Abstract
<title>Abstract</title> <p>Background Infant and young child feeding practices during the complementary feeding period (6–23 months) are suboptimal in South Africa, with implications for growth and development. Understanding dietary patterns among this vulnerable population is critical for designing targeted nutritional interventions. Objective To identify and characterize dietary patterns among infants and young children aged 6–23 months in an informal settlement in Pretoria using principal component analysis (PCA) and to describe these patterns in relation to anthropometric indices. Methods A descriptive, observational cross-sectional study was conducted at Woodlane Village Clinic among 93 children aged 6–23 months. Dietary intake was assessed using a 24-hour dietary recall based on the Food and Agriculture Organization (FAO) infant and young child feeding questionnaire, while the anthropometric measurements, including weight, length, and mid-upper arm circumference, were measured from the children. The PCA with varimax rotation was applied to eight food groups to derive dietary patterns. Results The mean age of the participants was 13.6 (5.46), with 51.6% being males. Seven distinct dietary patterns were identified, accounting for the variance in food consumption: animal-source protein and mixed foods pattern (characterized by eggs and flesh foods); other fruits pattern; grains, roots, and tubers pattern; vitamin A-rich vegetables and fruits pattern; continued breastfeeding pattern; legumes and nuts pattern; and dairy versus flesh contrast pattern. The mean dietary diversity score was 4.2 ± 1.73. Minimum dietary diversity was achieved by 63.4% of children, minimum meal frequency by 64.5%, and minimum acceptable diet by 43.0%. The grains, roots, and tubers pattern was nearly universal (97.8%), while vitamin A-rich foods were consumed by 69.9% of children. The prevalence of stunting was 29.0% (19.3% moderate, 9.7% severe), while underweight and wasting rates were low (3.2% and 1.1%, respectively). Higher scores on the legumes and nuts pattern (Component 6) were associated with lower height-for-age z-scores (HAZ) (β = −0.30, p = 0.045). Conclusions Seven dietary patterns among infants and young children in a resource-limited setting were identified, revealing moderate achievements in dietary diversity and meal frequency. However, high stunting rates are alarming. Notably, higher scores in the legumes and nuts dietary pattern correlated with lower HAZ, suggesting that reliance on these foods reflects dietary constraints rather than a diversified protein strategy. Thus, promoting legumes and nuts without enhancing overall diet quality and access to animal-source foods may not effectively improve growth outcomes.</p>