The effects of nutritional supplementation and psychosocial stimulation on the growth and development of stunted children - abstract

ABSTRACT

Supplementation programmes are used in many countries to reduce the prevalence of undernutrition. However, their effectiveness is uncertain. We have conducted a longitudinal study to determine the effects of nutritional supplementation with or without psychosocial stimulation on the growth of stunted children. Stunted (n = 128) and non-stunted (n = 32) children, aged 9-24 months, were recruited by house-to-house survey of poor areas of Kingston. Stunted children were randomly assigned to four groups control, nutritional supplementation (1 kg whole milk powder/week providing 750 kcals and 20 gm protein daily), stimulation (structured play sessions) and both interventions. All groups were visited weekly. Length, weight, head (HC) and arm (AC) circumferences, and triceps (TSF) and subscapular (SSF) skinfolds were measured on enrollment and 6 and 12 months later. Multiple regression analysis was used to determine the increases in the measurements attributable to supplementation (Table). The partial regression coefficient B, represents the difference between supplemented and non-supplemented groups controlling for age, sex, initial status and several socioeconomic variables. Supplemented children had significantly increased length, weight, HC and TSF in the first six months. There were no significant effects in the second six months. Weight-for-age and height-for age were increased but not weight-for-height. There was no effect of stimulation and no interaction between the interventions. The timing of the response to supplementation may have implications for the design of future interventions (AU)