EARLY-CHILDHOOD SUPPLEMENTATION DOES NOT BENEFIT THE LONG-TERM GROWTHOF STUNTED CHILDREN IN JAMAICA

The long-term benefits of early childhood supplementation and the exte nt to which catch-up growth occurs following linear growth retardation remain controversial. Stunted children (height-for-age < -2 so of NCH S references, n = 122) recruited from a survey of poor neighborhoods i n Kingston, Jamaica, participated in a 2-yr randomized, controlled tri al of supplementation beginning at ages 9-24 mo. A group of 32 non-stu nted children from the same neighborhoods was also followed. Four year s after the intervention ended, when children were 7 to 8 y old, there were no effects of supplementation on any anthropometric measure. Fro m the end of the trial until follow-up, the children who had been supp lemented gained 1.2 cm less (P < 0.05) than the non-supplemented child ren, approximately the same amount as they had gained during the trial compared with the non-supplemented children. After adjustment for reg ression to the mean, the height-for-age of stunted children (supplemen ted and non-supplemented combined) increased from enrollment to follow -up by 0.31 Z-score (95% CI 0.17, 0.46). The height-for-age of the non -stunted children also increased (0.96 Z-score; 95% CI 0.70, 1.22). Ou r results suggest that some catch-up growth is possible even when chil dren remain in poor environments. Longterm benefits of supplementation to growth may not be achieved when intervention begins after age 12 m o in children who have already become undernourished.