Contextualising complementary feeding in a broader framework for stunting prevention.
An estimated 165 million children are stunted due to the combined effects of poor nutrition, repeated infection and inadequate psychosocial stimulation. The complementary feeding period, generally corresponding to age 6-24 months, represents an important period of sensitivity to stunting with lifelong, possibly irrevocable consequences. Interventions to improve complementary feeding practices or the nutritional quality of complementary foods must take into consideration the contextual as well as proximal determinants of stunting. This review presents a conceptual framework that highlights the role of complementary feeding within the layers of contextual and causal factors that lead to stunted growth and development and the resulting short- and long-term consequences. Contextual factors are organized into the following groups: political economy; health and health care systems; education; society and culture; agriculture and food systems; and water, sanitation and environment. We argue that these community and societal conditions underlie infant and young child feeding practices, which are a central pillar to healthy growth and development, and can serve to either impede or enable progress. Effectiveness studies with a strong process evaluation component are needed to identify transdisciplinary solutions. Programme and policy interventions aimed at preventing stunting should be informed by careful assessment of these factors at all levels.
Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA.
Christine P
CP
Stewart
Lora
L
Iannotti
Kathryn G
KG
Dewey
Kim F
KF
Michaelsen
Adelheid W
AW
Onyango
D001827:Body Height; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D005191:Family Characteristics; D006130:Growth Disorders / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D009753:Nutritive Value
World Health Organization; complementary feeding; conceptual framework; healthy growth and development; stunting, transdisciplinary approaches