Knowledge, attitudes, and practices regarding complementary feeding among mothers in Rwamagana District, Rwanda: a cross-sectional study

Knowledge, attitudes, and practices regarding complementary feeding among mothers in Rwamagana District, Rwanda: a cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Knowledge, attitudes, and practices regarding complementary feeding among mothers in Rwamagana District, Rwanda: a cross-sectional study Samuel Nduwayezu, Nicaise Itangaza, Aaron Tuyishime, Vedaste Dushimimana, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8881023/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective Malnutrition remains a critical barrier to child health in low- and middle-income countries. In Rwanda, while national stunting rates have declined, they remain high among children under two years of age. To assess mothers' knowledge, attitudes, and practices (KAP) regarding complementary feeding for children aged 6–23 months in Rwamagana District, this study was conducted. Results A cross-sectional study was conducted with 92 mothers attending two health centers in Rwamagana. The majority of mothers (91.3%) correctly identified six months as the appropriate age to introduce complementary foods, and 89.1% had breastfed in the previous 24 hours. However, dietary diversity was suboptimal: 80.4% of children consumed dark green vegetables, 14.1% consumed meat, and 5.4% consumed fish. A significant proportion of mothers (71.7%) prioritized watery porridge over nutrient-dense thick porridge. Despite high maternal confidence (77.2%) and positive attitudes toward breastfeeding beyond six months (97.8%), gaps remain in the quality and diversity of complementary foods provided. Complementary feeding Stunting Malnutrition Rwanda Breastfeeding Mothers Introduction Complementary feeding is the process of introducing appropriate foods to children alongside breastfeeding when breast milk alone is no longer sufficient to meet nutritional requirements [1,2] . The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life, followed by the introduction of safe, nutritionally adequate solid, semisolid, or soft foods, while continuing breastfeeding for two years or beyond [3,4] . In Rwanda, chronic malnutrition remains a public health concern. While stunting rates among children under 5 years decreased from 48% in 2000 to 33% in 2019-20, the prevalence often peaks during the complementary feeding period (6–23 months) [5,6] . Evidence suggests that complementary feeding practices in Rwanda are often suboptimal; national data indicate that only 31.17% of children aged 6–23 months achieve a minimally acceptable diet [6,7] . Research on the specific determinants of these practices in rural districts is limited [5] . This study focuses on the Rwamagana District in the Eastern Province. This exploratory study aims to establish a foundation of knowledge regarding maternal KAP on complementary feeding in this specific demographic to inform targeted local interventions. Methods Study Design and Setting We conducted a descriptive cross-sectional study in Rwamagana District, Eastern Province, Rwanda. Two health centers, Rwamagana and Gishari, were selected as study sites. Rwamagana was purposively selected for this exploratory study because it has one of the highest fertility rates in the country, estimated at 4 children per woman by the National Institute of Statistics of Rwanda (NISR) [8] . This demographic trend places increased pressure on maternal and child health resources, making it a critical area for nutritional assessment. Participants and Sampling The study population comprised mothers of children aged 6–23 months attending child welfare clinics for vaccination services. The total accessible population was 597 mothers, of whom 350 attended Gishari Health Center, and 247 attended Rwamagana Health Center. Yamane’s formula was used to determine the minimum sample size required for this exploratory study. Given the exploratory nature of the study and the aim of establishing preliminary baseline data, we set a 10% margin of error. The minimum required sample size was approximately 86 participants. To ensure data robustness, we recruited 92 mothers. Participants were selected using simple random sampling from the daily attendance lists at the clinics. Data Collection and Analysis Data were collected using a