title: Feeding behaviors during home-based treatment of moderate acute malnutrition using corn-soy blends or lipid-based nutrient supplements.
abstract: Feeding behaviors have an important impact on children's nutritional status and are essential to consider when implementing nutrition programs. The objective of this study was to explore and compare feeding behaviors related to supplementary feeding with corn-soy blends (CSB) and lipid-based nutrient supplements (LNS) based on best practice feeding behaviors. The study was conducted as part of a randomized controlled trial assessing the effectiveness of new formulations of CSB and LNS and comprised 1,546 children from 6 to 23 months. The study included a mixed methods approach using questionnaires, focus group discussions and home visits and interviews with a subsample of 20 caretakers of trial participants. We found that LNS, compared to CSB, were more likely to be mixed into other foods (OR [95% CI] 1.7 [1.3-2.2], p = <.001), served with a meal (OR [95% CI] 1.6 [1.1-2.3], p = <.018)or between meals (OR [95% CI] 1.5 [1.1-1.9], p = <.005), and fed using an encouraging feeding style (mean difference in percentage points [95% CI] 23% [6%:40%], p = .01). CSB were more likely to be fed using a forced feeding style (mean difference in percentage points [95% CI] 18% [3%:33%], p = .02) and were often observed to be served unprepared. The main differences in feeding behaviors between the two diet groups were linked to how and when supplements were served. Educational instructions should therefore be adapted according to the supplement provided; when providing CSB, efforts should be made to promote an encouraging feeding style, and emphasis should be made to ensure preparations are made according to recommendations.
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen and Médecins Sans Frontières, Copenhagen, Denmark.
authors.forename: Ann-Sophie
authors.initials: AS
authors.lastname: Iuel-Brockdorf
authors.affiliation: The Alliance for International Medical Action, Paris, France.
authors.forename: Albertine
authors.initials: A
authors.lastname: Ouedraogo
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Christian
authors.identifier: 0000-0002-5095-0624
authors.initials: C
authors.lastname: Ritz
authors.affiliation: Department of International Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Tania Aase
authors.initials: TA
authors.lastname: Draebel
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Per
authors.initials: P
authors.lastname: Ashorn
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Filteau
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Kim F
authors.initials: KF
authors.lastname: Michaelsen
mesh_terms: D000208:Acute Disease; D000328:Adult; D004032:Diet; D019587:Dietary Supplements; D005247:Feeding Behavior; D005260:Female; D017144:Focus Groups; D005500:Follow-Up Studies; D006266:Health Education; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000032:analysis; D008055:Lipids / Q000008:administration & dosage; D008297:Male; D044342:Malnutrition / Q000178:diet therapy*; D062407:Meals; D010349:Patient Compliance; D012959:Socioeconomic Factors; D013025:Glycine max; D011795:Surveys and Questionnaires; D055815:Young Adult; D003313:Zea mays
chemical_list: D008055:Lipids
keywords: corn-soy blend; feeding behaviors; lipid-based nutrient supplements; malnutrition; supplementary feeding