Relationship between Maternal Knowledge and Feeding Practices in Relation to Infant Malnutrition among Breastfeeding Women in Savannah Region of Ghana

Abstract

Introduction: Child malnutrition remains a major public health concern in sub-Saharan Africa, disproportionately affecting Northern Ghana. Maternal knowledge and feeding practices are central determinants of child nutritional outcomes, yet little is known about their role in the Savannah Region. Aim: This study examined the relationship between maternal knowledge, infant feeding practices, and malnutrition among breastfeeding mothers in West Gonja District Hospital. Methods: A hospital-based cross-sectional study was conducted among 405 breastfeeding mothers with infants aged 0–23 months. Participants were selected using systematic random sampling. Data were collected through a structured interviewer-administered questionnaire adapted from WHO Infant and Young Child Feeding (IYCF) indicators and FAO Knowledge, Attitudes, and Practices guidelines. Anthropometric measurements were analysed using the WHO Anthro software. Descriptive statistics summarised maternal knowledge, feeding practices, and infant nutritional status. Binary logistic regression identified predictors of infant malnutrition, with results expressed as adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Results: Only 34.0% of mothers demonstrated high knowledge of infant feeding, while 26.7% had low knowledge. Good feeding practices were reported by 29.1%, with dietary diversity and timely complementary feeding being the most deficient indicators. The prevalence of infant malnutrition was high, with 22.2% stunted, 16.3% underweight, and 9.4% wasted. In multivariable analysis, low maternal knowledge was associated with higher odds of malnutrition (AOR = 3.42; 95% CI: 1.88–6.21; p < 0.001), as were poor feeding practices (AOR = 4.51; 95% CI: 2.37–8.59; p < 0.001). Additional significant predictors included no formal education (AOR = 2.67; 95% CI: 1.41–5.06), farmer occupation (AOR = 2.15; 95% CI: 1.16–3.99), housewife/unemployed status (AOR = 2.48; 95% CI: 1.22–4.99), parity ≥4 (AOR = 2.94; 95% CI: 1.43–6.03), home delivery (AOR = 2.63; 95% CI: 1.28–5.39), fewer than four ANC visits (AOR = 2.71; 95% CI: 1.39–5.31), and infant age 12–23 months (AOR = 3.26; 95% CI: 1.57–6.75). Conclusion: Maternal knowledge and feeding practices are critical determinants of infant malnutrition in West Gonja District. Interventions should prioritise improving complementary feeding quality and dietary diversity, particularly during the 6–23month period, while strengthening maternal health service utilisation and targeting high-risk groups such as low-education and high-parity mothers. Addressing these gaps is essential to reducing regional disparities in child malnutrition and advancing Ghana’s child health goals.