Mixed Milk Feeding Under Six Months

Outcome

% of infants under 6 months of age who received formula and/or animal milk in addition to breast milk during the previous day

This indicator measures the prevalence of a relatively common but potentially harmful practice of feeding formula or animal milk in addition to breast milk. Mixed milk feeding is associated with increased risks of early termination of breastfeeding, reduced breast milk production and changes in gut microflora. In areas with poor sanitation, there is also an increased diarrhoea risk.

Collect the following data by conducting individual interviews with caregivers of (a representative sample of) children aged less than 6 months:

       

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

Q1: Yesterday, during the day or at night, was [baby's name] given any breast milk?

A1: yes / no / does not know

 

Q2: Now, I would like to ask you about liquids that [baby's name] may have had yesterday during the day and at night. I am interested in whether your child had the item even if it was combined with other foods. Yesterday, during the day or at night, did [baby's name] receive any of the following?

Any water? 

Any infant formula, such as [insert local names of common formula]?

Any animal milk?

Any juice?

Any broth?

Any yogurt or sour milk?

Any thin porridge? 

Any tea or coffee with milk?

Any other water-based liquids?

A2: for all sub-questions, use one of the following answers: yes / no / does not know 

   

   

To calculate the indicator's value, divide the number of children aged less than 6 months who were fed formula and/or animal milk in addition to breast milk (i.e. breast milk and formula / animal milk) during the previous day by the total number of children aged less than 6 months (excluding those where "does not know" answer was provided). Multiply the result by 100 to convert it to a percentage. 

Disaggregate the data by gender, wealth, and other relevant criteria.

1) According to WHO/UNICEF (see below), mixed milk feeding includes any formula (e.g. infant formula, follow-on formula, “toddler milk”) or any liquid animal milk other than human breast milk, (e.g. cow’s milk, goat’s milk, evaporated milk or reconstituted powdered milk). Breastfeeding by a wet nurse, feeding of expressed breast milk and feeding of donor human milk all count as being fed breast milk. Yogurt, whether liquid or solid, is not counted here because it is not generally given as a substitute for breast milk.