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Abstract
For a number of reasons, progress in improving child feeding practices in the
developing world has been remarkably slow. First, complementary feeding practices
encompass a number of interrelated behaviors that need to be addressed simultaneously.
Child feeding practices are also age-specific within narrow age ranges, which add to the
complexity of developing recommendations and measuring responses. Finally, the lack of
clear international recommendations for some aspects of complementary feeding has
prevented the development of universal indicators to define optimal feeding. Without
appropriate measurement tools, the design and evaluation of programs to improve
complementary feeding practices cannot move forward.
The present paper is the first systematic attempt at filling this gap. It puts forth a
framework for the development of indicators of complementary feeding practices and
proposes a series of possible indicators to measure some of the most critical aspects of
infant and young child feeding. The emphasis is on simple indicators for use in large
surveys or in program contexts.
Indicators for the following aspects of complementary feeding of 6-23-month-old
children are discussed: (1) breastfeeding; (2) energy from complementary foods;
(3) nutrient density of complementary foods; and (4) safe preparation and storage of
complementary foods. Finally, possible approaches to validate the proposed indicators
are discussed and research priorities are highlighted.