不良的沉重负担。招募妊娠 28-32 周的孕妇对基于社区的营养教育计划进行基于队列的评估。为了确定引入固体/半固体/软性食物（补充喂养开始）时间的预测因素，我们在招募时和 3 个月和 9 个月的儿童时前瞻性地采访了 2078 名妇女（1042 名来自干预区，1036 名来自控制区） . 在孩子 3 个月大时评估了母亲对补充喂养的知识和态度、营养重要性和补充食品的成本。从正确响应的总和创建了两个量表。为分析创建了三分位数（知识：0-7、8-9、10-15；态度：18-25、26、27-34）。根据母亲在 9 个月时的回忆，婴儿开始补充喂养时的年龄分为早（≤4 个月）、及时（5-6 个月）或晚（≥7 个月）。我们使用分层多分类逻辑回归，根据社会经济地位、婴儿性别、母亲年龄、识字率和产次进行调整，以确定早期或晚期与及时补充喂养开始的预测因素。7% 的婴儿开始补充喂养较早，49% 的婴儿及时开始，44% 的婴儿较晚。只有 19% 的母亲知道 WHO 推荐的开始添加辅食的年龄。知识分数与及时开始补充喂养无关。与态度得分最低的母亲相比（调整后的 OR = 2.2，95% CI：1.1-4.4），态度最积极（态度得分最高的三分位数）的母亲更有可能开始后期补充喂养。在孟加拉国，较晚引入补充食品仍然普遍存在。提高母体知识或对辅食的积极态度与及时引入辅食无关，这表明其他因素可能决定辅食开始的时间。这为未来的研究提供了一条途径。表明其他因素可能决定补充喂养开始的时间。这为未来的研究提供了一条途径。表明其他因素可能决定补充喂养开始的时间。这为未来的研究提供了一条途径。