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      Complementary feeding practices for infants and young children in South Asia. A review of evidence for action post-2015

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      Maternal & Child Nutrition
      Wiley

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          Abstract

          Some 37% (~64 million) South Asian children under 5 years are stunted. Most stunting occurs during the complementary feeding period (6–23 months). Our objective was to (a) characterize complementary feeding practices in South Asia and (b) review the effectiveness of information, education, and counselling (IEC) interventions aiming to improve complementary feeding in South Asia. We conducted a comprehensive review of (a) the latest nationally representative survey data and (b) peer‐reviewed interventions (January 1990 to December 2015) that used IEC as the main strategy to improve complementary feeding. The analytical sample included 30,966 children aged 6–23 months. Foods made from grains are the main complementary food (76.8% of children). Only 33.2% of children are fed fruits and vegetables rich in vitamin A and a mere 17.1% are fed complementary foods containing meat, fish, poultry and/or eggs. Timely introduction, minimum meal frequency, minimum dietary diversity, and minimum acceptable diet were estimated at 57.4%, 47.7%, 33.0%, and 20.5%, respectively. The evidence on the effectiveness of IEC interventions is limited in quantity, quality, and scale. The 12 intervention studies that met the inclusion criteria indicate that IEC interventions delivered by many types of primary care workers/community resource persons using multiple contact opportunities improved the timeliness, frequency, diversity, and/or adequacy of complementary feeding. However, acceptability, availability, and affordability seem to constrain improvements in diet diversity, particularly foods of animal origin. The small size of most intervention studies and the training and/or supervision intensity of counsellors raise concerns about the potential for scale and/or sustainability of some of the interventions reviewed.

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          Most cited references20

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          Maternal and child undernutrition and overweight in low-income and middle-income countries

          The Lancet, 382(9890), 427-451
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            Long-term consequences of stunting in early life.

            This review summarizes the impact of stunting, highlights recent research findings, discusses policy and programme implications and identifies research priorities. There is growing evidence of the connections between slow growth in height early in life and impaired health and educational and economic performance later in life. Recent research findings, including follow-up of an intervention trial in Guatemala, indicate that stunting can have long-term effects on cognitive development, school achievement, economic productivity in adulthood and maternal reproductive outcomes. This evidence has contributed to the growing scientific consensus that tackling childhood stunting is a high priority for reducing the global burden of disease and for fostering economic development. Follow-up of randomized intervention trials is needed in other regions to add to the findings of the Guatemala trial. Further research is also needed to: understand the pathways by which prevention of stunting can have long-term effects; identify the pathways through which the non-genetic transmission of nutritional effects is mediated in future generations; and determine the impact of interventions focused on linear growth in early life on chronic disease risk in adulthood. © 2011 Blackwell Publishing Ltd.
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              Reducing Child Undernutrition: Past Drivers and Priorities for the Post-MDG Era

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                Author and article information

                Journal
                Maternal & Child Nutrition
                Matern Child Nutr
                Wiley
                17408695
                October 2017
                October 2017
                October 15 2017
                : 13
                : e12439
                Affiliations
                [1 ]United Nations Children's Fund (UNICEF). Programme Division; New York NY USA
                Article
                10.1111/mcn.12439
                6865921
                29032627
                d760e3f3-8225-400c-99da-04298fcc0ace
                © 2017

                http://doi.wiley.com/10.1002/tdm_license_1.1

                http://onlinelibrary.wiley.com/termsAndConditions#vor

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