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Mixed Milk Feeding Under Six Months

Indicator Phrasing

% of infants 0–5 months of age who were fed formula and/or animal milk in addition to breast milk during the previous day
See indicator in other languages

Indicator Phrasing

English: % of infants 0–5 months of age who were fed formula and/or animal milk in addition to breast milk during the previous day

French: % de nourrissons de 0 à 5 mois qui, le jour précédent, ont été nourris avec du lait maternisé et/ou du lait animal en plus du lait maternel

Portuguese: % de crianças de 0 a 5 meses de idade que receberam fórmula e / ou leite animal além do leite materno no dia anterior

Czech: % kojenců ve věku 0–5 měsíců, kteří byli během předchozího dne kromě mateřského mléka krmeni umělou výživou anebo zvířecím mlékem

What is its purpose?

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.

How to Collect and Analyse the Required Data

Collect the following data by conducting individual interviews with caregivers of (a representative sample of) children aged 0 - 5 months:



Q1Yesterday, during the day or at night, was [baby's name] given any breast milk?

A1: yes / no / does not know


Q2Now, 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 0-5 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 0 - 5 months (excluding those where "does not know" answer was provided). Multiply the result by 100 to convert it to a percentage. 

Disaggregate by

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

Important Comments

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.

This guidance was prepared by People in Need ©

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