World Health Organization infant and young child feeding indicators and their associations with child growth: a synthesis of recent findings

Abstract

This study aims to determine cross‐country patterns of associations of each of the World Health Organization (WHO) infant and young child feeding (IYCF) indicators with child stunting, wasting, height‐for‐age Z‐score (HAZ) and weight‐for‐height Z‐score (WHZ) in order to assess the constructs measured by the indicators across contexts. Seven studies using recent Demographic and Health Surveys data from a total of eight countries in sub‐Saharan Africa (5), Asia (2), and the Caribbean (1) were identified. The WHO indicators showed mixed associations with child growth across regions. Exclusive breastfeeding (EBF) under six months and continued breastfeeding demonstrated negative associations with HAZ while introduction of complementary foods (CF) and dietary diversity were positively associated (P<0.01 and P<0.05, respectively) with HAZ in Bangladesh and Zambia. EBF was also associated with higher WHZ in Bangladesh (P<0.05) and Zambia (P<0.001). The “minimum acceptable diet” (MAD) indicator was positively associated with HAZ in Bangladesh, Zambia and Ethiopia (P<0.05). Child stunting was associated only with introduction of CF in Bangladesh (P<0.01) and the MAD indicator in Zimbabwe (P<0.05). These indicators are useful tools for monitoring trends in breastfeeding and complementary feeding practices. However, additional measures of dietary quality that demonstrate consistent associations with child growth may be needed for research purposes.