Core and Optional Infant and Young Child Feeding Indicators in Sub-Saharan Africa: a Cross-sectional Study

Objective: The objective of the study is to determine the status of infant and young child feeding (IYCF) in Sub-Saharan Africa (SSA) based on multiple indicators.

Design: Secondary data analysis of 32 Demographic and Health Surveys conducted in SSA since 2010.

Setting: Thirty-two countries in SSA.

Participants: 151 575 infants and young children born in the preceding 2 years of the surveys.

Indicators Determined: Eight core and six optional IYCF indicators.

Results: Majority (95.8%) of the children born in the preceding 24 months were ever breastfed, and 50.5% initiated breastfeeding within the first hour of birth. Among infants 0-5 months of age, 72.3% were predominantly breastfed and 41.0% were exclusively breastfed. Continued breastfeeding at 1 year (89.5%) was reasonably high, but only 53.7% continued breastfeeding at 2 years and 60.4% had age-appropriate breastfeeding. About two-thirds (69.3%) of infants 6-8 months of age received solid, semisolid or soft food over the previous day across the countries. Among children 6-23 months of age, 41.9% met the minimum recommended meal frequency, while smaller proportions satisfied the minimum dietary diversity (21.0%) and acceptable diet (9.8%). About one-third (37.6%) of children 6-23 months of age consumed iron-rich or iron-fortified food over the previous day. Among non-breastfed children, only 15.0% received the recommended two or more milk feedings. Thirteen per cent were fed with a bottle with a nipple in the previous day. Country-level estimates for most indicators showed remarkable variations. Yet the minimum dietary diversity and acceptable diet indicators were consistently low.

Conclusion: Most breastfeeding-related indicators, except exclusive and early initiation of breastfeeding, are in an acceptable level in SSA. However, complementary feeding indicators are generally low.