Adequate complementary feeding practices in early childhood contribute to better food preferences and health outcomes throughout the life course.

We analyzed the most recent national survey carried out since 2010 in 80 LMIC to describe patterns and socioeconomic inequalities in complementary feeding practices – minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) – among children aged 6-23 months.

Between- and within-country inequalities were documented using wealth deciles, GDP per capita, and absolute household income. Only 21.3%, 56.2%, and 10.1% of the 80 countries showed prevalence levels above 50% for MDD, MMF, and MAD, respectively. Western & Central Africa showed the lowest prevalence for all indicators. In contrast, the highest for MDD and MAD was Latin America & the Caribbean, and for MMF in East Asia & the Pacific. Log GDP was positively associated with MDD (R2 = 48.5%), MMF (28.2%), and MAD (41.4%). We observed pro-rich within-country inequalities in most countries for the three indicators, and pro-poor inequalities in two countries for MMF and none for the other two indicators. Breastmilk was the only one with a pro-poor pattern, and the animal-source foods showed the most pronounced pro-rich inequality. MDD improved sharply when absolute annual household incomes exceeded about US$20,000. All three feeding indicators improved by child age, and no differences were observed between girls and boys.

Monitoring complementary feeding indicators and implementing policies and programs to reduce wealth-related inequalities are essential to achieve optimal child nutrition, especially to counteract the huge impact of the COVID-19 pandemic.

This work was published in The Journal of Nutrition as an Editor's choice and it is freely available at  https://doi.org/10.1093/jn/nxab088