The eco-cultural context of the undernourished children in a study on the effects of early supplementary feeding in Indonesia

Objectives: This paper describes the ecological and cultural backdrop of th e subjects enrolled in an experimental study to test the validity of a conc eptual model about the intellectual delay of undernourished children. Design: The experiment was a 12-month clinical, randomized trial on the eff ects of early supplementary feeding on two cohorts of children classified a s nutritionally-ar-risk. Three different supplements (condensed milk + micr onutrients; skimmed milk + micronutrients; skimmed milk) were given to the children during 6 or 12 months of the study, Setting: The plantations are 1500-1800 m above sea level in Pangalengan, 50 km south of Bandung, West Java. Temperature fluctuates from 10 to 17 degre es C. A high yearly precipitation is similar to 3000 mm. Communities are la id out at 5-15 km from one another. Living conditions are modest. Subjects: The 156 subjects were recruited from 24 day-care-centers (DCC) th at serviced families of 24 communities in six tea plantations. The 12- and 18-month-old cohorts included 73 and 83 children: respectively; each cohort included three subgroups that received distinct supplements. Observations: The interactions of the caretakers with the children in the D CCs were consistent with the socialization for survival mode. A primary con cern was the physical growth, health, cleanliness, sanitation and safety of the children. Stimulating children, providing toys and initiating play or other activities that would emphasize educational development had a low pri ority.