Table 1 shows the sociodemographic data of the study population. In total, 167 mothers were included in this study. About half of the participants (50.9%) were over 30 years old, and the majority were housewives (81.4%), more than half of them (54.5%) had high school or diploma educational level, and 38.3% had an income of more than 10,000 AED. More than half were either overweight or obese (57.5%) before pregnancy and did low-intensity physical activity (56.9%). Around one-quarter (26.3%) of the mothers were primiparous, 74.9% of them had no gestational diabetes, 68.1% had normal vaginal deliveries, and 23.1% reported having complications during pregnancy. As for the infant characteristics, more than half were males (57.5%). The mean ± SE birth weight and length were “3.22kg ± 0.04” and “50.17 cm ± 0.17” respectively. Around three-fourths of the infants had less than 40 weeks of gestational age. The infants’ gestational age classification was reported as follows: 74.4%, 8.1%, and 17.5% for AGA, SGA, and LGA, respectively.

Figure 2A describes breastfeeding related IYCF indicators. The majority of the mothers-initiated BF within one hour post-delivery (84.3%). Nearly all infants (99.4%) of the infants were EvBF, while 32.9% were EBF under six months, and 28.1% were mixed-fed [both breastmilk and formula (MixMF)]. Almost all the mothers (96.4%) introduced solid, semisolid, or soft foods (ISSSF) for their infants during their 6–8 months of age. Most of the mothers continued breastfeeding (CBF) their infants for 12 months (68.7%), yet this percentage dropped to 44.7% by 18 months of age.

A. Descriptive statistics of breastfeeding-related IYCF indicators at visit 3, 4, 5, and 6. B. Descriptive statistics of food-related IYCF indicators at visits 4, 5, and 6. Abbreviations: EvBF; Ever breastfed; EIBF; Early initiation of Breastfeeding. EBF; Exclusive breastfeeding under six months. MixMF; Mixed milk feeding under six months. ISSSF: introduced solid, semisolid, or soft foods 6–8 months. CBF; Continued breastfeeding 12–23 months; MDD; Minimum dietary diversity 6–23 months. MMF; Minimum meal frequency 6–23 months. MMFF; Minimum milk feeding frequency for non-breastfed children 6–23 months. MAD; Minimum acceptable diet 6–23 months. EFF; Egg and/or flesh food consumption 6–23 months. SwB; Sweet beverage consumption 6–23 months. UFC; Unhealthy food consumption 6–23 months. ZVF; Zero vegetable or fruit consumption 6–23 months. V4 = 6 months, V5 = 12 months, V6 = 18 months

Figure 2B describes food related IYCF indicators. Only 4.3% of infants consumed foods and beverages from at least five of the eight groups (MDD) at 6 months of age, while this percentage increased to 43.0% and 40.4% at 12 and 18 months of age, respectively. The percentages of infants who consumed solid, semi-solid, and soft foods the minimum number of times or more (MMF) were 33.6% at 6 and 12 months of age and increased to 56.7% at 18 months. While the percentage of infants who consumed a minimum acceptable diet (MAD) was 2.9% at 6 months of age, it increased to 13.3% and 23.1% at 12 and 18 months of age, respectively. The percentage of infants who consumed eggs and/or flesh foods (EFF) was 3.6% at 6 months; this figure increased to 59.4% at 12 months and 78.8% at 8 months of age. The percentage of infants who consumed SSB was 9.3%, 23.4%, and 26.9% at 6, 12, and 18 months of age respectively. The percentage of infants who consumed sentinel unhealthy foods (UCF) was 10.0% at 6 months, increased to 48.4% at 12 months, and to 65.4% at 18 months. The percentage of infants who did not consume vegetables or fruits (ZVF) was 55.7% at 6 months, decreased to 23.4% at 12 months, and then rose to 28.8% at 18 months.

As for the diet diversity, Fig. 3 describes the consumption of some food groups included in the MDD at 6, 12, and 18 months of the infant’s age. The percentage of breast milk feeding was 84% at 6 months, which decreased to 34% and 44% at 12 and 18 months, respectively. The consumption of grains, roots, tubers, and plantains was reported in 56% of the infants at 6 months, 46% at 12 months, and increased to 98% at 18 months. The consumption of pulses, nuts, and seeds increased gradually from 4% at 6 months, to 9% and 13% at 12 and 18 months, respectively. The consumption of dairy products was similar at 6 and 12 months, 45% and 41%, respectively, then increased to 95% at 18 months. The percentage of infants who consumed flesh foods was 4% at 6 months and increased to 25% at 12 months, and to 68% at 18 months. None of the infants consumed eggs at 6 months, and the percentage increased to 11% and 32% at 12 and 18 months, respectively. The proportion of infants who consumed vitamin A-rich fruits and vegetables decreased from 11% at 6 months, to 9% and 7% at 12 and 18 months, respectively. Finally, the percentage of infants who consumed other fruits and vegetables was comparable at 6 and 12 months (36% and 35%) and increased to 71% at 18 months.

