Complementary Food Supplements to Achieve Micronutrient Adequacy for Infants and Young Children

Abstract

Many children in developing countries survive on a nutritionally inadequate diet. Dietary inadequacies during the complementary feeding period can be prevented by using complementary food supplements (CFSs) such as water dispersible or crushable micronutrient tablets, micronutrient sprinkles added to food just before feeding, or fortified spreads added to food just before feeding or fed as a snacks. A meeting was convened to discuss technical and operational issues related to the development of these new approaches and to identify knowledge gaps. The technical issues covered: what micronutrients to include, tolerable upper intake limits, bioavailability, micronutrient and macronutrient stability, package systems and amounts, encapsulation technologies, methods to limit or eliminate allergens, bacterial and chemical contamination, interactions between CFSs and complementary foods, and flavoring agents. Operational issues included: identifying the market positioning of CFSs, cost positioning of CFSs, regulatory requirements, CFS production and technology transfer, quality assurance, and public-private sector partnership and coordination. Intervention trials are needed to determine the efficacy of CFSs in preventing micronutrient deficiencies. Other important knowledge gaps relate to technical and operational issues. Sprinkles and tablets are produced using well-known technologies, but further research is needed to modify them for use as CFSs. Spread development is not as advanced as sprinkle and tablet development, and further research is needed to improve the technology. Although none of the products is ready for widespread use, enough information is available to set research priorities and accelerate product development and implementation.

Randomised comparison of the effects of Sprinkles and Foodlets with the currently recommended supplement (Drops) on micronutrient status and growth in Iranian children

“…National supplementation and fortification programmes can be effective in reducing deficiencies, but the implementation of such programmes presents many challenges. Home fortification with complementary food supplements (CFS) has recently been promoted as an alternative intervention for combating deficiencies (Nestel et al, 2003). Few studies, however, have compared the efficacy and acceptability of these strategies in different population settings.…”

Improved adherence and anaemia cure rates with flexible administration of micronutrient Sprinkles: a new public health approach to anaemia control

“…Although iron supplementation with ferrous sulphate drops and syrup has been the primary therapeutic intervention for IDA in infants, iron drops have not proven to be effective as a large-scale public health intervention mainly because of poor adherence (Ciomarten et al, 1995;Nestel and Alnwick 1997). Thus, recent emphasis has been placed on finding new products and new approaches to increase adherence (Nestel et al, 2003).…”

Nutrition in Healthy Children

“…Significant amount of energy is necessary in growth period. Because the children have not learnt eating food by themselves yet, the diets that will be prepared for their nutrition should be in conformity with the child and include definite nutrient elements (Netsel, 2003).…”

“… 120 calories per kilogram between 1-3 months  110 calories per kilogram between 4-9 months  105 calories per kilogram between 10-12 months (Netsel, 2003).…”