{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T21:32:13Z","timestamp":1791495133222,"version":"4.3.4"},"reference-count":39,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,12,1]]},"abstract":"\n OBJECTIVE:<\/jats:title>\n To estimate the global burden of malnutrition and highlight data on child feeding practices and coverage of key nutrition interventions.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n Linear mixed-effects modeling was used to estimate prevalence rates and numbers of underweight and stunted children according to United Nations region from 1990 to 2010 by using surveys from 147 countries. Indicators of infant and young child feeding practices and intervention coverage were calculated from Demographic and Health Survey data from 46 developing countries between 2002 and 2008.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n In 2010, globally, an estimated 27% (171 million) of children younger than 5 years were stunted and 16% (104 million) were underweight. Africa and Asia have more severe burdens of undernutrition, but the problem persists in some Latin American countries. Few children in the developing world benefit from optimal breastfeeding and complementary feeding practices. Fewer than half of infants were put to the breast within 1 hour of birth, and 36% of infants younger than 6 months were exclusively breastfed. Fewer than one-third of 6- to 23-month-old children met the minimum criteria for dietary diversity, and only \u223c50% received the minimum number of meals. Although effective health-sector\u2013based interventions for tackling childhood undernutrition are known, intervention-coverage data are available for only a small proportion of them and reveal mostly low coverage.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Undernutrition continues to be high and progress toward reaching Millennium Development Goal 1 has been slow. Previously unrecognized extremely poor breastfeeding and complementary feeding practices and lack of comprehensive data on intervention coverage require urgent action to improve child nutrition.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2011-1392","type":"journal-article","created":{"date-parts":[[2011,11,8]],"date-time":"2011-11-08T01:56:43Z","timestamp":1320717403000},"page":"e1418-e1427","source":"Crossref","is-referenced-by-count":162,"title":["Undernutrition, Poor Feeding Practices, and Low Coverage of Key Nutrition Interventions"],"prefix":"10.1542","volume":"128","author":[{"given":"Chessa K.","family":"Lutter","sequence":"first","affiliation":[{"name":"Pan American Health Organization\/World Health Organization, Washington, DC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernadette M. E. G.","family":"Daelmans","sequence":"additional","affiliation":[{"name":"World Health Organization, Geneva Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes","family":"de Onis","sequence":"additional","affiliation":[{"name":"World Health Organization, Geneva Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica T.","family":"Kothari","sequence":"additional","affiliation":[{"name":"Demographic and Health Surveys, ICF Macro, Program in Appropriate Technology for Health, Washington, DC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie T.","family":"Ruel","sequence":"additional","affiliation":[{"name":"International Food Policy Research Institute, Washington, DC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Arimond","sequence":"additional","affiliation":[{"name":"Program in International and Community Nutrition, University of California, Davis, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Deitchler","sequence":"additional","affiliation":[{"name":"Food and Nutrition Technical Assistance II Project, Family Health International, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn G.","family":"Dewey","sequence":"additional","affiliation":[{"name":"Program in International and Community Nutrition, University of California, Davis, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Bl\u00f6ssner","sequence":"additional","affiliation":[{"name":"World Health Organization, Geneva Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Borghi","sequence":"additional","affiliation":[{"name":"World Health Organization, Geneva Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2011,12,1]]},"reference":[{"issue":"8","key":"2021120900061144100_B1","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.2105\/AJPH.83.8.1130","article-title":"Epidemiologic evidence for a potentiating effect of malnutrition on child mortality","volume":"83","author":"Pelletier","year":"1993","journal-title":"Am J Public Health"},{"issue":"11","key":"2021120900061144100_B2","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1001\/archpedi.160.11.1108","article-title":"Double burden of iron deficiency in infancy and low socioeconomic status: a longitudinal analysis of cognitive test scores to age 19 years","volume":"160","author":"Lozoff","year":"2006","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"9609","key":"2021120900061144100_B3","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/S0140-6736(07)61692-4","article-title":"Maternal