The result of our study revealed that timely initiation of complementary feeding is 62% with the median age of six months. House wife mothers, mothers and husbands education, ANC attendance, parity and birth preparedness were the factors found to increase initiation of complementary feeding on time.
The 62.8% prevalence we detected was higher than the national prevalence (51%) [8]. It is also much higher than the study from Nairobi, (less than 10%), Taiwan (50%) and West Bengal, India (55.1%) [10–12]. Our finding, although it is better than the one reported at national level and few other countries, it was still low as the remaining 38% of mothers did not start complementary feeding at the right time. This relatively higher prevalence of timely initiation of complementary feeding at six month can be explained by the expansion of the health extension workers in Ethiopia. The health extension workers among their other health activities are involved in continuous health education to the community which has contributed to high coverage of ANC attendance and health institutional delivery and also initiation of complementary feeding on time in Mekelle town. The median age of starting complementary feeding was six month, where as in a country like Ghana they started earlier at 5.4 months of the child age [18].
Not few mothers (8.7%) used family diet as a complementary feeding while solid foods are not recommended at this age of infancy. Furthermore, majority of mothers used fluids as a complementary food that might dilute the nutritional contents and affect growth and development of children. Approximately 18% of children started complementary feeding late at seventh month or beyond, which would lead to macro and micro nutrient deficiency and serious nutritional problem, slows growth and predisposes to infectious disease that further exacerbates the nutritional status [7].
Mothers who had at least one child were 2.344 times higher in initiating complementary feeding at six months than mothers who had only one child, which is congruent with findings in other places [19]. Studies revealed that mothers who had at least one child have high levels of breastfeeding related knowledge, including appropriate time of initiating complementary feeding [20]. This may also be related to repeated exposure of health education during the previous pregnancies and the experience they gained through time, therefore repeated exposure to health education will have an impact in subsequent pregnancies.
A higher maternal educational level, high school and above (AOD = 2.361), was noted to increase timely initiation of complementary feeding; similar findings were observed by other studies in Nairobi, Kenya [15], Hong Kong [19], Belgium [21], and Bavaria, Germany [22]. This can be explained that improved maternal education enhances mothers’ understanding and appreciation of the demands and benefits of introducing complementary feeding timely, and empowers them to resist external interferences and pressures.
A higher husband educational level, high school and above (AOD = 2.991), was also noted to favor timely initiation of complementary feeding as education is believed to enable the husbands to understand their wives and provide help and approval to what mothers would like to do to keep the child healthy.
Antenatal care attendance seems to have an impact, AOR = 2.845, on exclusive breastfeeding for the first six months and initiating complementary feeding at the six months. Therefore, ANC is very important to also deliver other maternal health related messages to women.
House-wife mothers were more likely to initiation of complementary feeding timely which was in line with finding in other places [22]. This can be because the housewives usually stay at home and would not be obliged like mothers who are working to wean early to go to work.
Mothers who made birth preparedness were 2.816 times more likely to initiate complementary feeding at six month than those who do not. This might enable mothers to arrange conditions which could help them initiate complementary feeding timely.
Though, some other findings revealed that being older age is favorable to initiate complementary feeding timely [19, 21, 22], in this study age had no association with timely initiation of complementary feeding, similar to the finding from Nigeria [23].