Insufficient quantities and inadequate quality of complementary foods, together with poor feeding practices, pose a threat to children's health and nutrition. Interventions to improve complementary feeding are critical to reduce all forms of malnutrition, and access to data to ascertain the status of complementary feeding practices is essential for efforts to improve feeding behaviours. However, sufficient data to generate estimates for the core indicators covering the complementary feeding period only became available recently. The current situation of complementary feeding at the global and regional level is reported here using data contained within the UNICEF global database. Global rates of continued breastfeeding drop from 74.0% at 1 year of age to 46.3% at 2 years of age. Nearly a third of infants 4-5 months old are already fed solid foods, whereas nearly 20% of 10-11 months old had not consumed solid foods during the day prior to their survey. Of particular concern is the low rate (28.2%) of children 6-23 months receiving at least a minimally diverse diet. Although rates for all indicators vary by background characteristics, feeding behaviours are suboptimal even in richest households, suggesting that cultural factors and poor knowledge regarding an adequate diet for young children are important to address. In summary, far too few children are benefitting from minimum complementary feeding practices. Efforts are needed not only to improve children's diets for their survival, growth, and development but also for governments to report on progress against global infant and young child feeding indicators on a regular basis.

No abstract

Age-appropriate complementary feeding practices are far from optimal among low-and middleincome countries with available data. The evidence on the association between feeding practices and linear growth is mixed. We sought to systematically examine the association between two indictors of dietary quality-dietary diversity and animal source food (ASF) consumption (WHO, 2008)-and stunting (length-for-age z-score) employing existing data from 39 Demographic and Health Surveys. Data on 74,548 children aged 6-23 months were pooled and multiple logistic regression models, adjusting for child, maternal, and household characteristics, employed to assess the association between dietary quality and stunting. Stratified models by child age and by World Bank country-income classifications (World Bank, 2015) were also applied. Children aged 6-23 months consuming zero food groups in the previous day had a 1.345 higher odds of being stunted when compared to the reference group (≥5 food groups); those who did not consume any ASF in the previous day had a 1.436 higher odds of being stunted compared to children consuming all three types of ASF (egg, meat, and dairy). We estimated that 2,629 cases of stunting would have been averted (12.6% of those stunted) among the population studied if all children had consumed five or more food groups. Outcomes by country-income groupings showed larger associations of diet diversity and ASF consumption for upper-and lower-middle income countries compared to low-income countries. In summary, dietary diversity and ASF consumption were associated with stunting, with associations varying by stratified groups.KEYWORDS animal source foods, child growth, diet diversity, infant and young child feeding, stunting, WHO feeding indicators

The purpose of this study was to identify caregiver characteristics that influence child nutritional status in rural Chad, when controlling for socioeconomic factors. Variables were classified according to the categories of a UNICEF model of care: caregiving behaviors, household food security, food and economic resources and resources for care and health resources. Sixty-four households with 98 children from ages 12 to 71 mo were part of this study. Caregivers were interviewed to collect information on number of pregnancies, child feeding and health practices, influence on decisions regarding child health and feeding, overall satisfaction with life, social support, workload, income, use of income, and household food expenditures and consumption. Household heads were questioned about household food production and other economic resources. Caregiver and household variables were classified as two sets of variables, and separate regression models were run for each of the two sets. Significant predictors of height-for-age were then combined in the same regression model. Caregiver influence on child-feeding decisions, level of satisfaction with life, willingness to seek advice during child illnesses, and the number of individuals available to assist with domestic tasks were the caregiver factors associated with children's height-for-age. Socioeconomic factors associated with children's height-for-age were the amount of harvested cereals, the sources of household income and the household being monogamous. When the caregiver and household socioeconomic factors were combined in the same model, they explained 54% of the variance in children's height-for-age, and their regression coefficients did not change or only slightly increased, except for caregiver's propensity to seek advice during child illnesses, which was no longer significant. These results indicate that caregiver characteristics influence children's nutritional status, even while controlling for the socioeconomic status of the household.