Introduction of Solid, Semi-Solid or Soft Foods

Outcome

% of infants aged 6–8 months who consumed solid, semi-solid or soft foods during the previous day

This indicator assesses the proportion of infants aged 6–8 months who are receiving solid, semi-solid or soft foods, as recommended when complementary feeding begins around 6 months of age. It helps programmes assess whether infants in this age group are receiving complementary foods. This is a current-status indicator based on food consumption during the previous day. It does not establish the exact age at which complementary foods were first introduced and cannot identify whether complementary foods were introduced before 6 months.

There are two main ways to determine the indicator's value. Both require interviewing the caregivers of a representative sample of infants aged 6–8 months:

1) Using Data from IYCF Food-List Questions – Recommended

If your survey measures Minimum Dietary Diversity – Children, use the food-consumption data collected for that indicator to calculate this indicator. The dietary diversity questionnaire records the solid, semi-solid and soft foods the child consumed during the previous day and night. An infant meets this indicator if they consumed at least one such food. Liquids alone do not count.

This is the preferred approach as it is consistent with the current WHO/UNICEF method for calculating the indicator from IYCF food-list questions.

2) Asking Directly

If your survey does not use the IYCF food-list questions, you can collect the required data using the following questions:

RECOMMENDED SURVEY QUESTION (Q) AND POSSIBLE ANSWERS (A)

Q1: Yesterday, during the day or at night, did [child's name] eat any solid, semi-solid or soft foods?

A1: yes / no / does not know

Ask the following question only if the previous answer is "yes".

Q2: What kind of solid, semi-solid or soft foods did [child's name] eat yesterday, during the day or at night?

A2: Based on the caregiver's answer, the interviewer records whether:

1) yes, solid, semi-solid or soft foods were eaten

2) no, solid, semi-solid or soft foods were not eaten

The second question helps verify that the foods reported actually meet the definition of solid, semi-solid or soft foods.

The direct question-and-probe approach was included in earlier WHO guidance, but the current WHO/UNICEF guidance calculates the indicator from the IYCF food-list questions. If the direct method is used, record this in the survey methodology, especially when comparing the results with data from other surveys.

To calculate the indicator’s value:

• Count the number of surveyed infants aged 6–8 months who consumed any solid, semi-solid or soft foods during the previous day or night.

• Divide this number by the total number of surveyed infants aged 6–8 months.

• Multiply the result by 100 to convert it to a percentage.

Infants whose caregiver answers ‘does not know’ should still be included in the total number of surveyed infants aged 6–8 months, but should not be counted as having consumed solid, semi-solid or soft foods.

This data can be disaggregated by sex, and, if relevant and feasible, also by location.

1) Ensure that the child’s age is assessed accurately, as only infants aged 6–8 completed months are included. Where possible, verify the child’s age using a birth certificate, vaccination card or another reliable record. If no reliable document is available, use a locally adapted events calendar. Read FAO’s Guidelines (see below) for guidance on preparing and using events calendars.

     

2) Because the denominator includes only infants aged 6–8 months, this indicator often has a relatively small effective sample size and a wide confidence interval. Before data collection, estimate how many eligible infants the sampling design is expected to include and assess whether this will provide adequate precision for the indicator. If this indicator is a key programme outcome and too few eligible infants are expected, adjust the sampling approach accordingly. When reporting the result, include its confidence interval. Do not assume that a sample-size target calculated for all children under two or under five will provide the same precision for this subgroup.

Also consider using the following indicators:

• Exclusive Breastfeeding Under Six Months (helps identify feeding with foods or liquids before six months)

• Minimum Dietary Diversity - Children (assesses the diversity of foods consumed after complementary feeding begins)

• Minimum Meal Frequency (assesses whether complementary foods are given sufficiently often)

• Minimum Acceptable Diet (provides a broader measure combining dietary diversity and feeding frequency)