Impact of the Introduction of Complementary Feeding Prior to the Sixth Month on Hemoglobin Levels and Weight Status


  • Aqeel Noaman Middle Technical University, Technical Institute/Baquba, Dept. of Community Health



Background: An infant’s requirement for daily energy and nutrients appears to exceed what breast-feeding gives; consequently, incorporating complementary foods into the diet becomes vital for the growth and development of the infant. The study aims to explore the correlation between the age of complementary feeding introduction before the sixth month and its impact on hemoglobin levels and weight status.

Subjects and Method: We conducted a case-series study at the Primary Health Care Center/Al-Tahrir, Baquba City, from April 18 to August 30, 2018. The study included a sample of three hundred fully developed infants, aged between 6 and 12 months, consisting of 180 males and 120 females. The dependent variable was complementary feeding. The independent variables were weight status, haemoglobin levels, and weught for age z-score. We obtained the data through face-to-face interviews with the child's mother using a structured questionnaire.

Results: Among the women who took part in the study, 43% initiated the practice of providing additional food to their infants between the ages of 4 and 6 months. It was observed that the average hemoglobin level was higher in infants who consumed complementary feeding during the period of 4–6 months. A significant percentage of infants (52.6%) who initiated food intake by nursing or bottle feeding between the ages of 4-6 months exhibited weight levels within the normal range. In contrast, infants who had not yet commenced supplemental feeding showed a lower prevalence of normal weight levels. Furthermore, a majority of infants (83.3%) who engaged in supplemental feeding experienced an increase in hemoglobin levels and an improvement in weight. The research findings indicate that the introduction of supplemental nutrition throughout the period of 4 to 6 months of age has a significant impact on enhancing hemoglobin levels and weight among infants.

Conclusion: The study's findings show that mothers frequently reported offering rice water, biscuits, and tea-soaked bread as their primary food sources.


complementary feeding, haemoglobin, weight status


Al-Samarrai MAM, Al-Rawi RA, Yaseen SM, Ali Jadoo SA (2020). Knowledge, attitude, and practice of mothers about complementary feeding for infants aged 6-12 months in Anbar Province, Iraq. Journal of Ideas in Health, 3(1), 125–129. doi: 10.47108/jidhealth.vol3.iss1.17

Asian Development Bank. Republic of Indonesia: Rice Fortification for the Poor (2009). Retrieved from:

Guidelines and Health Conditions Related to Timing of Early Infant Feeding: A Review (2021). Retrieved from:

Assis AMO, Gaudenzi EN, Gomes G, Ribeiro RdeC., Szarfarc SC, Souza, SBde (2004). Hemoglobin concentration, breastfeeding and complementary feeding in the first year of life. Revista de Saúde Pública. 38(4): 543–551. doi: 10.1590/s003489102004000400010.

Beinner MA, Velasquez-Meléndez G, Pessoa MC and Greiner T (2010). Iron-fortified rice is as efficacious as supplemental iron drops in infants and young children. The Journal of Nutrition, 140(1): 49–53. doi:

Binns C, Lee MK, Yun Low W, Baker P, Bulgiba A, Dahlui M, Thuy Duong DT, et al. (2020). Guidelines for complementary feeding of infants in the Asia Pacific Region: APACPH Public Health Nutrition Group. Asia Pacific Journal of Public Health. 32(4): 179–187. doi:

Campoy C, Campos D, Cerdó T, Diéguez E, García-Santos JA (2018). Complementary Feeding in Developed Countries: The 3 Ws (When, What, and Why?). Annals of Nutrition and Metabolism, 73(Suppl. 1) 27–36. doi: 10.1159/000490086

Infant Formula Distribution in Northern Iraq (2003). Retrieved from:

Friel JK, Isaak CA, Hanning R, Miller A (2009). Complementary food consumption of canadian infants. The Open Nutrition Journal. 3(1): 11–16. doi: 10.2174/1874288200903010011

Giugliani ERJ, Victoria CG (2000). Complementary feeding. Jornal de Pediatria, 76(8) 253–62. doi: 10.2223/jped.162

