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Title: Acceptability of three novel lipid-based nutrient supplements among Malawian infants and their caregivers

item Phuka, John - University Of Malawi
item Ashorn, Ulla - University Of Tampere Medical School
item Ashorn, Per - University Of Tampere Medical School
item Zeilani, Mamane - Nutriset
item Cheung, Yin Bun - University Of Tampere Medical School
item Dewey, Kathryn - University Of California
item Manary, Mark - Children'S Nutrition Research Center (CNRC)
item Maleta, Kenneth - University Of Malawi

Submitted to: Maternal and Child Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/21/2011
Publication Date: 10/1/2011
Citation: Phuka, J., Ashorn, U., Ashorn, P., Zeilani, M., Cheung, Y., Dewey, K.G., Manary, M., Maleta, K. 2011. Acceptability of three novel lipid-based nutrient supplements among Malawian infants and their caregivers. Maternal and Child Nutrition. 7(4):368-377.

Interpretive Summary: The effectiveness of lipid-based nutrient supplements (LNSs) in improving child growth has been demonstrated in multiple clinical trials. This study examined the acceptability of three new LNSs by looking at caregiver ratings and feeding practices. The LNSs were incorporated into porridge and Malawian infants were provided with a two-week supply of one of the three supplements. Amount of food consumed, time to consume food, and maternal rating of food was considered. Almost all caregivers rated all the LNS’s as very likeable and reported that their infants consumed over 50% of the food. Food sharing was found to be minimal. Information from the study reveals that the three new lipid nutrient supplements are considered acceptable among this population and can be incorporated successfully into infant’s diets as complementary foods.

Technical Abstract: We tested the acceptability of three new lipid-based nutrient supplements (LNSs) in two independent phases among 18 8–12-month-old healthy rural Malawians and their caregivers. In phase 1, acceptability was assessed by offering three new LNSs in random order, and an LNS already determined to be acceptable, Nutributter®, each added to 30 g of warm maize porridge over three consecutive days. In phase 2, infants from each village were provided one of the new supplements for a 2-week home-use trial. Outcome measures included the amount consumed, time completion of the dose and the maternal rating of likeability on a 5-point scale. The supplements were rated acceptable if consumption was over 50% of the offered dose in phase 1. The mean (95% confidence interval) proportion of the LNS test meals consumed under direct observation was 88% (82–94%) for LNS-10gM, 90% (84–95%) for LNS-20gM, 87% (79–95%) for LNS-20gNoM, and 86% (83–90%) for Nutributter. The median (25th and 75th centile) time (minutes) for completing the offered test meal was 4 (2, 7) for LNS-10gM, 5 (3, 6) for LNS-20gM, 4 (3, 8) for LNS-20gNoM and 4 (2, 6) for Nutributter. During both phases, almost all caregivers rated all study foods very likeable for themselves and their children, with mean scores slightly lower among the caregivers than among the infants. In the home-use phase, the test foods were almost exclusively used by the study participants with minimal sharing with siblings and other household members. Some infants were reported to prefer the new investigational products over traditional complementary food. Considering that the novel LNS was largely acceptable. Efficacy trials are now needed to assess their impact on child growth and development.