IYCF-MDD

Infant Young Child Feeding Minimum Dietary Diversity (IYCF-MDD)

Feeding practices for infants and young children directly influence the nutritional status of children under two years of age and consequently determine child survival. Proper feeding of infants and young children can increase their chances of survival.Therefore, improving infant and young child feeding practices in children 0-23 months is vital in the fight against global malnutrition and micronutrient deficiencies as it usually promotes optimal growth and development during the critical window (birth to 2 years of age).

The Infant and Young Child Feeding Minimum Dietary Diversity (IYCF-MDD) tells us the proportion of children 6-23 months of age who receive a minimum acceptable diet. This indicator was developed in 2008 but was later modified in 2017 by UNICEF & WHO to include a category for breastfeeding. Subsequently for the IYCF-MDD to be met, a child aged 6-23 months must consume at least 5 out of the 8 food groups in the last 24hrs.

The IYCF-MDD is calculated as follows:

It is important to note:

• There is no minimum quantity from each food group (except if an item is used as a condiment) to sufficiently ‘count’ thus, consumption of any amount of food from each food group should be included.
• The 5 or more food groups threshold was selected because it is associated with better quality diets for children. Consumption of at least 5 food groups the previous day would mean that in most populations, children have a high likelihood of consuming at least one animal-source food and at least one fruit or vegetable that day as well as a staple food.

An important advantage of using the IYCF-MDD is that it is simple to collect, tabulate and interpret as the questionnaire administered to the child’s caregiver simply asks them to indicate whether or not over the previous 24 hour period, their child consumed any food from each of the eight food groups. Additionally, another strength of the MDD is that it is applicable across socio-cultural contexts and can also be easily disaggregated into smaller ager groups like 6-11 months or 18-23 months, for example.

Most importantly, IYCF-MDD has been extensively validated and shown to be associated with micronutrient adequacy of the diet in multiple countries and contexts. However, one big drawback to using the IYCF-MDD indicator is that it cannot be used to compare the same population over time if rates of breastfeeding have varied. Similarly, the MDD cannot be used to compare populations with different rates of continued breastfeeding.

The MDD indicator like other dietary diversity measures can be constructed using a short Food Frequency Questionnaire (FFQ). In general, questions on infant and young child feeding are usually part of a larger survey with multiple objectives. For example, a questionnaire could be comprised of the following three modules:

• Household roster
• Initiation of breastfeeding (IBF) module
• Infant and young child feeding (IYCF) module

In the example above, the IYCF module would be administered to the caregiver (usually the mother) of the children recorded in the household roster who are in the 6 – 23 month age group.