280 Colombian infants at risk of malnutrition were randomly assigned to 1 of 4 experimental groups formed by the presence/absence of 2 interventions: (1) food supplementation for the entire family, from mid-pregnancy until the target child was 3 years old, and (2) a twice-weekly home-visiting program to promote cognitive development, from birth until age 3. All families received free medical care and were studied prospectively. At 3 years of age, children who had received food supplementation averaged 2.6 cm and 642 grams larger than controls. Home visiting and supplementation together reduced the number of children with severe growth retardation. 3 years after intervention (age 6), supplementation effects remained. Children in the home visit condition had become larger than controls, by 1.7 cm and 448 grams. The interactive effect to reduce stunting was marginally significant at this age, and the overall distribution of scores was improved. Other results suggest that changes in family functioning as well as biological mechanisms account for the observed pattern of results.
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