PONE-D-20-06067

Determinants of appropriate complementary feeding practice among mothers of children age 6-23 months in Western Ethiopia

PLOS ONE

Dear Dr.  Cherie

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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We look forward to receiving your revised manuscript.

Kind regards,

Choolwe Jacobs, PhD

Academic Editor

PLOS ONE

Additional Editor Comments:

The authors should ensure a thorough review of the manuscript and additionally attend to all typo and grammatical errors. The authors should also adequately demonstrate the additional value/contribution this study brings considering that many other similar studies have been done in Ethiopia.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: No

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: GENERAL COMMENTS

Determining the complementary feeding practices is critical for children aged six months and above. Therefore, this study is very critical in addressing behaviour change regarding best practices among the population of interest. This being the case, the arguments in this study are very weak in informing policy.

The grammar is generally poor and requires an English language editor’s services.

There are WHO guidelines on breastfeeding for HIV exposed infants and the rest of the population that are clear when each feeding method can be initiated and discontinued, however, this study has not referred to these.

ABSTRACT

If a researcher chose to read only the abstract, then they would consider the paper very inadequate in addressing the gap in research.

Lines 23-24, the authors said: “The magnitude of appropriate complementary feeding practice in the study area was very low”. What would you consider low.

BACKGROUND

Much as the background needs to be brief, it has very little to reflect the gap that this research is addressing.

There are certain questions one would like to answer: What is complementary feeding practice? Is it a collection of different activities or it is one event? This is not clear in the background.

The authors will do well to give a clear explanation of the food types as they appear in the national guidelines and also based on food types in the region. Any brief explanation of these groups and maybe what do they comprise of in Ethiopia. It would help also to provide information on guidelines relating to initiation of complementary foods in Ethiopia and also speaking to WHO guidelines.

What is context specific information?

OVERALL AIM

Lines 50-51-the authors collected data to determine the magnitude of appropriate complementary feeding practice and its determinants in Western Ethiopia to guide policy actions in the area.

This aim is two pronged because the authors can come up with just results on magnitude of complementary feeding practice in the population of interest….but also they can establish determinants of complementary feeding practice.

Handling the study in this way made it difficult for the authors to make scientifically based conclusions as shown later in the comments. Either one of the issues studied separately would provide evidence to inform policy.

For this study, the main outcome measure (lines 76 & 77) do not relate with the aim of the study. Therefore, the authors were not mindful of the importance of answering the research question adequately and might benefit from recasting the overall aim to tally with what the data is describing.

METHODOLOGY

Here it would help to describe what constitutes appropriate complementary feeding and its components

Under variables of the study, the authors mention that the mothers identified for this study should have ANC visits, delivered at the health facility and attended PNC with additional information on feeding counselling. The link is unclear, but how do you link this care to magnitude of appropriate complementary feeding?

Data collection procedures: Instead of saying diploma or BSc nurses, one would think describing their skills is better than their qualification.

RESULTS

This section of the manuscript should be reorganized based on the overall aim after recasting it.

DISCUSSION

This statement should open with the main outcome of the study to see that the research question has been answered.

Lines 208-209-This statement contradicts with the WHO recommendation of exclusive breastfeeding up to six months. This is worrying.

Lines 209-201-What would you consider to be premature for your study?

This comparison might not suffice because of differences in characteristics.

Lines 228-231: sentence is too long and needs recasting to make the message clear in this context.

Our finding shows that children in the study area as well as in Ethiopia in general are not getting adequate energy and nutrients compared to children in many African and Asian countries: This sentence requires a source; I doubt the authors have authority to this information.

Lines 256-257: This type writing is all over the discussion and it has become monotonous. The authors can vary the expression.

CONCLUSION

Lines 271-273: When you compare this statement with the aim of the study and the background, the authors appear to be contradicting themselves or tying themselves. Their study does not appear to be different from the survey they referred to in the background.

The recommendation: ‘Interventions on appropriate complementary feeding should therefore target uneducated mothers, mothers who gave birth for the first time and those with young children’.

If the idea is to improve the practices among the uneducated women, redesigning and packaging the intervention to suite this population then ties in with what authors earlier indicated in line 49-50 ‘context specific information to design appropriate interventions’

Reviewer #2: The study is well written and detailed and addresses its objectives..on the other hand their are many other similar studies conducted in different parts of Ethiopia . So that the authors should describe the contribution of their study to the existing literature.

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Reviewer #1: No

Reviewer #2: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

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Attachments

Attachment

Submitted filename: PLOS ONE-PONE-D-20-06067-Reviewer comments.docx

Attachment

Submitted filename: Comment plose.pdf

PONE-D-20-06067R1

Magnitude and determinants of appropriate complementary feeding practice among mothers of children age 6-23 months in Western Ethiopia

PLOS ONE

Dear Dr.Hirut Assaye Cherie

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by 21st August 2020. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols

We look forward to receiving your revised manuscript.

Kind regards,

Choolwe Jacobs, PhD

Academic Editor

PLOS ONE

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Magnitude and determinants of appropriate complementary feeding practice among mothers of children age 6-23 months in Western Ethiopia

PONE-D-20-06067R2

Dear Dr. Cherie,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Emily A Hurley, M.P.H., Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors endeavored to respond to the issues I raised in my first review. I am convinced that the editor will find this manuscript important for the rest of the research community and add to the body of knowledge in this area.

Reviewer #2: They tried to answer the questions raised during the first review process and the tried to improve the language.Overall, They have addressed my concerns.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No