Effects of an energy and micronutrient supplement on motor development andmotor activity in undernourished children in Indonesia

Objectives: This paper reports the effects of an energy and micronutrient s upplement on the motor development, motor milestones and motor activity of nutritionally at risk infants and toddlers in Pangalengan, Indonesia. Design: Two cohorts of children were randomly assigned to three treatments E = 1171 kJ + 12 mg iron; M = 209 kJ + 12 mg iron; S = 104 kJ. Supplementat ion was given for 12 months. Setting: The sites were six tea plantations in Pangalengan, West Java. Subjects: A 12-month-old (n = 53) and an 18-month-old (n = 83) cohort were recruited from day-care-centers. Twenty children that received S belonged t o the 12- and 18-month-old cohorts. Inclusion criteria were: no chronic dis ease; length-for-age less than or equal to-1 standard deviation (s.d.) and weight-for-length between -1 and -2 s.d. of the median of the reference of the World Health Organization. Methods: Evaluations of intake were made at baseline and every 2 months the reafter. Motor development was assessed with the Bayley Scale and with a cu stom-made scale to assess gross motor development leading to bipedal locomo tion. Motor activity was assessed through 4 h continuous observations of th e child's interaction with the social and physical environment. Results: In the 12-month-old cohort, as compared to the M and S groups the children that received the E supplement walked at an earlier age, had highe r scores in the Bayley Scale and were motorically more active. Similar inte rgroup differences were observed in the 18-month-old cohort in the total mo tor activity score.