As high as 69 percent of the children aged between six and 23 months in Nepal consume unhealthy foods, the Nepal Demographic and Health Survey-2022 has shown.

Unhealthy feeding practices replace nutritious foods, meaning that children will be deprived of the nutrients needed for their growth and such feeding practices promote unhealthy weight gain, according to child health experts.

The final report of the nationwide study, carried out by the Ministry of Health and Population between January 5 and June 22 last year with technical and financial support from the United States Agency for International Development, also stated that 43 percent of the children consume sweet beverages.

“For infants and young children, consumption of sweet foods and beverages increases the risk of dental caries and obesity in childhood,” said the report. “In addition, too much salt in the diet increases the risk of non-communicable diseases, and unhealthy fats and refined carbohydrates contribute to unhealthy weight gain.”

Around one third (33 percent) of children were not given any vegetables or fruits. Children’s consumption of unhealthy foods increases with age. Forty-nine percent of children of ages six to 11 months consume unhealthy foods, compared to 78 percent of children aged between 12 and 23 months.

Thirty percent of children from six to 11 months consume sweet beverages, compared to 52 percent of children aged between 18 and 23 months. There is no difference by place of residence in consumption of unhealthy foods. However, sweet beverage consumption is higher in urban areas than in the rural areas (45 percent versus 41 percent), according to the report.

Consumption of unhealthy foods is higher in the Tarai region (73 percent) than in the hills (62 percent) and the mountain (59 percent) region.

Consumption of unhealthy foods ranges from 57 percent in Karnali Province to 78 percent in Koshi Province. The percentage of children who are not consuming vegetables and fruits decreases with age, from 54 percent among those aged between six and 11 months to 20 percent among those aged between 18 and 23 months, according to the report.

“Children consuming diets low in vegetables and fruits have reduced nutrient intakes, which can negatively impact healthy growth and development,” said the report. “Low vegetable and fruit consumption is also associated with non-communicable diseases later in life.”

The study also reported on breastfeeding practices. According to the study, around one-fifth (22 percent) of children less than two are bottle-fed. The proportion of children who are bottle-fed is higher in the urban areas (26 percent) than in the rural areas (15 percent). The use of a bottle with nipple is lowest in Karnali Province (11 percent ) and Madhesh Province (12 percent) and highest in Bagmati Province (43 percent). The proportion of children who are bottle-fed increases with increasing mothers’ education, from 12 percent among those whose mothers have no education to 49 percent among those whose mothers have more than a secondary education. The use of a bottle with nipple is highest in the top wealth quintile (46 percent) and lowest in the bottom quintile (11 percent).

Exclusive breastfeeding has been steadily declining, from 70 percent in 2011 to 56 percent in 2022.

Both early initiation of breastfeeding and exclusive breastfeeding for the first two days after birth are lower among cesarean section births (17 percent and 21 percent, respectively), than among vaginal births (63 percent and 68 percent, respectively).

Nutritionists in Nepal say that findings of the Nepal Demographic and Health Survey report on feeding practices are alarming and must be addressed immediately.

“These are not issues that can be ignored,” said Dr Atul Upadhyay, a nutritionist. “More than two thirds of our small children consume unhealthy foods and it has direct and immediate consequences on their physical as well as mental growth.”

Experts say a nutrient profile model, which the country lacks, should be developed to help identify unhealthy products and use public policies to discourage their consumption. The producers should be held accountable and consumers made aware of what they are consuming.

“Regulatory mechanisms should be more effective while campaigns should continue to make the public aware of the negative effects of eating unhealthy foods,” said Upadhyay.