Adopting optimal feeding practices is fundamental to a child’s survival, growth and development, but too few children benefit

Proper feeding of infants and young children can increase their chances of survival. It can also promote optimal growth and development, especially in the critical window from birth to 2 years of age. Ideally, infants should be breastfed within one hour of birth, breastfed exclusively for the first six months of life and continue to be breastfed up to 2 years of age and beyond. Starting at 6 months, breastfeeding should be combined with safe, age-appropriate feeding of solid, semi-solid and soft foods.

An infant that is not exclusively breastfed could be at a substantially greater risk of death from diarrhoea or pneumonia than one who is. Moreover, breastfeeding supports infants’ immune systems and may protect them later in life from chronic conditions such as obesity and diabetes. In addition, breastfeeding protects mothers against certain types of cancer and other health conditions. Adequate feeding from 6 months onwards can prevent undernutrition and decrease the risk of infectious diseases, such as diarrhoea and pneumonia. Yet despite all the potential benefits, only about two fifths of infants 0-5 months of age worldwide are exclusively breastfed, and slightly more than two thirds are introduced to solid foods in a timely manner.

Data

Infant and young child feeding

  • Initiation of breastfeeding (birth)

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  • Exclusive breastfeeding (< 6 months)

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  • Introduction of solid, semi-solid or soft foods (6-8 months)

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  • Complementary feeding (6-23 months)

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  • Continued breastfeeding (12-23 months)

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  • Infant feeding patterns

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Notes on the data

The indicators

The standard indicators for infant and young child feeding practices were developed in alignment with WHO’s Guiding Principles on feeding the breastfed and non-breastfed child. The aim is to use the guidelines to assess infant and young child feeding practices within and across countries and to evaluate progress in this programme area. While it is not possible to develop standard indicators for all desirable and recommended practices, 15 indicators (8 core and 7 optional) were developed and are presented in WHO’s 2008 publication, Indicators for Assessing Infant and Young Child Feeding Practices. Part 1: Definitions. These indicators are a culmination of six years of inter-agency work and are used to assess a subset of practices.

This set of indicators provides i) an update of the 1991 WHO and UNICEF indicators on breastfeeding practices and ii) a broad set of indicators[2] to assess, for the first time, feeding practices in children aged 6 to 23 months.

Core indicators for infant and young child feeding practices

Indicator name

Definition

Numerator Denominator
Early initiation of breastfeeding Children born in the last 24 months who were put to the breast within one hour of birth Children born in the last 24 months
Exclusive breastfeeding Infants 0─5 months of age who received only breast milk during the previous day Infants 0─5 months of age
Continued breastfeeding at 1 year[3] Children 12─15 months of age who received breast milk during the previous day Children 12─15 months of age
Introduction of solid, semi-solid or soft foods Infants 6─8 months of age who received solid, semi-solid and soft foods during the previous day Infants 6─8 months of age
Minimum dietary diversity Children 6─23 months of age who received foods from ≥ 4 food groups during the previous day Children 6─23 months of age
Minimum meal frequency Breastfed children 6─23 months of age who received solid, semi-solid and soft foods the minimum number of times or more during the previous day Breastfed children 6─23 months of age
Non-breastfed children 6─23 months of age who received solid, semi-solid and soft foods or milk feeds the minimum number of times or more during the previous day Non-breastfed children 6─23 months of age
Minimum acceptable diet Breastfed children 6─23 months of age who had at least the minimum dietary diversity and the minimum meal frequency during the previous day Breastfed children 6─23 months of age
Non-breastfed children 6─23 months of age who received at least two milk feedings and had at least the minimum dietary diversity not including milk feeds and the minimum meal frequency during the previous day Non-breastfed children 6─23 months of age
Consumption of iron-rich or iron-fortified foods Children 6─23 months of age who received an iron-rich food or a food that was specially designed for infants and young children and was fortified with iron, or a food that was fortified in the home with a product that included iron during the previous day Children 6─23 months of age

 

Data collection and reporting

Data for these indicators are collected through household surveys. With the exception of early initiation of breastfeeding, they are based on questions about liquid and food intake of children aged 0─23 months in the 24 hours preceding the survey. Standard questions and other practical methodological instructions for the core and optional indicators are available in the WHO document, Indicators for Assessing Infant and Young Child Feeding Practices. Part 2: Measurement. Large household survey programmes, such as MICS and DHS, are major sources of country-level estimates for seven of the core indicators as well as a subset of the optional indicators.  Other national household surveys, such as national nutrition surveys, often include questions used to report on these indicators as well.


[2] These dimensions include continued breastfeeding or minimum milk feeds, appropriate timing of introduction of solid, semi-solid and soft foods, as well as optimum quantity and quality of foods consumed.

[3] Note that continued breastfeeding at 2 years (20─23 months) is an optional indicator, but is included in UNICEF’s global database.