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Hillis, Susan; Weigle, Kristen A.; Miranda, Clarybel; McCann, Margaret F.; Bender, Deborah E.; & Stewart, Paul (1994). Supplementary Feeding in Colombian Child Care Centers and Growth Velocity. Pediatrics, 94(6 Part 2), 1066-1069.


Because of the widespread prevalence of malnutrition among children living in developing countries, supplementary feeding programs have become a widely endorsed strategy for promoting health and preventing disease. In a number of Latin American countries, such supplementation is commonly provided through child-care centers (CCCs) that serve children from economically underprivileged environments. In Colombia, for example, the federal government funds a national network of public CCCs, as a service to low-income families. Approximately 396 000 children (10% of all children under 5) are cared for in these centers (Farides Feris de Harb, personal communication, December 3, 1987). These children are provided 50% of their recommended daily nutritional allowances through supplementary feeding programs.
Reports to date about the benefits of supplementary feeding programs have focused on cross-sectional growth and are inconclusive. Studies conducted in Brazil and Chile have shown that feeding supplementation within CCCs helps overcome acute malnutrition, indicated by wasting (low weight-for-age) but has no effect on chronic malnutrition, as indicated by stunting (low height-for-age). In contrast, a recent Colombian study found that supplementary feeding led to a decrease in chronic malnutrition but had no effect on acute malnutrition.
Though investigators have recommended using rate of growth, in contrast with cross-sectional growth measures (such as weight-for-age or weight-for-height), to evaluate the effect of supplementary feeding on children's health,8 to our knowledge no previous studies have done so. Both epidemiologic and clinical patterns of a child's weight gain is a more sensitive indicator of health status than is a single measure of weight or height.


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Journal Article

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Hillis, Susan
Weigle, Kristen A.
Miranda, Clarybel
McCann, Margaret F.
Bender, Deborah E.
Stewart, Paul