Objective: To formulate age- and context-specific complementary feeding
recommendations (CFR) for infants and young children (IYC) and to compare
the potential of filling population-level nutrient gaps using common sets of CFR
across age groups.
Design: Linear programming was used to develop CFR using locally available and
acceptable foods based on livelihood- and age-group-specific dietary patterns
observed through 24 h dietary recalls. Within each livelihood group, the nutrient
potential of age-group-specific v. consolidated CFR across the three age groups
was tested.
Setting: Three food-insecure counties in northern Kenya; namely, settled communities
from Isiolo (n 300), pastoralist communities from Marsabit (n 283) and agro-pastoralist
communities from Turkana (n 299).
Subjects: Breast-fed IYC aged 6–23 months (n 882).
Results: Age-specific CFR could achieve adequacy for seven to nine of eleven
modelled micronutrients, except among 12–23-month-old children in agro-pastoralist
communities. Contribution of Fe, Zn and niacin remained low for most groups, and
thiamin, vitamin B6 and folate for some groups. Age-group-consolidated CFR could
not reach the same level of nutrient adequacy as age-specific sets among the settled
and pastoralist communities.
Conclusions: Context- and age-specific CFR could ensure adequate levels of more
modelled nutrients among settled and pastoralist IYC than among agro-pastoralist
communities where use of nutrient-dense foods was limited. Adequacy of all eleven
modelled micronutrients was not achievable and additional approaches to ensure
adequate diets are required. Consolidated messages should be easier to implement as
part of a behaviour change strategy; however, they would likely not achieve the same
improvements in population-level dietary adequacy as age-specific CFR.