Nutrition experts call for child malnutrition supplement scale-up

Feeding children just four teaspoons of a nutrient-dense dietary supplement a day can reduce their risk of mortality by 27%, according to an analysis of existing studies on the product’s effectiveness. Nutrition experts have called for a global scale-up of the supplement, known as small-quantity lipid-based nutrient supplements, or SQ-LNS. The substance can address multiple nutrient deficiencies when added to a child’s regular diet to help avert the 45% of child deaths caused by undernutrition. Less than 30% of children aged 6 to 23 months eat a diet with the minimum diversity of food groups. “We’re at this inflection point of incredibly robust evidence base,” Shawn Baker, chief program officer at Helen Keller Intl, told Devex. “Now how do we act on it? I’m just incredibly excited about the potential to add this to our suite of solutions to address child malnutrition.” In an article published in Nature Food, the U.S. Agency for International Development, World Bank, Bill & Melinda Gates Foundation, World Food Programme, UNICEF, Helen Keller, and the University of California, Davis presented compelling evidence in favor of SQ-LNS and highlighted how it could dramatically improve child nutrition globally. The text compared its prospects to thirty years ago when nutritionists realized how beneficial Vitamin A supplementation could be for children. In addition to decreasing mortality, studies of more than 37,000 children show SQ-LNS brings a 31% drop in severe wasting, a 17% decline in stunting, a 64% decrease in iron deficiency anemia, and a 16 to 19% reduction in developmental delay. It is most effective if children receive the supplement as soon as they turn six months while breastfeeding continues, Baker said. SQ-LNS, which is a paste and comes in a packet, can be taken on its own or mixed into other foods a child is beginning to eat at that age. The supplement can have variations on its formula, but it generally includes an omega-3 fatty acid-rich vegetable oil; a legume, such as peanuts, lentils, soybeans, or chickpeas; and milk powder. Most formulations are also fortified with 22 vitamins and minerals. Nutrient-dense foods are unavailable to many children globally, and Baker said it can be time consuming to find and prepare them. They’re often out of reach financially, too. “This sort of new product is really a supplement to help close that incredible gap,” Baker said, noting many families cannot access the recommended nutritional diet for their children. “You can actually have tremendous impact.” The question now, Baker said, is how to use the strong evidence for how well the product works to expand access to more children. Organizations and donors must consider where SQ-LNS can have the biggest impact, he said. The focus should be on rolling it out in areas with high child mortality and wasting rates, many of which are in Africa. Getting early government buy-in will be essential to successful uptake, he said, even as UNICEF and WFP play large roles. The two agencies are already involved in distributing products which treat child malnutrition, including ready-to-use-therapeutic foods, and ready-to-use-supplemental foods. Increasing access to SQ-LNS cannot come at the expense of treatment for acute malnutrition, Baker said, and the two are “intimately linked.” “To me, making sure we’re also improving wasting treatment programs at the same time we’re rolling this out is going to be absolutely essential,” Baker said.