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Community and International Nutrition

An Energy-Dense Complementary Food Is Associated with a Modest Increase in Weight Gain When Compared with a Fortified Porridge in Malawian Children Aged 6–18 Months^1,2

³ Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110; ⁴ Department of Community Health, College of Medicine, University of Malawi Blantyre 3; ⁵ Children's Nutrition Research Center, Houston, TX 77030; ⁶ Institut de Recherche pour le Développement, 75003 Paris, France; ⁷ Department of Paediatrics, Tampere University Hospital, Finland FIN-33014; and ⁸ Department of International Health, University of Tampere Medical School, Finland FIN-33014

^* To whom correspondence should be addressed. E-mail: manary{at}kids.wustl.edu.

Poor complementary feeding practices are associated with stunting and growth faltering throughout the developing world. The objective was to compare the effect of using peanut-/soy-based fortified spread (FS) and corn porridge fortified with fish powder (FP) as complementary foods on growth in rural Malawian children. A total of 240 children were enrolled at the age of 6 mo and randomized to receive FS or FP. Both complementary foods provided 836 kJ/d from 6 to 9 mo of age and 1254 kJ/d from 9 to 18 mo of age. Children were followed monthly for anthropometry and fortnightly for the symptoms of fever, cough, or diarrhea until they were 18 mo old. Zn and Se status were assessed at 6 and 12 mo. The primary outcomes were the rates of weight and length gain from 6–12 mo and from 12–18 mo. Children who received FS gained 110 g more (95% CI 220 to 10) from 6–12 mo of age than children receiving FP. Weight gain did not differ between children receiving FS and FP between 12 and 18 mo of age, nor did statural growth from 6 to 12 mo or 12 to 18 mo. A total of 23% of all children were Zn deficient at 6 mo of age and this increased to 37% at 12 mo of age. Neither FS nor FP was associated with significantly improved Zn status. FS was associated with better weight gain from 6–12 mo of age and may be useful in conjunction with additional interventions to improve infant growth in the developing world.

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