Complementary feeding of young children in developing countries
A review of current scientific knowledge
Child malnutrition remains a common problem in developing countries. Early growth retardation is associated with a broad range of adverse functionnal consequences, including delayed motor development and impaired cognitive function and school performance, and malnourished children have a higher risk of infection, ill-health and death. Indeed, recent analyses indicate that as much as one half of under-five child mortality is associated with malnutrition. In many countries faulty complementary feeding practices - primarilly nutritionally inadequate and frequently contaminated foods that are introduced too early or too late - are a major contributing factor to infant and young child malnutrition, growth failure, and high morbidity and mortality.
This review is intended primarily for health professionals and others concerned with the nutrition, health, and well-being of children. The objective is to provide the background information that is necessary for the development of scientifically sound feeding recommendations and appropriate intervention programmes to enhance children's dietary intake and nutritional status. Although much of the information may be relevant for young children in low-income settings, and the recommendations have been formulated with consideration for the economic and environmental constraints that are common in developing countries.
The review is organized in nine sections. An introductory chapter provides the rationale for the exercise and defines some of the terms used. Chapter 2 discusses the importance of breastfeeding and the appropriate age of introduction of complementary foods, and breastfeeding duration. Chapter 3 is devoted to technical information, including energy requirements at different ages, feeding frequency, energy density, and organoleptic characteristics of food, while Chapter 4 discuss protein and micronutrients. Chapter 5 considers the role of caregivers, Chapter 6 food processing and food safety, Chapter 7 child feeding practices and children's dieatary intake, and Chapter 8 a range of programmatic interventions to promote improved child feeding. Lastly, Chapter 9 summarizes current conclusions regarding appropriate child feeding and future research needs.