Background: Stunting among toddlers is highly prevalent in Indonesia. As a chronic malnutrition problem, stunting is closely related to internal (maternal health) and external factors such as feeding practices, illness and socio-economics of the community. The purpose of this study was to analyze the relationship between low birth weight (LBW), child feeding practices and neonatal illness with stunting among Indonesian toddlers. Methods: For this study, we took data from the 2010 Indonesian National Basic Health Survey (RISKESDAS). Totally 3024 children aged of 12-23 months included in this analysis. Stunting was measured using standardized body length and was defined based on criteria from WHO AnthroII.PC2007. Data analysis was done through bivariate and multivariate logistic regressions. Results:The results showed that the prevalence of stunting among Indonesian toddlers (12 23 months) was 40.4%. Early initiation of breast-feeding and exclusive breast feeding was experienced by 42.7% and 19.7% of the babies. More than half of the babies were given pre-lacteal feeds, while early complementary feeding was given to 68.5% of the subjects. Multivariate analysis showed infants born with LBW were 1.74 times more likely to be stunted (95% CI 1.38-2.19) than those born with normal weight. Boys were 1.27 times (95% CI 1.10-1.48) more likely to be stunted than girls. Infants with a history of neonatal illness, they were 1.23 times (95% CI 0.99-1.50) more susceptible to stunting. Being poor was another indirect variable that significantly associated with stunting (OR = 1.3, 95% CI 1.12-1.51). Conclusion: LBW, gender (boys), history of neonatal illness and poverty are factors related to stunting among children aged 12-23 months in Indonesia, with LBW being the major determinant of stunting.

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Objectives: This paper reports the effects of an energy and micronutrient supplementation on mental and motor development, activity and behavior under natural conditions of children classi®ed as iron de®cient anemic and iron replete. Design: Children were randomly assigned to two different nutritional supplements: (1) 12 mg iron either 1171 or 209 kJ; (2) 104 kJ 0 iron. Treatment lasted for 6 months. Setting: The sites were six tea plantations in Pangalengan, West Java. Subjects: Eighteen anemic subjects (hemoglobin`110 gaL; transferrin saturation (TS)`16%) and 18 matched (sex and age) controls (hemoglobin b 110 gaL; TS b 16%) were selected from a pool of children with the following characteristics: no chronic disease; length-for-age 7 1 standard deviation (s.d.) and weight-forlength between 71 and 72 s.d. of the median of the reference of the World Health Organization. Methods: Hemoglobin, ferritin, transferrin saturation and erythrocyte protoporphyrin were evaluated before and 6 months after treatment. The following psychological measurements were obtained at baseline and 2, 4 and 6 months later. Mental and motor development was evaluated with the Bayley Scale. Motor activity was measured by 4 h continuous observations at home and at day care centers. The interactions between the child and its social and physical environment were also evaluated during 4 h of observations. Results: Anemic children showed faster motor development and greater physical activity than the control children did. None of the other tests showed inter-group differences.

A controlled trial of fortification of crystalline monosodium glutamate (MSG) with 810 micrograms RE vitamin A/g was undertaken in an area of endemic vitamin A deficiency in Indonesia. Powdered MSG was used to mask the yellow color of the vitamin A. Fortified MSG was marketed through ordinary channels in five villages in the program area and five nearby villages served as the control area. The product retained 84% of its potency after 4 mo and 57% after 11 mo in the marketplace. Base-line serum and breast-milk vitamin A levels were slightly higher in the control areas. Follow-up serum levels increased dramatically in program villages, 0.67 +/- 0.33 at prefortification base line to 0.92 +/- 0.33 mumol/L (p less than 0.001) at 11 mo after introduction of the fortified product. Breast-milk levels also rose, from 0.60 +/- 0.29 at base line to 0.67 +/- 0.30 mumol/L at 11 mo (p less than 0.05). Serum and breast-milk levels in control villages did not change.

Objectives: This paper reports the effects of an energy and micronutrient supplement on mental development and on the social ± cognitive and emotionally regulatory behaviors 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 12 mg iron 209 kJ; S 104 kJoule. Supplementation 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 who received S belonged to the 12-and 18-month-old cohort. Inclusion criteria were: no chronic disease; length-for-age À1 standard deviation (s.d.) and weight-for-length between À1 and À2 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 thereafter. Motor development was assessed with the Bayley Scale and with a custom-made scale to assess gross motor development leading to bipedal locomotion. Four hours of continuous observations were made of the child's interaction with the social and physical environment. Results: In the 12-month-old cohort, as compared with the M and S groups, the children who received the E supplement walked at an earlier age, had higher scores in the Bayley Scale and showed more mature social ± cognitive and emotional regulatory behaviors. Similar intergroup differences were observed in the 18-month-old cohort in social cognition and regulation of emotions.

Objectives: This paper reports the effects of an energy and micronutrient supplement 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. Supplementation 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 to the 12-and 18-month-old cohorts. Inclusion criteria were: no chronic disease; length-for-age À1 standard deviation (s.d.) and weight-for-length between À1 and À2 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 thereafter. Motor development was assessed with the Bayley Scale and with a custom-made scale to assess gross motor development leading to bipedal locomotion. Motor activity was assessed through 4 h continuous observations of the 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 higher scores in the Bayley Scale and were motorically more active. Similar intergroup differences were observed in the 18-month-old cohort in the total motor activity score.

The CoD analysis is a useful entry point for discussions on constraints on achieving adequate nutrition in different areas and on possible ways to improve nutrition, including the use of special foods and different distribution strategies.

Objectives: The paper presents the results of an ecological-economic approach to identifying community-level factors that in¯uence the physical growth of young children. Design: A cross-sectional design was used to obtain both the anthropometry and the ecological-economic data. Setting: The sites were 24 communities located in a tea plantation near Bandung, West Java, Indonesia. Subjects: 415 children between the ages of 6 and 18 months. Methods: Epidemiological and ethnographic methods were used to measure community infrastructure and services related to child growth. Anthropometry was used to measure child growth. Econometric methods, including probit and ordinary least squares regression, were used to analyze the effect of community-level factors on child growth. Results: Community vaccination programs, child care services, environmental sanitation and latrines were associated with better child growth. We concluded that community-level goods and services substantially contributed to health in early childhood.