Improving Child
Diets in Low- and Middle-Income Countries

Photo @ World Bank/Binyam Teshome

Current food systems are failing young children worldwide. According to a 2021 UNICEF report, two out of three children aged 6 to 23 months are being “Fed to Fail”—they are not receiving the right nutritious foods, in the right quantities, and in the right frequencies for healthy growth, development, and future economic success.

In response to this pressing issue, the Micronutrient Forum convened two expert consultations to address gaps in evidence, identify barriers and opportunities, and agree on priority actions to improve child diets during the complementary feeding period (from ages 6–23 months), especially for low-income households.

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

Meeting Report from Expert Consultation Held on 4-5 December 2023

Food Systems for Kids: Nourishing the Future

Expert Consultation on Improving the Micronutrient Quality of Complementary Feeding in Early Childhood

On June 8–9, 2023, 31 participants from academia, research institutes, implementing organizations, and the United Nations convened to discuss priorities and key activities aimed at aligning and catalyzing food-based actions to enhance the micronutrient quality of diets for older infants and young children. The experts formulated a set of recommendations focusing on research, implementation and programming, and advocacy and policy.

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

Meeting Report from Expert Consultation Held on 8-9 June 2023

Synthesis of Evidence, Knowledge Gaps, and Priorities for Food-Based and Home-Fortification Interventions

Landscape of Key Actors in Micronutrient Nutrition and Child Diets

Photos @ World Bank/Kenneth Pornillos and World Bank/A’Melody Lee

Photos @ World Bank/Kenneth Pornillos and World Bank/A’Melody Lee

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