structured questionnaire adapted from a similar KAP study in Ethiopia [9,10] . The tool assessed socio-demographic characteristics, breastfeeding practices, 24-hour dietary recall, and maternal knowledge and attitudes. Data were analyzed using SPSS version 27.1. Descriptive statistics (frequencies and percentages) were used to summarize the variables. Results Socio-demographic Characteristics A total of 92 mothers participated. The majority (56.5%) were aged 31–40 years, followed by 30.4% aged 18–30 years. Educational attainment was varied: 57.6% had secondary education, 21.7% had university education, while 9.8% were not educated. The children were fairly evenly distributed by sex (52.2% male), with half (51.1%) being 6 months old. Maternal Practices Breastfeeding practices were strong, with 89.1% of children breastfed in the last 24 hours. However, complementary feeding quality varied. While consumption of dark green vegetables (80.4%) and Vitamin A-rich fruits (78.3%) was high, intake of animal-source proteins was low: only 14.1% consumed meat/poultry, 20.7% consumed organ meats, and 5.4% consumed fish. Notably, 71.7% of mothers reported providing watery porridge, while only 7.6% provided thick porridge. Knowledge and Attitudes Knowledge regarding the timing of complementary feeding was high, with 91.3% of mothers correctly stating it should begin at 6 months. However, practical knowledge regarding food consistency was lower, as evidenced by the high use of watery porridge. Attitudes were overwhelmingly positive: 97.8% believed in continuing breastfeeding beyond six months, and 77.2% felt "very confident" in preparing food for their children. Discussion This study reveals a gap between knowledge and practice in Rwamagana. While 91.3% of mothers knew the correct age to introduce solids, the quality of the diet provided was often poor. The high prevalence of providing watery porridge (71.7%) in our study contrasts with findings from Tanzania by Michael et al., who reported that 58.8% of mothers preferred thick consistency complementary foods [11] . Watery porridge is less energy-dense and may contribute to the stunting rates observed in the region. Our findings on low dietary diversity, particularly the low intake of animal-source foods (14.1% for meat), align with national trends reporting that few children achieve a minimally acceptable diet. However, our results on timely initiation knowledge (91.3%) are higher than those from Ethiopia, where only 50.2% of mothers had correct knowledge of the appropriate age for initiation [9] . Limitations This study utilized a cross-sectional design with a relatively small sample size (n = 92), which was calculated based on an exploratory margin of error (10%). This limits the generalizability of the findings to the wider district or country. Additionally, data relied on maternal recall, which may be subject to social desirability bias. Conclusions Mothers in Rwamagana demonstrate high adherence to breastfeeding recommendations and to the appropriate timing of complementary feeding initiation. However, the nutritional quality of the complementary diet remains suboptimal, characterized by low dietary diversity and a preference for nutrient-poor watery porridge. Interventions should focus on practical demonstrations of food consistency and diversifying protein sources. Declarations Ethics approval and consent to participate This study was conducted in accordance to Rwanda National Ethics Committee (RNEC) guidelines. Ethical clearance was obtained from the Institutional Review Board (IRB) of the College of Medicine and Health Sciences, University of Rwanda (Ref: CMHS/IRB/020/2024). Written informed consent was obtained from all participants prior to data collection. Consent for publication Not applicable. Availability of data and materials The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Authors' contributions SN, NI, AT, AS and VD conceived the study, developed the methodology, and conducted data collection. AS and SN performed the statistical analysis. All authors contributed to the drafting of the manuscript and approved the final version. References Shrestha S, Pokhrel M, Mathema S. Knowledge, Attitude and Practices among Mothers of Children 6 to 24 months of Age Regarding Complementary Feeding. JNMA J Nepal Med Assoc 2020;58(230):758–63. Capra ME, Decarolis NM, Monopoli D, Laudisio SR, Giudice A, Stanyevic B, et al. Complementary Feeding: Tradition, Innovation and Pitfalls. Nutrients 2024;16(5):737. World Health Organisation. Infant and young child feeding [Internet]. 