and child undernutrition: consequences for adult health and human capital","volume":"371","author":"Victora","year":"2008","journal-title":"Lancet"},{"key":"2021120900061144100_B4","volume-title":"Repositioning Nutrition as Central to Development: A Strategy for Large-Scale Action","author":"World Bank","year":"2006"},{"issue":"9608","key":"2021120900061144100_B5","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/S0140-6736(07)61690-0","article-title":"Maternal and child undernutrition: global and regional exposure and health consequences","volume":"371","author":"Black","year":"2008","journal-title":"Lancet"},{"key":"2021120900061144100_B6","volume-title":"World Health Assembly Progress Report on Infant and Young Child Nutrition","author":"World Health Organization","year":"2010"},{"issue":"9610","key":"2021120900061144100_B7","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/S0140-6736(07)61693-6","article-title":"What works? Interventions for maternal and child undernutrition and survival","volume":"371","author":"Bhutta","year":"2008","journal-title":"Lancet"},{"key":"2021120900061144100_B8","volume-title":"Global Strategy for Infant and Young Child Feeding","author":"World Health Organization","year":"2003"},{"key":"2021120900061144100_B9","volume-title":"Joint WHO\/UNICEF Meeting on Infant and Young Child Feeding","author":"World Health Organization","year":"1979"},{"key":"2021120900061144100_B10","volume-title":"Indicators for Assessing Infant and Young Child Feeding Practices: Part 1\u2014Definitions","author":"World Health Organization","year":"2008"},{"key":"2021120900061144100_B11","volume-title":"Indicators for Assessing Infant and Young Child Feeding Practices: Part 2\u2014Measurement","author":"World Health Organization","year":"2010"},{"key":"2021120900061144100_B12","volume-title":"Indicators for Assessing Infant and Young Child Feeding Practices: Part 3\u2014Country Profiles","author":"World Health Organization","year":"2010"},{"key":"2021120900061144100_B13","volume-title":"Guiding Principles for Complementary Feeding of the Breastfed Child","author":"Pan American Health Organization\/World Health Organization","year":"2003"},{"key":"2021120900061144100_B14","volume-title":"Guiding Principles for Feeding Non-breastfed Children 6\u201324 Months of Age","author":"World Health Organization","year":"2004"},{"issue":"4","key":"2021120900061144100_B15","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1093\/ije\/dyg099","article-title":"The World Health Organization Global Database on Child Growth and Malnutrition: methodology and applications","volume":"32","author":"de Onis","year":"2003","journal-title":"Int J Epidemiol"},{"key":"2021120900061144100_B16","unstructured":"Standing Committee on Nutrition Task Force on Assessment Monitoring and Evaluation. Establishing stunting as an additional indicator of endemic poverty to monitor progress made towards the achievement of MDG1. www.unscn.org\/files\/Statements\/Establishing_stunting_as_an_additional_indicator. Accessed October 24, 2011"},{"issue":"1","key":"2021120900061144100_B17","doi-asserted-by":"crossref","first-page":"22","DOI":"10.2471\/BLT.10.078618","article-title":"Progress towards Millennium Development Goal 1 in Latin America and the Caribbean: the importance of the choice of indicator for undernutrition","volume":"89","author":"Lutter","year":"2011","journal-title":"Bull World Health Organ"},{"issue":"21","key":"2021120900061144100_B18","doi-asserted-by":"crossref","first-page":"2600","DOI":"10.1001\/jama.291.21.2600","article-title":"Estimates of global prevalence of childhood underweight in 1990 and 2015","volume":"291","author":"de Onis","year":"2004","journal-title":"JAMA"},{"issue":"6","key":"2021120900061144100_B19","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1093\/ije\/dyh202","article-title":"Methodology for estimating regional and global trends of child malnutrition","volume":"33","author":"de Onis","year":"2004","journal-title":"Int J Epidemiol"},{"key":"2021120900061144100_B20","unstructured":"United Nations, Statistics Division. Composition of macro geographical (continental) regions, geographical sub-regions, and selected economic and other groupings. Available at: http:\/\/unstats.un.org\/unsd\/methods\/m49\/m49regin.htm. Accessed August 15, 2011"},{"key":"2021120900061144100_B21","volume-title":"World Population Prospects: The 2008 Revision","author":"United Nations, Department of Economic and Social Affairs","year":"2009"},{"key":"2021120900061144100_B22","volume-title":"Countdown to 2015: Tracking Progress in Maternal, Newborn and Child Survival","author":"Bryce","year":"2008"},{"issue":"3","key":"2021120900061144100_B23","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2009-1519","article-title":"Worldwide timing of growth faltering: revisiting implications for interventions","volume":"125","author":"Victora","year":"2010","journal-title":"Pediatrics"},{"key":"2021120900061144100_B24","unstructured":"Countdown Core Group. Countdown to 2015 decade report (1990 to 2010): taking stock of maternal, newborn and child