Non-Adherence to WHO recommendations regarding infant feeding practices results in dilemma of malnourishment: A community-based prospective cohort study conducted in Karachi, Pakistan

Background: The prevalence of chronic malnutrition and its associated morbid outcomes has been a significant cause of health loss globally, affecting millions of children hampering their mental, physical, social, and immune system development. World Health Organization\u27s (WHO) recommendations presenting infant feeding guidelines have largely controlled this burden. However, developing countries including Pakistan have failed to promote these guidelines and still succumb to a huge burden of morbidity and mortality secondary to malnourishment among infants.Methodology: Our study is a prospective cohort including 300 infants without predisposing congenital anomaly, followed from 6 months to 18 months of age. The primary outcome involved was classifying patients as malnourished based on anthropometric measurements, assessing the prevalence of co-morbidities and comparison of results in compliance with WHO guidelines.Results: A total of 276 infants were included and the rest were lost to follow-up. Stratification on socioeconomic status was done; 53% of infants were diagnosed as malnourished, either due to stunted growth, underweight, or both. The odds of development of malnourishment based on non-adherence to WHO guidelines on breastfeeding were 2.87 (p=0.001). The incidence of morbid complications was higher in the malnourished group, including gastrointestinal and respiratory tract infections.Conclusion: The implementation of WHO recommendations on infant feeding techniques can prove to be a pivotal instrument to control the soaring index of morbidities and mortalities associated with malnourishment. A strong focus on parental education and awareness among masses is required for its promulgation and controlling the infant health burden linked to this preventable condition