Ashorn Ulla, Alho Lotta, Arimond Mary, Dewey Kathryn G, Maleta Kenneth, Phiri Nozgechi, Phuka John, Vosti Stephen A, Zeilani Mamane, Ashorn Per
Department of International Health, School of Medicine, University of Tampere, Tampere, Finland;
Department of Nutrition, Program in International and Community Nutrition, and.
J Nutr. 2015 Jul;145(7):1588-95. doi: 10.3945/jn.114.209593. Epub 2015 May 20.
Lipid-based nutrient supplements (LNSs) offer a vehicle to improve children's diets in low-income countries where complementary foods are typically deficient in essential nutrients. Sustained acceptability by the intended users is essential for achieving growth-promoting effects.
We aimed to determine the sustained acceptability of LNSs among 6- to 18-mo-old children in Malawi.
In the context of a trial testing the growth-promoting effect of different formulations and doses of LNSs, we delivered LNSs to the homes of the children biweekly according to the randomization protocol. We defined acceptability to include adherence to feeding recommendations and mothers' experiences of feeding LNSs to their child. We conducted brief interviews each week with the mothers. At 2 time points we conducted knowledge, attitudes, and practices (KAP) interviews. In addition, we conducted repeated in-depth interviews with a subset of mothers.
Of the 1612 children who received the LNS intervention, we analyzed adherence data from 1478 (91.7%) children and KAP data at 2 time points (child's age of 12 and 18 mo) from 839 (52.1%) of the children. The mean ± SD overall adherence (proportion of days when the study child reportedly consumed LNSs considering only those weeks when the supplement had been successfully delivered to the home) was 92.4 ± 9.6%, and there was no difference between children receiving milk-containing or milk-free LNSs. There was also no increasing or decreasing trend over time in any of the groups. Sharing and deviation from other feeding recommendations were common. Maternal experiences were mostly very positive.
The acceptability of LNS products was good and was sustained for 12 mo in this rural Malawian population. However, sharing of the products with family members and deviation from other feeding recommendations were frequent, which means that individually targeted children were likely to receive less than the intended dose of the LNS. This trial was registered at clinicaltrials.gov as NCT00945698.
在低收入国家，辅食通常缺乏必需营养素，基于脂质的营养补充剂（LNSs）为改善儿童饮食提供了一种途径。目标用户的持续接受度对于实现促进生长的效果至关重要。
我们旨在确定LNSs在马拉维6至18月龄儿童中的持续接受度。
在一项测试不同配方和剂量的LNSs促进生长效果的试验中，我们按照随机方案每两周将LNSs送到儿童家中。我们将接受度定义为包括遵守喂养建议以及母亲给孩子喂LNSs的体验。我们每周与母亲进行简短访谈。在两个时间点进行了知识、态度和行为（KAP）访谈。此外，我们对一部分母亲进行了多次深入访谈。
在1612名接受LNS干预的儿童中，我们分析了1478名（91.7%）儿童的依从性数据以及839名（52.1%）儿童在两个时间点（儿童12和18月龄）的KAP数据。总体平均依从性（仅考虑补充剂已成功送到家中的那些周，据报道研究儿童食用LNSs的天数比例）为92.4±9.6%，接受含牛奶或不含牛奶LNSs的儿童之间没有差异。任何一组随时间都没有上升或下降趋势。与其他喂养建议的偏差和分享情况很常见。母亲的体验大多非常积极。
在这个马拉维农村人群中，LNS产品的接受度良好且持续了12个月。然而，与家庭成员分享产品以及偏离其他喂养建议的情况很频繁，这意味着个别目标儿童可能摄入的LNS剂量低于预期剂量。该试验在clinicaltrials.gov上注册为NCT00945698。
