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Background  Mothers and caregivers typically feed infants according to their culture, purchase power and level of awareness with no due diligence to nutritional quality of the diet. Scientific evidence on nutritional adequacy of predominant complementary foods is critical for planning and prioritising interventions. The purpose of the current study was to evaluate the quality of complementary foods and the optimality of complementary feeding practices in Southwest Ethiopia.    Methods  In this cross-sectional study, a stratified multistage sampling procedure was used to sample 433 children, 6–24 months old. A semi-structured questionnaire was used to collect demographic, socio-economic and dietary data. Dietary diversity score was measured using a 24-h dietary recall. Six customary complementary food types were assayed for proximate composition, energy and mineral density using standard methods. Adequacy of the complementary foods in nutrients for complementary feeding purposes was assessed as a ratio between actual composition and recommended composition of complementary foods.    Results  Only 16.1% of the children get the minimum dietary diversity. The children were reported to be fed with cereals & grains (68.8%), discretionary calories (53.6%), protein-rich foods (44.6%), oils and fat (40.5%), vegetables (38.5%), dairy products (17.9%) and fruits (28.1%). The sampled foods contained 4.3–24.4%, 0.9–8.5%, 8.2–11.9%, 27.9–162.6 Kcal/100 g, 168.4–250.4 mg/100 g, 1.8–4.1 mg/100 g and 22.5–42.4 mg/100 g of total carbohydrate, crude fat, protein, energy content, calcium, zinc and iron, respectively. All the complementary food samples predominantly fed to children were not composed of adequate protein, fat, carbohydrate, energy and calcium as recommended for complementary feeding purposes. However, most of the complementary foods are composed of adequate iron and zinc.    Conclusions  The nutrient density and diversity of complementary foods of 6–24-month-old children in the study area were found to be sub-optimal. Upgrading the nutritional composition of the starchy complementary foods should be of highest priority to improve nutrition of the infants and young children.

journal of health, population and nutrition

Complementary feeding practices, dietary diversity, and nutrient composition of complementary foods of children 6–24 months old in Jimma Zone, Southwest Ethiopia