2023 [cited 2026 Feb 13];Available from: https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding Webb Girard A, Waugh E, Sawyer S, Golding L, Ramakrishnan U. A scoping review of social‐behaviour change techniques applied in complementary feeding interventions. Matern Child Nutr 2019;16(1):e12882. Umugwaneza M, Havemann-Nel L, Vorster HH, Wentzel-Viljoen E. Factors influencing complementary feeding practices in rural and semi-urban Rwanda: a qualitative study. J Nutr Sci 2021;10:e45. Demographic and Health Survey (2019/20) | National Institute of Statistics of Rwanda [Internet]. [cited 2026 Feb 13];Available from: https://www.statistics.gov.rw/data-sources/surveys/Demographic-and-Health-Survey/demographic-and-health-survey-201920 Harindintwari I, Mochama M, Nsanzabera C, Kubahoniyesu T. Factors Associated With Minimum Acceptable Diet among Children Aged 6 to 23 Months in Rwanda. Rwanda J Med Health Sci 2024;7(3):445–53. Fifth Population and Housing Census - 2022 | National Institute of Statistics of Rwanda [Internet]. [cited 2026 Feb 13];Available from: https://www.statistics.gov.rw/data-sources/censuses/Population-and-Housing-Census/fifth-population-and-housing-census-2022 Gemede HF, Ayele K, Demisew M. Maternal Knowledge and Practices on Complementary Feeding and Associated Factors in Sedal District, Western Ethiopia. Food Sci Nutr 2025;13(5):e70286. Assefa DG, Woldesenbet TT, Molla W, Zeleke ED, Simie TG. Assessment of knowledge, attitude and practice of mothers/caregivers on infant and young child feeding in Assosa Woreda, Assosa Zone, Benshangul Gumuz Region, Western Ethiopia: a cross-sectional study. Arch Public Health 2021;79:170. Sichalwe MM, Behera MR, Behera D, Dehury RK, Degge H. Knowledge and practice of complementary feeding among mothers in Dar-es-Salaam, Tanzania: Community-based cross-sectional study. Clin Epidemiol Glob Health [Internet] 2023 [cited 2026 Feb 14];24. Available from: https://www.ceghonline.com/article/S2213-3984(23)00217-8/fulltext Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8881023","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":592130304,"identity":"7ce3011d-93fa-4dfe-a0fe-91f955f99f12","order_by":0,"name":"Samuel Nduwayezu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8UlEQVRIiWNgGAWjYFCCBDApwyABoiqAmJm5gSgtPBAtZ0BaGEnRwtgGYhPQYs6e/vDTzTYbHgbp5sMffs6rjeZvB2r5UbENpxbLnjfG0rltaTwMMscSDHu3Hc+dcZixgbHnzG2cWgxu5DAAtRwGOizHIIF327HcBqAWZsY2fFrSH//ObfsP1JL/4eDfOcdy5xPWkmAGtOUAyBbGZt6GmtwNBLWceWNmnXMumYdNIs2YWebYgdyNQC0H8frlePrj2zlldnL8EsmPP76pqcudd/7wwQc/KnBrgQM2CHUYTB4grB4B6khRPApGwSgYBSMEAAAyxVm50nO1HgAAAABJRU5ErkJggg==","orcid":"","institution":"University of Rwanda","correspondingAuthor":true,"prefix":"","firstName":"Samuel","middleName":"","lastName":"Nduwayezu","suffix":""},{"id":592130305,"identity":"e66bab06-7276-4f04-ab6a-f630869afc79","order_by":1,"name":"Nicaise Itangaza","email":"","orcid":"","institution":"University of Rwanda","correspondingAuthor":false,"prefix":"","firstName":"Nicaise","middleName":"","lastName":"Itangaza","suffix":""},{"id":592130306,"identity":"4b8ff594-aaac-4e4e-8b8a-aad338bd83b6","order_by":2,"name":"Aaron Tuyishime","email":"","orcid":"","institution":"University of Rwanda","correspondingAuthor":false,"prefix":"","firstName":"Aaron","middleName":"","lastName":"Tuyishime","suffix":""},{"id":592130308,"identity":"802da372-fb7f-4c0e-83b2-408048323f68","order_by":3,"name":"Vedaste Dushimimana","email":"","orcid":"","institution":"University of Rwanda","correspondingAuthor":false,"prefix":"","firstName":"Vedaste","middleName":"","lastName":"Dushimimana","suffix":""},{"id":592130309,"identity":"e79a53b8-127f-49ae-bcf5-79e4329cd3ed","order_by":4,"name":"Axel Shimwa","email":"","orcid":"","institution":"University of Global Health Equity","correspondingAuthor":false,"prefix":"","firstName":"Axel","middleName":"","lastName":"Shimwa","suffix":""}],"badges":[],"createdAt":"2026-02-14 15:23:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8881023/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8881023/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":102963267,"identity":"2cd48965-19be-4716-8370-b5bfac119d04","added_by":"auto","created_at":"2026-02-19 04:14:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":432307,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8881023/v1/fb1ae2ca-1f79-4ad1-b734-b6a1ffc73d62.