Background: Malnutrition remains a major health burden globally. To date the focus in South Africa has been on exclusive breastfeeding from birth to 6 months, with less attention on feeding of the infants beyond 6 months.

Objectives: To describe infant and young child feeding practices at home and in hospital in KwaZulu-Natal Midlands, South Africa, and determine if feeding practices conform to national feeding policies. No statistical correlation was done.

Methodology: A descriptive study, using structured questionnaires for mothers of infants and young children up to the age of five years, and healthcare professionals in state hospitals, was conducted in 2011 in 12 hospitals in the KwaZulu-Natal Midlands, South Africa.

Results: Seventy-six percent (76%) of infants were ever exclusively breastfed with just 36% being exclusively breastfed beyond three months. Complementary feeds were commenced in 84% of infants younger than 6 months of age. Age-specific meals were provided for children below 2 years (93%) and for participants above 2 years (78%). Approximately 61% of infants and children between 6 and 24 months received more than three cups of milk per day in hospital with only 26% of children between 2 to 5 years receiving any milk. Majority of children (48%) aged 2 to 5 years received only one snack per day, which is suboptimal.

Conclusion: Feeding messages focus on breastfeeding. Breastfeeding rates have improved in this region since 2003, but exclusive breastfeeding is of limited duration. Early complementary feeding is a problem in the Midlands. This study has identified that age-specific feeding of infants and young children is not recognised in state hospitals, due to the inadequate frequency of feeding. There is a discrepancy between intention and practice among healthcare professionals in feeding infants and young children. Feeding messages have to expand beyond breastfeeding and complementary feeding, with ongoing training of healthcare professionals in this field.