Despite efforts to improve feeding practices globally, 48% of children do not meet the recommended minimum meal frequency. Thus, the aim of this study was to assess minimum meal frequency and its associated factors in children aged 6–23 months in cash crop districts of Kercha, Southern Ethiopia.

A community-based cross-sectional design was used to conduct this study from 29 February 2024 to 29 March 2024.

Kercha district, Southern Ethiopia

A total of 543 children aged 6–23 months were selected using a multistage sampling technique.

The primary outcome of this study was minimum meal frequency, defined as the percentage of children aged 6–23 months who consumed solid, semisolid or soft foods (including milk for non-breastfed children) at least the required number of times for their age in the previous day.

The secondary outcome of this study was factors associated with minimum meal frequency. Bivariable and multivariable multilevel mixed-effect logistic regression analyses were performed to find factors related to minimum meal frequency. Adjusted ORs (AORs) with 95% CIs and p values

A total of 539 (99.3%) children aged 6–23 months and their mothers participated in this study. The prevalence of minimum meal frequency was 62.3% (95% CI 58.1% to 66.4%) among children in the cash crop district of Kercha. The final model yielded an intracluster correlation coefficient of 7.3%, reflecting unexplained variations in the prevalence of minimum meal frequency among children at the kebele level. Factors associated with higher odds of meeting minimum meal frequency included being a first-born child (AOR 2.91, 95% CI 1.06 to 8.05), mothers (AOR 2.66, 95% CI 1.48 to 4.76) and fathers (AOR 3.43, 95% CI 1.98 to 5.95) with primary education, having mother attending postnatal visits (AOR 2.74, 95% CI 1.52 to 4.94), introducing additional food at 6 months (AOR 4.71, 95% CI 2.79 to 7.94), good maternal knowledge on child feeding (AOR 1.98, 95% CI 1.21 to 3.22) and living in the household with medium (AOR 2.98, 95% CI 1.59 to 5.53) and rich (AOR 2.39, 95% CI 1.37 to 4.18) wealth status.

The study revealed that only three-fifths of children met the recommended minimum meal frequency. Birth order, introducing additional foods at 6 months, parental education, maternal postnatal visits, good maternal knowledge on child feeding and wealth were linked to minimum meal frequency. To improve child nutrition, it is crucial to enhance maternal education, increase access to postnatal healthcare and educate parents about the importance of introducing additional foods at 6 months.

Improving the quality of life for preterm children is a global health priority, given their vulnerability to neurocognitive impairments and adverse health consequences. Lack of posthospital care further exacerbates these risks, necessitating effective interventions during the neonatal period. This protocol for a pilot study aims to investigate the effects of touch interventions, including physiotherapy and osteopathic manipulative treatment, on brain activity in moderately preterm infants using brain functional MRI (fMRI), computerised EEG and metabolomics.

A 3-arm randomised sham-controlled trial will be conducted with 15 infants per experimental group. The study will include stable preterm infants born between 32.0 and 33.6 weeks of gestational age who do not require any intensive care treatments.

The study aims to assess the impact of touch interventions on brain activity and metabolic sequelae. Using fMRI will primarily examine the pre-post changes between groups in blood oxygenation level dependent levels among different brain areas, specifically the anterior insula and the medial prefrontal cortex. Secondarily, we will explore the preterm brain’s neural effects on EEG slow delta wave band. Metabolomics will provide data on the effects among the three groups on metabolic changes associated with touch interventions.

Ethical approval has been obtained from the Ethics Committee of the local health agency in Milan (CET 449-2024). Understanding the effects of touch interventions on brain activity in moderately preterm infants, without needs of intensive care, can contribute to improving their clinical outcomes and promoting their growth, development and social behaviour. Findings from this pilot study will pave the way for future research, enabling the development of evidence-based interventions to enhance preterm infants’ well-being and long-term outcomes.

NCT05853991.