Consumption of food groups at visits 4, 5, and 6 (6, 12 and 18 months)

Table 2 shows the associations between maternal sociodemographic, lifestyle, child, and pregnancy-related factors and BF indicators as depicted by simple and multiple logistic regression. The results of the multiple regression showed that mothers aged between 25 and 30 years, who delivered by cesarean section and had female babies have higher odds of initiating breastfeeding (EIBF) early (aOR = 0.09, 95%CI: 0.01,0.67; aOR = 0.19, 95%CI: 0.07–0.55, aOR = 0.28, 95%CI: 0.1,0.84). While being a housewife was associated with higher odds of EIBF (aOR = 6.77, 95%CI: 1.32,34.62). As for EBF, having three or more children was associated with higher odds (aOR = 3.43, 95%CI: 1.36,8.66), whereas pregnancy complications were associated with lower odds of EBF (aOR = 0.38, 95%CI: 0.15,0.97). Being a housewife has fewer odds of practicing mixed feeding (MixMF) (aOR = 0.23, 95%CI: 0.06,0.95), whereas having GDM was positively associated with this indicator (aOR = 3.74, 95%CI: 1.03,13.75). Having three children or more was associated with higher odds of CBF at 12 months (aOR = 4.84, 95%CI: 1.23,19.01); while gestational age of 40 weeks or more was inversely associated with CBF (aOR = 0.31, 95%CI: 0.11,0.82). Regarding CBF at 18 months, mothers aged 25–30 years and those older than 30 years had higher odds as compared to younger mothers (18–24 years) (aOR = 8.4, 95%CI: 1.29,54.78; aOR = 8.82, 95%CI: 1.47,52.83 respectively). Having a household income of 5,000 to 10,000 AED and greater than 10,000 AED were negatively associated with CBF at 18 months as compared to an income lower than 5,000 AED (aOR = 0.08, 95%CI: 0.01,0.79; aOR = 0.08, 95%CI: 0.01,0.79 respectively).

Table 3 describes the associations between maternal sociodemographic, lifestyle, child, and pregnancy-related factors and CF indicators measured at 12 months as depicted by simple and multiple logistic regression. The results of the multiple regression showed that mothers who did high-intensity physical activity during pregnancy have higher odds of offering their infants foods and beverages from at least five out of the eight defined food groups (MDD) (aOR = 6.02, 95%CI: 1.07,33.93), whereas those who had GDM exhibited higher odds of providing their infants with SSB (aOR = 2.62, 95%CI: 1,6.88). Higher monthly household income of more than 10,000 AED, caesarian delivery, and gestational age of more than or equal to 40 weeks were associated with lower odds of offering children selected sentinel unhealthy foods (UCF) (aOR = 0.17, 95%CI: 0.04,0.85; aOR = 0.3, 95%CI: 0.11,0.8, and aOR = 0.26, 95%CI: 0.1,0.7, respectively). Finally, mothers with educational levels of high school/technical diploma and university had lower odds of ZVF compared to those with an intermediate or lower educational level (aOR = 0.23, 95%CI: 0.06,0.92; aOR = 0.16, 95%CI: 0.03,0.81 respectively).

Figure 4 compares MDD and MAD levels at 18 months based on breastfeeding practices at earlier visits, namely EBF at 2 months and CBF at 12 months. Children who were exclusively breastfed at 2 months showed significantly higher MDD levels at 18 months compared to those not exclusively breastfed (52.8% vs. 30.0%, p-value = 0.026). However, no significant difference in MAD levels was observed between the exclusive and non-exclusive breastfed groups at 2 months. Additionally, children who were continuously breastfed at 12 months demonstrated significantly higher MDD levels at 18 months compared to those who were not continuously breastfed (52.9% vs. 7.4%, respectively, p-value < 0.001). Similarly, the MAD level at 18 months was significantly higher for continuously breastfed children at 12 months (27.9%) compared to those not continuously breastfed (3.7%) (p-value = 0.009).

Comparison of Minimum Dietary Diversity (MDD) and Minimum Acceptable Diet (MAD) at 18 Months (Visit 6) by Breastfeeding Status at 2 Months (Exclusive Breastfeeding, EBF) (Visit 3) and 12 Months (Continuous Breastfeeding, CBF) (Visit 5). * Indicates statistical significance. Abbreviations: EBF; Exclusive breastfeeding under six months. CBF; Continued breastfeeding 12–23 months; MDD; Minimum dietary diversity 6–23 months