News Excerpt:

India has ranked high in a study calculating the prevalence of children aged 6-23 months who have not eaten anything over a 24-hour period across 92 low- and middle-income countries (LMIC).

About the study:

• The research, recently published in the journal JAMA Network Open, looked at 276,379 babies aged 6 to 23 months in 92 LMICs.
• Of the total sample size, 51.4% were boys.
• The researchers gathered data from demographic and health surveys (DHS) and multiple indicator cluster (MICS) surveys conducted from May 20, 2010, to January 27, 2022. For India, the National Family Health Survey's 2019-2021 data was used.
• DHS and MICS surveys used standardised questions on feeding practices, covering common and country-specific solid or semisolid foods.
• The researchers also warned that it used data reported by individuals in household surveys.
• Parents or caregivers might not accurately remember what the child ate in the 24 hours before the survey, introducing a recall bias that could result in either underestimating or overestimating the prevalence of zero-food instances.
• Zero-food children are the ones who did not consume any animal milk, formula or solid or semisolid food during the last 24 hours.

Key findings of the study:

• The data showed there were 13.9 million children who had not eaten anything in the studied countries or 10.4 per of the sample.
• In the total sample, 20% of children aged 6 to 11 months had zero food, which decreased to 6.6% for those aged 12 to 17 months and further to 4.1% for those aged 18 to 23 months.
• Prevalence rate of zero food children:
  • The highest rates seen in South Asia (15.7%) and West and Central Africa (10.5%).
  • Latin America and the Caribbean had the lowest prevalence and number of zero-food children, at 1.9%, or 120,000 children.
  • East Asia and the Pacific had the second-lowest prevalence, at 2.9%.
  • India has the third highest prevalence among 92 LMICs.
    • With 19.3% of ‘zero-food’ children, India was third highest globally after West African countries Guinea (21.8%) and Mali (20.5%).
• Absolute numbers of zero food children:
• India had the most ‘zero-food’ children at 6.7 million — almost half of all the zero-food children in the surveys.
• Nigeria had the second-highest number of zero-food children (962,000), followed by Pakistan (849,000).
• Pakistan, Ethiopia and the Democratic Republic of the Congo also showed substantial numbers of zero-food children.
• Indonesia and the Philippines had relatively many zero-food children despite relatively lower prevalence rates.
• This highlighted the importance of considering both prevalence and absolute numbers when designing interventions, even in countries with apparently lower risk.

• More than 99% of the children who experienced zero-food situations had been breastfed.
• This suggests that nearly all these children received some calories even during the 24-hour period when they did not receive other food sources.

• Short- and Long-term benefits of adequate feeding:

• Reduced risk of mortality, malnutrition, stunting, underweight and micronutrient deficiencies.
• Improved brain development, cognition and school readiness.

Recommendations provided by the study:

• The zero-food situations indicate the necessity for focused interventions to enhance feeding practices for infants and young children.
• Strategies should include enhancing access to nutritious foods, improving maternal and caregiver knowledge about appropriate feeding practices and strengthening health systems to ensure the availability of necessary resources and support.
• The design and implementation of interventions should be context-specific, accounting for cultural practices and local challenges.
  • It is crucial to tackle the socioeconomic and environmental factors that contribute to food insecurity.
• At approximately six months of age, breastfeeding is no longer sufficient to provide the child with the necessary nutrition.
  • Introducing solid or semisolid foods along with breastfeeding is essential for fulfilling the nutritional needs of early childhood.