Complementary Food Supplements for Reducing Childhood Undernutrition

• Stunting and wasting [ Time Frame: Change from 6 months to 18 months of age ] [ Designated as safety issue: No ]
  Change in length-for-age and weight-for-length Z scores and the prevalence of stunting and wasting at 18 months of age.
  
  

• Morbidity [ Time Frame: weekly from 6 to 18 months of age ] [ Designated as safety issue: No ]
  weekly morbidity will be assessed for a year and episodes of diarrhea, dysentery ALRI, and fever will be recorded.
  
  
• Body composition [ Time Frame: At 6, 9 and 12 months of age ] [ Designated as safety issue: No ]
  Bioelectrical impedance analysis will be used to look at body composition changes from baseline until 18 months of age
  
  
• Developmental milestones [ Time Frame: At 6, 12, and 18 months of age ] [ Designated as safety issue: No ]
  Age-specific developmental milestones will be assessed
  
  
• Cognitive and motor function [ Time Frame: At 18 months of age ] [ Designated as safety issue: No ]
  Using Bayley III
  
  

Childhood stunting and growth faltering is highly prevalent in South Asia. Among other strategies, adequate complementary feeding practices and provision of complementary foods that are appropriate and fill the nutrient gap by providing macro and micronutrients essential for growth are important means to reduce the global burden of undernutrition and related morbidity and mortality.

We propose to evaluate the impact of three complementary food supplement products that are fortified with micronutrients in a rural, remote setting in Bangladesh, where high rates of childhood undernutrition persist on child growth, health, and development. The three foods being tested are an enhanced wheat-soy blend (WSB++) developed by WFP, and locally developed chickpea-based and a rice-based complementary food supplements.

We will assess the impact of feeding these daily against the non-fed controls, hypothesizing that the children fed these foods show increased length for age Z scores (LAZ) and weight for length age Z scores (WLZ) of >0.21 and decreased prevalence of stunting and wasting by >10%. We expect that the impact of the three foods will be equivalent/ non-inferior to that of Plumpy'Doz.