Designing appropriate complementary feeding recommendations: tools for programmatic action.

Suboptimal complementary feeding practices contribute to a rapid increase in the prevalence of stunting in young children from age 6 months. The design of effective programmes to improve infant and young child feeding requires a sound understanding of the local situation and a systematic process for prioritizing interven- tions, integrating them into existing delivery platforms and monitoring their implementation and impact. The identification of adequate food-based feeding recommendations that respect locally available foods and address gaps in nutrient availability is particularly challenging.We describe two tools that are now available to strengthen infant and young child-feeding programming at national and subnational levels.ProPAN is a set of research tools that guide users through a step-by-step process for identifying problems related to young child nutrition;defining the context in which these problems occur; formulating, testing, and selecting behaviour-change recommenda- tions and nutritional recipes; developing the interventions to promote them; and designing a monitoring and evaluation system to measure progress towards intervention goals.Optifood is a computer-based platform based on linear programming analysis to develop nutrient-adequate feeding recommendations at lowest cost,based on locally available foods with the addition of fortified products or supplements when needed, or best recommen- dations when the latter are not available.The tools complement each other and a case study from Peru illustrates how they have been used.The readiness of both instruments will enable partners to invest in capacity develop- ment for their use in countries and strengthen programmes to address infant and young child feeding and prevent malnutrition.