Improving Child
Diets in Low- and Middle-Income Countries
Photo: World Bank/Binyam Teshome
Current Food Systems are Failing Young Children Worldwide
According to the 2024 UNICEF Food Poverty report, 440 million children under five live in food poverty. This means they are not receiving the right nutritious foods in the right quantities and frequencies necessary for healthy growth, development, and future economic success. One in four children (27%) experience severe child food poverty, consuming only two or fewer food groups daily.
Infants and young children aged 6-23 months are hit hardest, as the first foods they eat to complement breastmilk are often unavailable, unaffordable, inaccessible, or unappealing. This failure is two-fold: nutritious, safe, and affordable foods tailored to the high nutritional needs of young children are scarce, while markets are saturated with nutrient-poor, unhealthy snacks, foods, and beverages.
The Micronutrient Forum works with partners to address these gaps by convening government authorities, investors, producers, and technical experts to improve the micronutrient quality of and access to complementary foods. Children’s first foods must be safe and nutritious to ensure proper growth and development—critical for their future health, learning, and productivity.
The Micronutrient Forum is a member of the Global Complementary Feeding Collective led by UNICEF and the WHO. The Forum supports their call for governments, policymakers, and civil society to take eight concrete, coordinated actions to improve access to nutritious, safe, and diverse diets during the complementary feeding period.
Regional Dialogue on Improving Access to Locally Produced Complementary Foods
From December 1–3, 2024, the Micronutrient Forum convened a “Regional Dialogue on Improving Access to Locally Produced Nutritious and Safe Complementary Foods in Low- and Middle-Income Countries” in Dakar, Senegal. This important meeting, supported by the European Union and Expertise France through their EU4SUN project, brought together local producers, policymakers, regulatory authorities, funders, social impact investors, and technical agencies based on a mapping of complementary food actors. The discussions focused on applying a whole-of-systems approach to address barriers to producing safe and nutritious, locally made complementary foods, as described in an article published in Emergency Nutrition Network (ENN)’s Field Exchange.
Increasing access to nutritious local complementary foods: A whole-of-systems approach
Photo credit: Nutrizaza
In February 2025, the Micronutrient Forum published a Summary Brief (Résumé en français) from the regional dialogue, which outlines five critical priority action areas to improve access to and use of locally produced, nutritious, safe, complementary foods. These recommendations will inform regional and country commitments on local complementary food production at the Nutrition for Growth Summit in Paris in March 2025. The full meeting report (available soon in English and French) delves deeper into each core area, provides detailed insights into the barriers, highlights examples and includes case studies of the potential solutions and a list of useful resources. The meeting report also presents a complementary feeding ecosystem framework, which can be used for a country assessment and identification of national priority areas for development of locally produced complementary foods.
Prior to the meeting, the pre-read material titled, “Barriers to improving access to locally produced nutritious and safe complementary foods in low- and middle-income,” was published in English and en français.
Local solutions to improve access to nutritious and safe complementary foods in Africa
Solutions locales pour améliorer l’accès à des aliments de complément nutritifs et sûrs en Afrique
Photo credit: Demissew Bizuwerk / UNICEF (left); GAIN (right)
Expert Consultation on Making Food Systems Work for Complementary Feeding in Low- and Middle-Income Countries
A group of 43 experts gathered on December 4–5, 2023 to deliberate strategies for increasing the availability, affordability, accessibility, and aspirational aspects of nutritious and safe foods suitable for complementary feeding, particularly for low-income households. These participants, representing diverse expertise in nutrition, food systems, policy, and business, proposed thirteen recommendations across four core areas, including six priority actions to be urgently implemented.
Six Priority Actions Across Four Core Areas
1. Create compendiums of successes and failures in approaches, policies, and business models to prevent food losses and waste and improve supply chain efficiencies for nutrient-dense foods and commercialized fortified complementary foods.
2. Build the evidence base on consumption and purchase of complementary foods and the impact of food systems approaches on the 4As of complementary foods and business viability.
3. Adopt “R&D-as-a-service” model and provide expertise, capacity strengthening, and technical assistance to food system actors, particularly small and medium enterprises (SMEs), to develop safe, nutritious, and aspirational complementary foods.
4. Develop and align financing strategies at the national and organizational levels to mobilize a pipeline of investments to support individual SMEs in bringing more high-quality and safe complementary foods to markets at affordable prices.
5. Organize expert consultations to discuss recommendations for product standards for fortified complementary foods and appropriate monitoring mechanisms.
6. Develop unified standards and tools to inform decisions and guide engagement with food system stakeholders, including the food industry, on appropriate formulation of complementary foods.
Making Food Systems Work for Complementary Feeding in Low- and Middle-Income Countries
Expert Consultation on Improving the Micronutrient Quality of Complementary Feeding in Early Childhood
Recommendations from the Expert Consultation
Encourage governments to include specific guidance for complementary feeding of older infants and young children 6–23 months in national food-based dietary guidelines.
Encourage stakeholders in the food system and the social protection system to take infant and young child feeding requirements into consideration as part of their systems’ policies, strategies, and programs.
Recommend the development of implementation guidance for programming in plain language, with concrete examples to accompany the updated WHO complementary feeding guidelines (to be published by end 2023). Countries should be encouraged to update their young child feeding policies accordingly.
Recommend that the various child feeding recommendations included in different WHO guidelines be aligned with complementary feeding guidelines.
Recommend that complementary feeding guidelines specify that dietary components that contribute to nutrient deficiencies and obesity (such as high-sugar beverages and nutrient-poor, high-fat snacks) should be avoided.
Encourage the integration of micronutrient-rich, affordable, and acceptable diets and practices in complementary feeding, including traditional and indigenous foods.
Recommend that cost, convenience, time, and availability of foods be considered when making recommendations for a healthy complementary food diet. These are highly relevant factors to low-income urban and rural families when making decisions on child
feeding (and household diet).
Encourage governments to include complementary feeding interventions in annual budgets, costed development plans, resource mobilization strategies, expenditure tracking, and accountability systems across national budgets for food, health, and social protection systems.
Recommend holding additional expert convenings to review the following topics:
- Unhealthy foods and beverages (low in micronutrient density, high in sugar or unhealthy fat)
- Commercially produced fortified complementary foods
- Demand creation and social behavior change communication
- Complementary feeding in humanitarian contexts
Improving the Micronutrient Quality of Complementary Feeding in Early Childhood
Photo: World Bank/Rama George-Alleyne
Synthesis of Evidence, Knowledge Gaps, and Priorities for Food-Based and Home-Fortification Interventions
Photos @ World Bank/Kenneth Pornillos and World Bank/A’Melody Lee
Photos: World Bank/Kenneth Pornillos and World Bank/A’Melody Lee
