Complementary Feeding Practices and Associated Maternal Factors among Children Aged 6–24 Months Attending Dinajpur Medical College Hospital

Complementary feeding during the first two years of life is critical for growth, nutrition, and neurodevelopment. While timely initiation has improved in many low and middle income countries, inadequate dietary diversity and inappropriate practices remain major concerns in Bangladesh. Maternal knowledge, education, and socioeconomic status are known to influence feeding practices, but evidence from northern Bangladesh is limited. This study was conducted to assess complementary feeding practices and maternal factors among children aged 6-24 months attending a tertiary health facility. A cross-sectional study was conducted in the Department of Paediatrics, Dinajpur Medical College Hospital (DjMCH) between December 2025 and May 2026. One hundred mother–child pairs were consecutively recruited. Data were collected using a structured, pretested questionnaire based on WHO recommendations. Maternal knowledge was assessed using a six-item scoring system. Descriptive statistics were presented as mean ± SD, frequencies, and percentages. Associations were evaluated using Chi-square tests, and univariate logistic regression estimated crude odds ratios (ORs) with 95% confidence intervals (CIs) for factors associated with early initiation (<6 months). Most mothers (46%) were aged 20–30 years, resided in rural areas (66%), and had completed secondary education (58%). The mean age of children was 14.2 ± 5.1 months; 56% were female. Cesarean delivery was common (61%). Exclusive breastfeeding, followed by complementary feeding at 6 months, was reported by 84%, while 16% introduced foods earlier. Continued breastfeeding after initiation was practiced by 94%. Complementary feeding was dominated by cereal-based foods such as khichuri (28%), with limited animal-source foods (14%) and fruits/vegetables (8%), reflecting poor dietary diversity. Maternal knowledge was generally good (70%). Bivariate analysis showed significant associations between complementary feeding practices and monthly household income (p=0.017), but no significant associations were found between age, education, residence, employment, or knowledge. However, in univariate logistic regression, compared with households earning ≤BDT 10,000 per month, the odds of early initiation were significantly higher among households earning BDT >10,000-20,000 and BDT >40,001-60,000, but other maternal factors were not significant. Although most mothers initiated complementary feeding and continued breastfeeding, dietary diversity and nutritional quality remained inadequate. Household income was the only factor significantly associated with early initiation, underscoring the role of socioeconomic circumstances. Strengthening nutrition education and targeted interventions may improve complementary feeding practices in Bangladesh. Bangladesh Med J. 2026 Jan; 55(1): 11-20