Our grant from USAID will allow us to import a product called Nutributter into Guatemala. Nutributter is a Ready to Use Supplemental Food (RUSF) produced by Edesia LLC, a nonprofit in Rhode Island. (Some organizations are actively working towards producing a RUSF locally in Guatemala, but are still about a year away from that). Nutributter has been effectively used in numerous settings worldwide to address chronic malnutrition. In Ghana, for example, a 2004-06 Nutributter trial reduced childhood anemia and growth stunting and doubled the number of children who could walk independently at one year of age. In our case, a frequent lack of reliable water supply and cooking resources requires a product in a ready-to-use form.
As the name implies, RUSFs are designed to supplement a child’s diet – not as a sole food source. Nutributter is specifically designed for children 6-24 months of age. Interestingly, the children we see are born with normal weights and heights and grow well along their growth curves until 6 month of age. This means that maternal nutrition and breastfeeding practices are sufficient to guarantee child health until they are 6 months old.
Around 6 months of age, we observe that, due to lack of sufficient food (especially high quality foods), mothers tend to avoid introducing complementary foods to their infants until 9-10 months of age or later, despite World Health Organization (WHO) recommendations that complementary foods should be introduced to infants at 6 months of age. As a result, infants between 6-9 months of age rapidly fall off of their height curves. By 12-15 months of age, the majority of infants are stunted. Caloric intake generally is sufficient to maintain weight, however, so children do not become severely underweight. Indeed the incidence of underweight (low weight for age) and wasting (low weight for length) are both very low, emphasizing the point that stunting is the main concern. Since all of you are becoming experts on the issue of malnutrition, you know the lifelong effects that stunting indicates. (If you don’t know what I am talking about, then you missed my last post :-).
Nutributter supplementation for children 6-24 months of age is therefore ideally suited to prevent stunting. By introducing a high quality food and micronutrient supplement at 6 months, when infants should be transitioning to complementary foods, we can provide food security to the kids and prevent the decline in their length/height-for-age.
Another environmental feature which aggravates the onset of stunting in this age range is the exposure to contaminated water and food products, and the development of frequent bouts of diarrhea. Importantly, Nutributter delivers a daily dose of zinc, which has been shown in clinical trials to reduce the incidence and severity of diarrheal illness. Therefore, we anticipate that Nutributter supplementation will also impact diarrheal illness and interrupt the infection-malnutrition cycle.
And, all of this benefit comes in a foil packet, similar to the soy sauce in your Chinese take-out. It costs about $2.50 per child, per month. It is easily stored, won’t go bad, and doesn’t require any mixing or cooking. To read more about Edesia, our long-term partner, please visit their website at http://www.edesiaglobal.org/. There you can get more information about malnutrition, and other Edesia products that are changing the world!