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Knowledge, attitudes, and practices regarding complementary feeding among mothers in Rwamagana District, Rwanda: a cross-sectional study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eComplementary feeding is the process of introducing appropriate foods to children alongside breastfeeding when breast milk alone is no longer sufficient to meet nutritional requirements \u003csup\u003e[1,2]\u003c/sup\u003e. The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life, followed by the introduction of safe, nutritionally adequate solid, semisolid, or soft foods, while continuing breastfeeding for two years or beyond \u003csup\u003e[3,4]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn Rwanda, chronic malnutrition remains a public health concern. While stunting rates among children under 5 years decreased from 48% in 2000 to 33% in 2019-20, the prevalence often peaks during the complementary feeding period (6\u0026ndash;23 months) \u003csup\u003e[5,6]\u003c/sup\u003e. Evidence suggests that complementary feeding practices in Rwanda are often suboptimal; national data indicate that only 31.17% of children aged 6\u0026ndash;23 months achieve a minimally acceptable diet \u003csup\u003e[6,7]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eResearch on the specific determinants of these practices in rural districts is limited \u003csup\u003e[5]\u003c/sup\u003e. This study focuses on the Rwamagana District in the Eastern Province. This exploratory study aims to establish a foundation of knowledge regarding maternal KAP on complementary feeding in this specific demographic to inform targeted local interventions.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003cdiv id=\"Sec4\" class=\"Section3\"\u003e \u003ch2\u003eStudy Design and Setting\u003c/h2\u003e \u003cp\u003eWe conducted a descriptive cross-sectional study in Rwamagana District, Eastern Province, Rwanda. Two health centers, Rwamagana and Gishari, were selected as study sites. Rwamagana was purposively selected for this exploratory study because it has one of the highest fertility rates in the country, estimated at 4 children per woman by the National Institute of Statistics of Rwanda (NISR) \u003csup\u003e[8]\u003c/sup\u003e. This demographic trend places increased pressure on maternal and child health resources, making it a critical area for nutritional assessment.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e\n\u003ch3\u003eParticipants and Sampling\u003c/h3\u003e\n\u003cp\u003eThe study population comprised mothers of children aged 6\u0026ndash;23 months attending child welfare clinics for vaccination services. The total accessible population was 597 mothers, of whom 350 attended Gishari Health Center, and 247 attended Rwamagana Health Center.\u003c/p\u003e \u003cp\u003eYamane\u0026rsquo;s formula was used to determine the minimum sample size required for this exploratory study. Given the exploratory nature of the study and the aim of establishing preliminary baseline data, we set a 10% margin of error.\u003c/p\u003e \u003cp\u003eThe minimum required sample size was approximately 86 participants. To ensure data robustness, we recruited 92 mothers. Participants were selected using simple random sampling from the daily attendance lists at the clinics.\u003c/p\u003e\n\u003ch3\u003eData Collection and Analysis\u003c/h3\u003e\n\u003cp\u003eData were collected using a structured questionnaire adapted from a similar KAP study in Ethiopia\u003csup\u003e[9,10]\u003c/sup\u003e. The tool assessed socio-demographic characteristics, breastfeeding practices, 24-hour dietary recall, and maternal knowledge and attitudes. Data were analyzed using SPSS version 27.1. Descriptive statistics (frequencies and percentages) were used to summarize the variables.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eSocio-demographic Characteristics\u003c/h2\u003e \u003cp\u003eA total of 92 mothers participated. The majority (56.5%) were aged 31\u0026ndash;40 years, followed by 30.4% aged 18\u0026ndash;30 years. Educational attainment was varied: 57.6% had secondary education, 21.7% had university education, while 9.8% were not educated. The children were fairly evenly distributed by sex (52.2% male), with half (51.1%) being 6 months old.