Child Feeding Practices and Double Burden of Malnutrition in Peri-Urban Communities of Rivers State

The double burden of malnutrition, defined as the coexistence of undernutrition and overweight or obesity within the same household, community, or individual, is an emerging nutritional challenge in peri-urban Nigerian settings where nutrition transition is occurring alongside residual undernutrition. This study examines child feeding practices and their association with the double burden of malnutrition among children under five in peri-urban communities of Obio-Akpor and Eleme local government areas, Rivers State, South South Nigeria. An analytical cross-sectional study enrolled 380 mother-child pairs through community-based systematic sampling. Child anthropometric data including weight-for-height z-scores, height-for-age z-scores, and weight-for-age z-scores were collected to classify each child's nutritional status. Maternal body mass index was measured concurrently. Feeding practices were assessed using the WHO Infant and Young Child Feeding indicators, while a food frequency questionnaire and 24-hour recall generated data on ultra-processed food exposure and dietary diversity. Household-level variables including food expenditure, dwelling type, water source, and income were also collected. Logistic regression and household-level concordance analysis were used to examine associations between feeding practices and the double burden of malnutrition. Findings will highlight the emerging nutritional paradox in peri-urban Rivers State and contribute to programming that simultaneously addresses both ends of the malnutrition spectrum. Keywords: double burden of malnutrition, child feeding, peri-urban, Rivers State, nutrition transition.