Early introduction of water and complementary feeding and nutritional status of children in northern Senegal

Objective: Malnutrition is responsible globally for 60% of deaths among children under 5 years and is often attributed to suboptimal feeding practices. In response, the World Health Organization recommends exclusive breast-feeding for the first 6 months of life. The objective of this study was to determine if an association exists between the early introduction of water and complementary foods (CFs) and the nutritional status of children in northern Senegal. Design/Setting/Subjects: A cross-sectional study of 374 children in the Podor Health District between the ages of 6 and 23 months was conducted. Knowledge and behaviours of mothers regarding introduction of water and Us were assessed via individual interviews. Results: Water was introduced to about 85% of the children in the first 3 months of life and 62% were fed CFs before 6 months. Overall, 16% had clinically significant wasting (weight-for-length Z-score (WHZ) less than - 2) and 20% had stunting (height-for-age Z-score (HAZ) less than - 2). There was no significant association between wasting or stunting and introduction of water before 3 months (WHZ: odds ratio = 0.99, 95% confidence interval 0.46-2.14, P = 0.97; HAZ: 0.68, 0.34-1.36, P = 0.3) or introduction of CFs before 6 months (WHZ: 0.81, 0.46-1.42, P = 0.5; HAZ: 0.79, 0.46-1.35, P = 0.4). A significant association was found between wasting and male sex, age, living in Guede community, drinking river/pond water and large family size, while stunting was associated with age and drinking tap water. Conclusion: The results of the present study suggest that early introduction of water and CFs is frequent and is not associated with increased risk for malnutrition among children from this region of northern Senegal, but the possibility of reverse causality cannot be excluded.