Diet diversity during complementary feeding and childhood acute respiratory infection and diarrhoea in rural China.

Objective: Childhood acute respiratory infections (ARI) and diarrhoea are prevalent and have placed significant medical burden on the society. This study was conducted to examine the associations between maternal feeding practices and childhood ARI and diarrhoea in rural China. To allow wider comparison across studies, the most recent WHO feeding indicators were adopted. Design: A prospective cohort study (n=629). Setting: Five rural regions of China. Participants: Multi-stage stratified random cluster sampling was applied to recruit mothers who had given live birth to their child within 6 months. A baseline survey was conducted in participants' houses or village health centres between January 2014 and August 2016. A follow-up survey was conducted with all participants through telephone interviews from January 2017 to September 2018. Results: The prevalence of childhood ARI and diarrhoea during the past 2 weeks at follow-up was 14.2% and 11.4%, respectively. Poor complementary feeding practices were found, with only 33.1% and 22.3% of mothers feeding their children with sufficient diet diversity (MDD) and meeting the WHO requirement of minimal acceptable diet (MAD), respectively. Logistic regression analyses demonstrated that MDD was associated with a lower risk for childhood ARI (adjusted OR=0.39, 95% CI 0.17 to 0.93) and diarrhoea (adjusted OR=0.38, 95% CI 0.15 to 0.93). MAD was protective for childhood diarrhoea (adjusted OR=0.36, 95% CI 0.14 to 0.94). Conclusion: Interventions to ensure children's diet diversity during complementary feeding stage might be useful to prevent and reduce childhood ARI and diarrhoea in rural areas.