Food supplementation with encouragement to feed it to infants from 4 to 12months of age has a small impact on weight gain

It is unclear whether a substantial decline in malnutrition among infants i n developing countries can be achieved by increasing food availability and nutrition counseling without concurrent morbidity-reducing interventions. T he study was designed to determine whether provision of generous amounts of a micronutrient-fortified food supplement supported by counseling or nutri tional counseling alone would significantly improve physical growth between 4 and 12 mo of age. In a controlled trial, 418 infants 4 mo of age were in dividually randomized to one of the four groups and followed until 12 mo of age. The first group received a milk-based cereal and nutritional counseli ng; the second group monthly nutritional counseling alone. To control for t he effect of twice-weekly home visits for morbidity ascertainment, similar visits were made in one of the control groups (visitation group); the fourt h group received no intervention. The median energy intake from nonbreast m ilk sources was higher in the food supplementation group than in the visita tion group by 1212 kJ at 26 wk (P < 0.001), 1739 kJ at 38 wk (P < 0.001) an d 2257 kJ at 52 wk (P < 0.001). The food supplementation infants gained 250 g (95% confidence interval: 20-480 g) more weight than did the visitation group. The difference in the mean increment in length during the study was 0.4 cm (95% confidence interval: -0.1-0.9 cm). The nutritional counseling g roup had higher-energy intakes ranging from 280 to 752 kJ at different ages (P < 0.05 at all ages) but no significant benefit on weight and length inc rements. Methods to enhance the impact of these interventions need to be id entified.