Reducing
child malnutrition requires nutritious food, breastfeeding, improved hygiene, health services, and (
prenatal) care. Poverty and food insecurity seriously constrain the accessibility of nutritious diets that have high
protein quality, adequate
micronutrient content and bioavailability, macrominerals and
essential fatty acids, low antinutrient content, and high nutrient density. Diets based largely on plant sources with few animal-source and fortified foods do not meet these requirements and need to be improved by processing (dehulling, germinating, fermenting), fortification, and adding animal-source foods, e.g., milk, or other specific nutrients. Options include using specially formulated foods (fortified blended foods, commercial infant cereals, or ready-to-use foods [RUFs;
pastes, compressed bars, or biscuits]) or complementary food supplements (
micronutrient powders or powdered complementary food supplements containing
micronutrients,
protein,
amino acids, and/or
enzymes or
lipid-based nutrient supplements (120 to 250 kcal/day), typically containing milk
powder, high-quality
vegetable oil, peanut
paste,
sugar, and
micronutrients. Most supplementary feeding programs for moderately malnourished children supply fortified blended foods, such as corn-soy blend, with oil and
sugar, which have shortcomings, including too many antinutrients, no milk (important for growth), suboptimal
micronutrient content, high bulk, and high viscosity. Thus, for feeding young or malnourished children, fortified blended foods need to be improved or replaced. Based on success with ready-to-
use therapeutic foods (RUTFs) for treating
severe acute malnutrition, modifying these recipes is also considered. Commodities for reducing
child malnutrition should be chosen on the basis of nutritional needs, program circumstances, availability of commodities, and likelihood of impact. Data are urgently required to compare the impact of new or modified commodities with that of current fortified blended foods and of RUTF developed for treating
severe acute malnutrition.