Exploring the relationship between mothers' knowledge, attitudes, and complementary feeding practices and nutritional status of children aged 6–23 months in Jeddah, Saudi Arabia

Background Proper complementary feeding (CF) during the first 1,000 days of life is essential for optimal growth and development. These CF practices are influenced by maternal knowledge, attitudes, and practices (KAP). The relationship between these parameters is not well investigated within the Saudi context. Objectives To assess maternal KAP regarding CF and examine their association with the nutritional status of children aged 6–23 months in Jeddah, Saudi Arabia. Methods A cross-sectional study was conducted in four well-baby clinics, including mothers with children aged 6–23 months. Data were collected using the Food and Agriculture Organization (FAO) for assessing nutrition-related Knowledge, Attitudes, and Practices (KAP). Children's anthropometric measurements (weight, length) were taken and converted to Weight-for-Age (WFA), Length-for-Age (LFA), and Weight-for-Length (WFL) Z-scores. Results Of the 390 mothers participating in the study, 74.4% relied on digital media for information about CF. While 82.3% of children met minimum dietary diversity, only about 50% met minimum meal frequency recommendations. According to WFL, 6.7% of children were overweight. WFA was significantly correlated with maternal nutritional knowledge (r = 0.18, p < 0.001), attitude (r = 0.11, p = 0.031), and complementary feeding practices (r = 0.11, p = 0.028). In multivariable analyses, maternal BMI ( β = 0.016, p < 0.001) and nutritional knowledge ( β = 0.041, p = 0.013) were positively associated with WFA. For LFA, maternal working status (vs. not working) had a negative association ( β = –0.058, p = 0.046). In contrast, nutritional knowledge ( β = 0.026, p = 0.048) showed a positive association. No significant associations were observed for WFL. Conclusion Maternal nutritional knowledge was associated with weight-for-age and length-for-age, while maternal BMI was independently associated with weight-for-age. The small effect sizes suggest that these factors alone are unlikely to explain substantial variation in child growth. These findings support multifactorial approaches to complementary-feeding education and child-growth monitoring.