(The FASEB Journal. 2006;20:A1050)
© 2006 FASEB
Developing indicators for complementary feeding : issues for operationalization at local levels
Cecilia Santos Acuin1,2 and
Gretel Pelto3
1 Nutritional Sciences, Cornell University, Savage Hall, Ithaca, NY, 14853,
2 University of the Philippines, National Institutes of Health, Manila, 1000, Philippines,
3 Nutritional Sciences, Cornell University, MVR, Ithaca, NY, 14853
ABSTRACT
The complementary feeding (CF) period is crucial to the growth and health of infants and young children, particularly in developing countries where inappropriate feeding practices and illness contribute to growth faltering and poor developmental outcomes that begin at this time. Guidelines of appropriate feeding practices, based on existing evidence, have been developed but are not in a form that can be readily used for practice, program or policy. Current efforts to assess the adequacy and efficacy of approaches to changing CF behaviors are hampered by the lack of appropriate indicators that will allow comparison between groups, and make it possible to draw inferences across different groups. The global initiative to improve CF is in the process of validating three possible indicators of diet intake– diet diversity, use of sentinel foods, and frequency of feeding – which are intended for 1) assessment: for comparison across groups and over time 2) screening and targeting populations at risk to guide decisions about resource allocation 3) monitoring and evaluation of goals and impact of interventions. While validating these indicators on a Philippine data set, operational issues arose: 1) unavailability of nutrient composition of local foods, 2) diversity of local plant and animal food products with wide variations in nutrient composition, 3) rapidly changing milk and CF patterns within short periods of observation, 4) evolving nutrition standards and requirements for this age group. The resolution of these issues present challenges not just to researchers but to program and policy-makers who will eventually make use of these indicators and base decisions on them.
