Effect of an improved complementary food on nutrition of Zambian infants

Background: Infant growth faltering is common in developing countries. A major cause is inappropriate feeding practices and poor quality complementary foods with low energy density and deficiency in micronutrients and which may displace breast milk. The impact o f micronutrient fortification o f complementary foods or adding a-amylase to increase energy density on growth o f infants from middle income urban populations in developing countries has been inadequately studied. Objectives: To assess current complementary feeding practices, develop and test the acceptability and effect of amylase-treated-fortified complementary blends named Chilenje Baby Mix (CBM) on growth and haemoglobin concentration o f infants from a middle income community in Lusaka, Zambia. Design: Three-stage study comprising assessment of, 1) current complementary feeding practices, 2) acceptability o f amylase-treated-fortified complementary food and, 3) the effect of the complementary food on growth, haemoglobin concentration and breast milk intake o f 9-month old infants in a randomized controlled trial. Methods: Current complementary feeding practices were assessed by qualitative (focus group discussions, interviews and home observations) and quantitative methods. Acceptability to mothers o f roasted maize-beans-groundnutsbambaranuts porridge recipes was assessed prior to the industrial production o f aamylase-treated-fortified blends. Infants were randomized to receive a fortified blend with (CBMA) or without amylase (CBM) from 6 9 months o f age. Anthropometric measurements, dietary intake and morbidity were determined monthly. Non-intervention infants were