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eMaternal Practices\u003c/h3\u003e\n\u003cp\u003eBreastfeeding practices were strong, with 89.1% of children breastfed in the last 24 hours. However, complementary feeding quality varied. While consumption of dark green vegetables (80.4%) and Vitamin A-rich fruits (78.3%) was high, intake of animal-source proteins was low: only 14.1% consumed meat/poultry, 20.7% consumed organ meats, and 5.4% consumed fish. Notably, 71.7% of mothers reported providing watery porridge, while only 7.6% provided thick porridge.\u003c/p\u003e\n\u003ch3\u003eKnowledge and Attitudes\u003c/h3\u003e\n\u003cp\u003eKnowledge regarding the timing of complementary feeding was high, with 91.3% of mothers correctly stating it should begin at 6 months. However, practical knowledge regarding food consistency was lower, as evidenced by the high use of watery porridge. Attitudes were overwhelmingly positive: 97.8% believed in continuing breastfeeding beyond six months, and 77.2% felt \"very confident\" in preparing food for their children.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study reveals a gap between knowledge and practice in Rwamagana. While 91.3% of mothers knew the correct age to introduce solids, the quality of the diet provided was often poor. The high prevalence of providing watery porridge (71.7%) in our study contrasts with findings from Tanzania by Michael et al., who reported that 58.8% of mothers preferred thick consistency complementary foods\u003csup\u003e[11]\u003c/sup\u003e. Watery porridge is less energy-dense and may contribute to the stunting rates observed in the region.\u003c/p\u003e \u003cp\u003eOur findings on low dietary diversity, particularly the low intake of animal-source foods (14.1% for meat), align with national trends reporting that few children achieve a minimally acceptable diet. However, our results on timely initiation knowledge (91.3%) are higher than those from Ethiopia, where only 50.2% of mothers had correct knowledge of the appropriate age for initiation\u003csup\u003e[9]\u003c/sup\u003e.\u003c/p\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003e This study utilized a cross-sectional design with a relatively small sample size (n\u0026thinsp;=\u0026thinsp;92), which was calculated based on an exploratory margin of error (10%). This limits the generalizability of the findings to the wider district or country. Additionally, data relied on maternal recall, which may be subject to social desirability bias.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eMothers in Rwamagana demonstrate high adherence to breastfeeding recommendations and to the appropriate timing of complementary feeding initiation. However, the nutritional quality of the complementary diet remains suboptimal, characterized by low dietary diversity and a preference for nutrient-poor watery porridge. Interventions should focus on practical demonstrations of food consistency and diversifying protein sources.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance to Rwanda National Ethics Committee (RNEC) guidelines. Ethical clearance was obtained from the Institutional Review Board (IRB) of the College of Medicine and Health Sciences, University of Rwanda (Ref: CMHS/IRB/020/2024). Written informed consent was obtained from all participants prior to data collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSN, NI, AT, AS and VD conceived the study, developed the methodology, and conducted data collection. AS and \u0026nbsp;SN performed the statistical analysis. All authors contributed to the drafting of the manuscript and approved the final version.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eShrestha S, Pokhrel M, Mathema S. Knowledge, Attitude and Practices among Mothers of Children 6 to 24 months of Age Regarding Complementary Feeding. JNMA J Nepal Med Assoc 2020;58(230):758\u0026ndash;63. \u003c/li\u003e\n\u003cli\u003eCapra ME, Decarolis NM, Monopoli D, Laudisio SR, Giudice A, Stanyevic B, et al. Complementary Feeding: Tradition, Innovation and Pitfalls. Nutrients 2024;16(5):737. \u003c/li\u003e\n\u003cli\u003eWorld Health Organisation. Infant and young child feeding [Internet]. 