Background/Objectives: Complementary feeding is a key determinant of child nutrition and health, and its quality is strongly influenced by socioeconomic conditions. In socially vulnerable settings, limited access to diverse and nutritious foods and the early consumption of ultra-processed products may compromise healthy feeding practices. In the Brazilian Amazon, evidence on socioeconomic inequalities in complementary feeding quality during early childhood remains scarce. This study examine the indicators of complementary feeding quality (ICFQ) according to socioeconomic characteristics in Cruzeiro do Sul, Acre, Western Brazilian Amazon.

Methods: This study included children participating in the 1- and 2-year follow-up waves of the MINA-Brazil birth cohort (n = 971). In both waves, a 24-hour dietary recall survey was administered. The ICFQ, adapted from World Health Organization recommendations, included: (i) minimum dietary diversity (MDD); (ii) consumption of meat and/or eggs; (iii) consumption of ultra-processed foods (UPF); and (iv) zero consumption of fruits and vegetables (ZFV). Socioeconomic, demographic, obstetric, neonatal, and morbidity variables were analyzed as independent variables. Prevalence Ratios (PR) were estimated using multiple Poisson regression models in Stata 18.0.

Results: Regarding meat/egg consumption, 79.0% of 1-year-olds and 89.9% of 2-year-olds consumed at least one food from this group on the previous day. High frequencies of UPF consumption were observed both in the first (89.1%) and second years (94.6%). In the first year, MDD was less frequent among children from households with lower wealth (lowest tertile: PR = 0.74; 95%CI: 0.63-0.86; middle tertile: PR = 0.90; 95%CI: 0.82-0.99; highest tertile: reference) and among those whose mothers did not engage in paid work (PR = 0.87; 95%CI: 0.80-0.95). ZFV was more prevalent among families in the lowest wealth tertile (PR = 4.89; 95%CI: 2.90-8.24) and the middle tertile (PR = 2.48; 95%CI: 1.45-4.23).

Conclusions/Recommendations: These findings underscore the influence of socioeconomic factors on young children’s dietary patterns and reinforce the need for intersectoral strategies integrating health, education, social assistance, and agriculture to advance food and nutrition security.

Funding: Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, processo 407255/2013- 3) e Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, processo 2016/00270-6), Brasil.