survival. Available at: www.countdown2015mnch.org\/reports-publications\/2010-report\/2010-report-downloads. Accessed October 24, 2011"},{"key":"2021120900061144100_B25","volume-title":"Tracking Progress in Maternal and Child Nutrition","author":"United Nations Children's Fund","year":"2009"},{"issue":"1","key":"2021120900061144100_B26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ajcn\/50.1.1","article-title":"Nutritional supplementation: effect on child stunting because of diarrhea","volume":"50","author":"Lutter","year":"1989","journal-title":"Am J Clin Nutr"},{"key":"2021120900061144100_B27","first-page":"307","article-title":"Interaction of diet and disease","volume-title":"Child Growth in Breastfeeding, Nutrition, Infection and Infant Growth in Developed and Emerging Countries","author":"Martorell","year":"1990"},{"issue":"9694","key":"2021120900061144100_B28","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1016\/S0140-6736(09)60950-8","article-title":"Child undernutrition, tropical enteropathy, toilets, and handwashing","volume":"374","author":"Humphrey","year":"2009","journal-title":"Lancet"},{"issue":"1","key":"2021120900061144100_B29","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1177\/156482650302400104","article-title":"Improving feeding practices: current patterns, common constraints, and the design of interventions","volume":"24","author":"Pelto","year":"2003","journal-title":"Food Nutr Bull"},{"key":"2021120900061144100_B30","unstructured":"Working Group on Infant and Young Child Feeding Indicators. Developing and validating simple indicators of dietary quality of infants and young children in developing countries: additional analysis of 10 data sets. Available at: www.fantaproject.org\/publications\/iycf_datasets.shtml. Accessed October 18, 2011"},{"issue":"10","key":"2021120900061144100_B31","doi-asserted-by":"crossref","first-page":"2579","DOI":"10.1093\/jn\/134.10.2579","article-title":"Dietary diversity is associated with child nutritional status: evidence from 11 demographic and health surveys","volume":"134","author":"Arimond","year":"2004","journal-title":"J Nutr"},{"key":"2021120900061144100_B32","volume-title":"Diarrhoea: Why Children Are Still Dying and What Can Be Done","author":"United Nations Children's Fund, World Health Organization","year":"2009"},{"issue":"9687","key":"2021120900061144100_B33","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/S0140-6736(09)60828-X","article-title":"Effect of integrated management of childhood illness strategy on childhood mortality and nutrition in a rural area in Bangladesh: a cluster randomized trial","volume":"374","author":"Arifeen","year":"2009","journal-title":"Lancet"},{"issue":"3","key":"2021120900061144100_B34","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1590\/S0102-311X2005000300011","article-title":"Evaluation of the impact of a nutritional program for undernourished children in Brazil","volume":"21","author":"Santos","year":"2005","journal-title":"Cad Saude Publica"},{"key":"2021120900061144100_B35","article-title":"Agricultural interventions and nutrition: lessons from the past and new evidence","volume-title":"Combating Micronutrient Deficiencies: Food-Based Approaches","author":"Arimond","year":"2010"},{"issue":"8","key":"2021120900061144100_B36","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1017\/PHN2006973","article-title":"Determinants of nutrition improvement in a large-scale urban project: a follow-up study of children participating in the Senegal Community Nutrition Project","volume":"9","author":"Gartner","year":"2006","journal-title":"Public Health Nutr"},{"issue":"2","key":"2021120900061144100_B37","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1080\/19439340902924043","article-title":"The impact of conditional cash transfer programmes on nutrition: A review of evidence using a programme theory framework","volume":"1","author":"Leroy","year":"2009","journal-title":"J Dev Effect"},{"key":"2021120900061144100_B38","unstructured":"United Nations. Scaling Up Nutrition: a framework for action. Available at: www.unscn.org\/files\/Announcements\/Scaling_Up_Nutrition-A_Framework_for_Action.pdf. Accessed October 18, 2011"},{"key":"2021120900061144100_B39","article-title":"Nutrition agenda setting, policy formulation and implementation: lessons from the Mainstreaming Nutrition Initiative","author":"Pelletier","year":"2011","journal-title":"Health Policy Plan"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/128\/6\/e1418\/845458\/zpe012110e1418.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/128\/6\/e1418\/845458\/zpe012110e1418.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T00:32:34Z","timestamp":1639009954000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/128\/6\/e1418\/31185\/Undernutrition-Poor-Feeding-Practices-and-Low"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,12,1]]},"references-count":39,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2011,12,1]]},"published-print":{"date-parts":[[2011,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2011-1392","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,12,1]]}}}