2023 [cited 2026 Feb 13];Available from: https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding \u003c/li\u003e\n\u003cli\u003eWebb Girard A, Waugh E, Sawyer S, Golding L, Ramakrishnan U. A scoping review of social‐behaviour change techniques applied in complementary feeding interventions. Matern Child Nutr 2019;16(1):e12882. \u003c/li\u003e\n\u003cli\u003eUmugwaneza M, Havemann-Nel L, Vorster HH, Wentzel-Viljoen E. Factors influencing complementary feeding practices in rural and semi-urban Rwanda: a qualitative study. J Nutr Sci 2021;10:e45. \u003c/li\u003e\n\u003cli\u003eDemographic and Health Survey (2019/20) | National Institute of Statistics of Rwanda [Internet]. [cited 2026 Feb 13];Available from: https://www.statistics.gov.rw/data-sources/surveys/Demographic-and-Health-Survey/demographic-and-health-survey-201920 \u003c/li\u003e\n\u003cli\u003eHarindintwari I, Mochama M, Nsanzabera C, Kubahoniyesu T. Factors Associated With Minimum Acceptable Diet among Children Aged 6 to 23 Months in Rwanda. Rwanda J Med Health Sci 2024;7(3):445\u0026ndash;53. \u003c/li\u003e\n\u003cli\u003eFifth Population and Housing Census - 2022 | National Institute of Statistics of Rwanda [Internet]. [cited 2026 Feb 13];Available from: https://www.statistics.gov.rw/data-sources/censuses/Population-and-Housing-Census/fifth-population-and-housing-census-2022 \u003c/li\u003e\n\u003cli\u003eGemede HF, Ayele K, Demisew M. Maternal Knowledge and Practices on Complementary Feeding and Associated Factors in Sedal District, Western Ethiopia. Food Sci Nutr 2025;13(5):e70286. \u003c/li\u003e\n\u003cli\u003eAssefa DG, Woldesenbet TT, Molla W, Zeleke ED, Simie TG. Assessment of knowledge, attitude and practice of mothers/caregivers on infant and young child feeding in Assosa Woreda, Assosa Zone, Benshangul Gumuz Region, Western Ethiopia: a cross-sectional study. Arch Public Health 2021;79:170. \u003c/li\u003e\n\u003cli\u003eSichalwe MM, Behera MR, Behera D, Dehury RK, Degge H. Knowledge and practice of complementary feeding among mothers in Dar-es-Salaam, Tanzania: Community-based cross-sectional study. Clin Epidemiol Glob Health [Internet] 2023 [cited 2026 Feb 14];24. Available from: https://www.ceghonline.com/article/S2213-3984(23)00217-8/fulltext \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Complementary feeding, Stunting, Malnutrition, Rwanda, Breastfeeding, Mothers","lastPublishedDoi":"10.21203/rs.3.rs-8881023/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8881023/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eMalnutrition remains a critical barrier to child health in low- and middle-income countries. In Rwanda, while national stunting rates have declined, they remain high among children under two years of age. To assess mothers' knowledge, attitudes, and practices (KAP) regarding complementary feeding for children aged 6\u0026ndash;23 months in Rwamagana District, this study was conducted.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA cross-sectional study was conducted with 92 mothers attending two health centers in Rwamagana. The majority of mothers (91.3%) correctly identified six months as the appropriate age to introduce complementary foods, and 89.1% had breastfed in the previous 24 hours. However, dietary diversity was suboptimal: 80.4% of children consumed dark green vegetables, 14.1% consumed meat, and 5.4% consumed fish. A significant proportion of mothers (71.7%) prioritized watery porridge over nutrient-dense thick porridge. Despite high maternal confidence (77.2%) and positive attitudes toward breastfeeding beyond six months (97.8%), gaps remain in the quality and diversity of complementary foods provided.\u003c/p\u003e","manuscriptTitle":"Knowledge, attitudes, and practices regarding complementary feeding among mothers in Rwamagana District, Rwanda: a cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-17 05:30:03","doi":"10.21203/rs.3.rs-8881023/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e0c8e9d0-1705-45ef-9497-4aa4903ed0af","owner":[],"postedDate":"February 17th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-02-18T11:24:30+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-17 05:30:03","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8881023","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8881023","identity":"rs-8881023","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}