Objective: To systematically review studies that used indexes to assess feeding practices of children under 2 years. Design: Seven databases were searched with no limit on language or publication date. Setting: The reviewed studies included 13 Asian, 10 Latin American, 4 European, 4 North American, 3 Oceanian, and 3 African. Participants: Children under 2 years. Results: We analyzed 36 studies: 22 presenting original indexes and 14 using adapted indexes. Among the original indexes, 13 assess breastfeeding, 14 food consumption, 10 food groups, and 10 other feeding practices. Original indexes were mainly adapted to fit the data available in the study, to update for current nutritional recommendations, or to add components not present in the original indexes. Seven studies evaluated the associations between the indexes and nutrient intake or nutritional status. The main limitations cited by the authors were: flaws in the definition of the index components, criteria for cut-off points, and weighting of the evaluated index components. Conclusions: The assessment of feeding practices for young children and its comparison across countries remains a challenge, especially due to the lack of consensus on the construction of indexes and regional differences in dietary recommendations and practices. Lack of validation for some indexes also makes it difficult to choose the most appropriate index for a given objective. Adapting existing indexes is a viable option. We point out relevant recommendations that may contribute to future research. Validation and longitudinal studies in diverse populations are favorable to qualify the assessment of feeding practices in this group.
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