Prevalence of underweight rates in Indian preschool children is higher than underweight rates in sub-Saharan Africa. (1) In 1999, the National Family Health Survey (NFHS II) found that 47 percent of all children under age three were under weight. Data from NFHS-3 (2006) shows only a very small decline, with under-nutrition level remaining around 45 percent for children below three. (2) As per World Health Organization (WHO) every infant and child has the right to good nutrition according to the Convention on the Rights of the Child. (6) The first two years of a child's life are particularly important, as optimal nutrition during this period will lead to reduced morbidity and mortality, to reduced risk of chronic diseases and to overall better development. (6)

National Family Health Survey-3 (NFHS-3) (2) and District Level Household Survey-2 (DLHS-2) (3) showed that in India, breast feeding is nearly universal; however less than 30% of infants were exclusively breast fed up to 6 months. Very few infants received semisolid complementary feeds at 6 month. Majority of children received household food along with breast feeding by 9-11 month. Too early introduction of milk substitutes and too late introduction of complementary food are associated with increased risk of under nutrition and infection. (4) Further rise in underweight rates occurs between 6-23 months due to late introduction, inadequate quantity and low calorie density of complementary feeds and increase in morbidity due to infections.(4) Infact WHO has recommended early initiation of breastfeeding with one hour of birth, exclusive breastfeeding for the first six months of life and the introduction of nutritionally adequate and safe complementary foods at six months together with continued breastfeeding up to two years and beyond. (6)

The Tenth Five year Planning Commission had set up the National Nutritional Goals which were to be achieved by 2007 which included decreasing the under nutrition prevalence among children less than 3 years to 40 percent and by 50 percent in children 0-6 years of age, early initiation of breast feeding in atleast 50 percent of deliveries, exclusive breast feeding in children upto 6 months of age in atleast 80 percent of children and enhance complementary feeding rate. (5) However these goals have not been achieved.

The Infant and Young Child Feeding (ICYF) chapter of Indian Academy of Pediatrics formulated technical guidelines related to infant and child feeding in 2010. (7) These include:

• Initiation of breastfeeding as early as possible after birth, preferably within one hour.
• Exclusive breastfeeding in the first six months of life i.e., only breastfeeding or breast milk feeding and no other foods or fluids (no water, juices, tea, pre-lacteal feeds), with the exception of drops or syrups consisting of micronutrition supplements or medicines in compromised/diseased babies.
• Appropriate and adequate complementary feeding after completion of six months of age while continuing breastfeeding. Complementary foods should not be confused with supplementary foods.
• Hand washing with soap and water at critical times - including before eating or preparing food and after using the toilet.
• Full immunization and Vitamin-A supplementation with deworming
• Appropriate feeding for children during and after illness.
• Effective home based care and treatment of children suffering from severe acute malnutrition.
• Adequate nutrition and anemia control for adolescent girls, pregnant and lactating mothers.
• Effective implementation and monitoring of Infant Milk Substitute (IMS) Act.

Government with the support of the international community and other concerned parties, are taking seriously their commitments to protect and promote the health and nutritional well-being of infants, young children, and pregnant and lactating women. Essential interventions to protect, promote and support appropriate infant and young child feeding are being taken to ensure that children develop to their full potential, free from the adverse consequences of compromised nutritional status and preventable illnesses. (8)

1.		United Nations Children's Fund. The State of the World Children 2008: Child survival. www.unicef.org./sowc08/docs/sowc08fullreport-En.pdf Accessed on 23.2.2008
2.		National Family Health Survey (NFHS-3): http://mohfw.nic.in/nfhsfactsheet.htm. accessed on 12.12.2007.
3.		District Level Household Survey http://www.rchindia.org/dlhs_india.htm. accessed on 24/09/09.
4.		Ramachandran P. Adoption of WHO growth standards (2006) issues and implications. Bulletin of Nutrition Foundation of India.2007; 23: 1-6.
5.		National Guidelines for Infant and Young Child Feeding. Ministry of Human Resource development. New Delhi: Department of Women and Child Development, Government of India, 2004. From: http://wcd.nic.in/nationalguidelines.pdf. Accessed on April 12, 2010.
6.		World Health Organization. (WHO). Infant and young child feeding Fact sheet N°342. Available at URL: http://www.who.int/mediacentre/factsheets/fs342/en/index.html. Accessed on 13th March 2011.
7.		Infant and Young Child Feeding Chapter, Indian Academy of Pediatrics, Rajeshwari K, Bang A, Chaturvedi P, Kumar V, Yadav B, Bharadva K, Gupta S, Gupta P, Shah D, Aneja S, Dubey AP, Tiwari S, Choudhury P, Agarwal RK. Infant and young child feeding guidelines: 2010. Indian Pediatr. 2010 Dec;47(12):995-1004
8.		Global Strategy for infant and young child feeding. World Health Organization, Geneva, 2003.