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1.1.   Background information

Nigeria like many developing countries in Africa is still far from reducing the rate of infant and under-five (U5) mortality.  Malnutrition in early life occurs due to nutritional deficiencies  particularly energy and micronutrient deficiencies, including the foetal growth, development and health, contributing to impairment in immune competence and cognitive function, blindness, aneamia, growth failure, and increased morbidity, mortality and disability (FGN/UNICEF, 2001; ACC/SCN, 2001).

There is a wide range of factors leading to malnutrition.  The most important direct factors include poor feeding practices and / or short falls in food intake as well as illness.  In the case of children, three factors determine growth failure.  They are birth weight, duration of breast feeding and adequacy of complementary feeding upto 24 months of age  (Dewey et al., 1999).

It is generally agreed that breast milk is adequate both in quantity and quality to meet the nutrient and energy requirements of the infants.  Breast milk alone can meet the nutritional needs of the child for the first-six months of life.  After six months, the quantity of breast milk can no longer sustain the young child and must be complemented with other foods if the rapid growth rate usually associated with this period and optimal health must be maintained (ACC/SCN, 2001).

Complementary foods can be described as any nutrient containing food/ or liquid other than breast milk given to young children during the period of complementary feeding.  Therefore, complementary feeding is the period during which foods or liquid are provided along with continued breast feeding. So this period is the most critical in the life of the infants.  Unfortunately Nigerian traditional complementary foods are made from cereals, starchy roots and tubers that provide mainly carbohydrates and low quality protein.   Also in Nigerian the use of fermented gruel or porridge  alone made from maize, sorghum or millets are the leading cause of protein – energy malnutrition (PEM) in infants and pre-school children ACC/SCN, 2001; Dewey et al., 1999;  Akinrele and Edwards., 1971).

The World Health Organization (WHO) recommends that children begin complementary feeding in addition to breast milk between four to six months of age in order to ensure adequate growth and nourishment (FMOH / WHO, 1999).  In many developing countries, however, traditional complementary foods /gruels are based on starchy staple foods such as wheat, rice, maize or sorghum that produce viscous porridges that are difficult for children to consume (Hellstrom et al., 1981, Lungqvist et al., 1999).

The problem of high viscosity, low energy density or both in complementary food is referred to as dietary bulk. Children consuming these foods grow poorly and have higher mortality rate (Allen 1994; Pelletier et al., 1995).  Therefore breast and complementary feeding behaviours are important predictors of infant and child nutrition, health and survival.  In order to detect protein-energy malnutrition (PEM) and micronutrient deficiencies, it is very important to assess the nutritional status of any population at a given time.

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