Infant and Young Child Feeding Practices Among Mothers with Children Below 24 Months in Ikotos County, Eastern Equatoria, South Sudan: A Community-Based Cross-Sectional Study

Background: Inappropriate Infant and Young Child Feeding (IYCF) practices remain a critical public health concern in sub-Saharan Africa, with significant short- and long-term consequences on child morbidity and mortality. South Sudan, burdened by protracted conflict and food insecurity, reports among the worst child nutrition indicators on the continent. Despite national policies on Maternal, Infant and Young Child Nutrition (MIYCN), IYCF practices remain largely suboptimal and understudied at the community level, particularly in Ikotos County, Eastern Equatoria. Methods: A community-based cross-sectional study employing quantitative methods was conducted in March 2020. Using systematic random sampling, 317 mothers or caregivers of children below 24 months were recruited from 12 villages across four payams in Ikotos County. Data were collected via structured, pre-tested questionnaires administered through face-to-face interviews and analysed using descriptive statistics and chi-square tests in SPSS version 21. Results: Only 35.0% (n=111) of infants were initiated to breastfeeding within one hour of birth; 65.0% experienced delayed initiation. Exclusive breastfeeding (EBF) prevalence among children under six months was 75.0%. Prelacteal feeds were administered to 44.8% of newborns, with honey being the most common (48.0%). Complementary feeding commenced before six months in 58.9% of children, while only 22.0% were introduced at the recommended age of six months. Continued breastfeeding beyond 18 months was practised by 45.0% of mothers. Cereals constituted the dominant complementary food (54.9%), with dietary diversity remaining critically low. Conclusion: IYCF practices in Ikotos County are suboptimal across most WHO-recommended indicators. Targeted health education ca