The purpose of this study is to test the impact on child growth of three specially formulated complementary food supplements vs. Plumpy'Doz, a previously tested, commercially available complementary food, and vs. a control group that receives no food. All groups will receive nutrition education related to infant and young child feeding. This will be a cluster-randomised trial in children 6-18 months old in rural Rangpur and Gaibandha in Bangladesh.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
5,449
A wheat formulation containing protein from milk solids and soybeans, essential fats and sugar to provide optimal caloric density, and added vitamins and minerals.
A chickpea-based complementary food supplement with added milk powder, oil, sugar and added vitamins and minerals.
Locally developed rice based complementary food with and added vitamins and minerals.
The JiVitA Project, Johns Hopkins Bangladesh
Gaibandha, Bangladesh
Stunting in Children at 18 mo
Prevalence of stunting at 18 months of age.
Time frame: 18 months of age
Morbidity
weekly morbidity will be assessed for a year and episodes of diarrhea, dysentery ALRI, and fever will be recorded.
Time frame: weekly from 6 to 18 months of age
Body Composition
Bioelectrical impedance analysis will be used to look at body composition changes from baseline until 18 months of age
Time frame: At 6, 9 and 12 months of age
Developmental Milestones
Age-specific developmental milestones will be assessed
Time frame: At 6, 12, and 18 months of age
Cognitive and Motor Function
Using Bayley III
Time frame: At 18 months of age
Micronutrient Status
Iron, vitamin A, zinc and other micronutrient status of children will be examined by intervention group.
Time frame: 18 months of age
Intestinal Function
Intestinal function using L:M and other biomarkers will be assessed by intervention group and its association with child growth
Time frame: At 24 months of age
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Plumpy Doz is a prepackaged ready-to-use complementary food supplement enriched with added vitamins and minerals.