Jamil NF, Abul-Razzak S (2008). Feeding practices of Children under Two Years of Age in Karbalaa, Iraqi Journal of Community Medicine, (3): 183-188. Retrieved from:

Kostecka M, Jackowska I, Kostecka, J (2020). Factors affecting complementary feeding of infants. a pilot study conducted after the introduction of new infant feeding guidelines in Poland. Nutrients, 13(1): 61. doi: 10.3390/nu13010061

Luo R., Shi Y, Zhou H, Yue A, Zhang L, Sylvia S, Medina A, et al (2014). Anemia and feeding practices among infants in Rural Shaanxi Province in China. Nutrients, 6(12): 5975–5991. doi:

Mathew JL, Gupta V, Tiwari S (2015). Age of introduction of complementary feeding and iron deficiency anemia in breastfed infants. Indian Pediatrics, 52(11): 975–978.

Ntouva A (2013). Timing of complementary feeding: Its association with growth, diet, iron status, and eating behaviours in infants and toddlers. [PhD thesis]: University of Brighton 2014.

Prieto A, Detzel P (2015). Association between feeding types and hemoglobin concentrations in India. Conference: ISPOR Milan 2015.

Puranitee P, Fuangfu S, Dumrongwongsiri O (2021). Determination of hemoglobin level among 9-month-old infants visiting well child clinic. Global Pediatric Health, 8 2333794X2110366. doi: 10.1177/2333794x211036629

Qasem W (2015). The Recommended First Complementary Foods: A Review of the Literature. Journal of Pediatrics & Neonatal Care, 2(2). 10.15406/jpnc.2015.02.00069

Queiroz S de S, Torres MA (2000). Iron deficiency anemia in children. Jornal de pediatria, 76 Suppl 3: S298-304. doi:10.2223/jped.167

Rao S (2011). Study of complementary feeding practices among mothers of children aged six months to two years – A study from coastal south India. Australasian Medical Journal, 4(5) 252–257. doi: 10.4066/amj.2011.607

Rasania Sk, Sachdev TR (2001). Nutritional status and feeding practices of children attending MCH Centre. Indian Journal of Community Medicine, XXVI (3):145-150

Reinbott A, Jordan I, Herrmann J, Kuchen-becker J, Kevanna O, Krawinkel MB (2016). Role of breastfeeding and complementary food on hemoglobin and ferritin levels in a cambodian cross-sectional sample of children aged 3 to 24 months MA Cardoso (ed.). PLOS ONE, 11(3): e0150750. doi:

Saleem MB (2006). Complementary foods for children under two years of age and its relation to nutritional status and selected Socio-demographic factors in Basrah. The Medical Journal of Basrah University, 4(1):33–44. doi: 10.33762/MJBU.2006.46415

Samuel FO, Ibidapo EG (2020). Complementary feeding practices and associated factors among nursing mothers in southwestern Nigeria. International Journal of Maternal and Child Health and AIDS (IJMA), 9(2): 223–231. DOI: 10.21106/ijma.363

Souza FI, Caetano MC, Ortiz TT, Silva SG, Sarni RO (2014). Complementary feeding of infants in their first year of life: focus on the main pureed baby foods. Revista da Associacao Medica Brasileira (1992), 60 (3): 231-235.

Tamiru D, Aragu D, Belachew T (2013). Survey on the introduction of complementary foods to infants within the first six months and associated factors in rural communities of Jimma Arjo. International Journal of Nutrition and Food Sciences, 2(2):77-84. doi: 10.11648/j.ijnfs.20130202.18

WHO, guiding principles for complementary feeding of the breastfed child (2012). Retrieved from:

WHO, Hemoglobin concentrations for the diagnosis of anemia and assessment of severity (2011). Retrieved from:




How to Cite

Noaman, A. (2024). Impact of the Introduction of Complementary Feeding Prior to the Sixth Month on Hemoglobin Levels and Weight Status. Journal of Maternal and Child Health, 9(2), 260–268.