Association of Infant Feeding Practices and Dietary Diversity with Malnutrition among Hospitalized Children in Pakistan

Background: Malnutrition among children under five remains a major public health challenge, contributing significantly to morbidity and mortality in low and middle-income countries, including Pakistan. Poor infant and young child feeding (IYCF) practices and inadequate dietary diversity are recognized as leading determinants of this condition. Methodology: A cross-sectional quantitative study was conducted among 100 children admitted to a stabilization center of a tertiary care hospital in Islamabad. Data were collected through anthropometric screening and caregiver interviews. WHO growth standards were applied to assess weight-for-height and height-for-age indices. Statistical analyses were performed using SPSS. Results: Of the total number of children assessed, 40% were classified with severe acute malnutrition (SAM), 30% with moderate acute malnutrition (MAM), and 30% as stunted. Feeding practices showed significant associations with nutritional status (p < 0.01). 30% of children were breastfed for less than six months, 62% received non-exclusive breastfeeding, and only 10% were introduced to complementary feeding at the recommended age. Dietary patterns were also strongly linked to nutritional outcomes: SAM children had the lowest dietary diversity, animal-source food intake, fruit/vegetable consumption and meal frequency, while junk food intake was highest in this group (p < 0.01). In contrast, sociodemographic factors including maternal education, income, family type and residence did not show significant associations with nutritional status. Conclusion: Suboptimal feeding practices, particularly non-exclusive breastfeeding, inappropriate timing of complementary feeding and poor dietary diversity, were major contributors to acute malnutrition. Targeted interventions focusing on maternal education and community-based nutrition awareness are essential to improve child health outcomes.