Infant and Young Child Feeding Practices and Their Determinants in Sagar District, Madhya Pradesh: A Facility-Based Cross-sectional Study

Abstract Background: Infant and young child feeding (IYCF) practices are essential for growth and development during the first two years. However, district-level evidence on IYCF practices and determinants remains limited in India. This study assessed IYCF practices, maternal knowledge, and determinants of IYCF indicators among children aged 0–23 months in Sagar, Madhya Pradesh. Methods: A facility-based cross-sectional study was conducted among 430 mother–child pairs attending immunization sessions at selected Anganwadi centers between March 2020 and October 2021. IYCF practices were assessed using World Health Organization (WHO) indicators, and maternal knowledge was evaluated using a pretested 17-item questionnaire. Logistic regression models were used to identify independent predictors of IYCF indicators. Results: Early initiation of breastfeeding, exclusive breastfeeding (EBF), continued breastfeeding at one year, and timely introduction of complementary feeding were reported in 73.5%, 86.1%, 98.1%, and 76.5% of children, respectively. However, only 12.5% achieved minimum dietary diversity (MDD), 33.9% minimum meal frequency (MMF), 7.8% minimum acceptable diet (MAD), and 2.3% consumed iron-rich or iron-fortified foods. Adequate maternal knowledge was observed in 22.6% of mothers. Normal vaginal delivery independently predicted early initiation of breastfeeding, whereas male children had lower odds of EBF. Adequate maternal knowledge regarding IYCF was positively associated with MMF, MDD, and MAD, while urban residence was independently associated with improved MDD and MAD. Conclusion: Despite satisfactory breastfeeding practices, complementary feeding remained suboptimal. Strengthening nutrition counseling through existing maternal and child health programs, with emphasis on maternal knowledge and rural populations, may improve IYCF practices.