Background . Optimal nutrition during the first 1 000 days of life can reap lasting benefits throughout life. Objectives . To assess infant and young child-feeding (IYCF) practices and mother/caregiver-child anthropometry in two vulnerable Breede Valley communities, Western Cape. Methods . Mothers of children aged 0 - 23 months (N=322) were interviewed to assess IYCF practices. Anthropometric measurements of mothers/caregivers and children were performed according to standard procedures. Results . Mothers reported early breastfeeding (BF) initiation in 75.2% (242/322) of cases. Of infants <6 months old, 38.5% (45/117) were recorded as exclusively breastfed (EBF). Cross-checking this figure with other research from the area, however, suggests significant over-reporting of EBF. One in five infants <6 months were exclusively bottle fed (19.7%; 23/117) and 48.4% (156/322) aged 0 - 23 months had received bottle feeding in the preceding 24 hours. Eighty-four percent (36/43) of 6 - 8-month-old infants were receiving complementary foods. BF was continued in 32.5% (13/40) of children 12 - 15 months old. In children 6 - 23 months, 44.0% (90/205) received foods from four or more food groups, 71.0% (145/205) received complementary foods the recommended minimum number of times or more, and 44.4% (91/205) received a minimum acceptable diet. The prevalence of stunting and overweight in children was 28.9% and 21.8%, respectively. The prevalence of overweight in mothers/caregivers was 28.9%, and 33.7% were obese, with a mean waist circumference of 88.6 cm. Conclusion . Indicators showed sub-optimal IYCF practices with child under- and overnutrition coexisting with maternal/caregiver overnutrition. This profile signals a need for urgent and appropriate interventions focusing on the first 1 000 days of life.