PhilSPEN Online Journal of Parenteral and Enteral Nutrition

(Article 48 | POJ_0043.html) Issue )

Thesis Abstract


Abstract | Introduction | Methodology | Results | Discussion | Conclusion | References | PDF (756 KB) |Back to Articles Page

Submitted: October 2010


Diane S. Mendoza


Philippine Women's University, Metro-Manila, Philippines

Malnutrition has been a problem especially in developing countries. In the Philippines, malnutrition among children continues to persist. Malnutrition permeates all aspects of health, growth, cognition, motor and social development of young children. However, present nutritional status of Filipino children (0-5 years old) shows three million children are still undernourished. With a steady growth rate that happens in this stage, all nutrients must be adequately provided. It should also be noted that feeding difficulties arises, making the delivery of adequate nutrients needed to support growth and development also hard to achieve. Supplemental feedings can be very helpful during this stage to address the difficulty in delivering adequate nutrients.

This study focused on the effect of milk supplementation as the main intervention in improving pre-school children's anthropometric, nutrient intake and psychomotor development.

A randomized controlled trial was used to determine the effects of three month milk supplementation among children ages three to five years old. A stratified randomization was used where the eligible subjects were divided into three sub groups of (normal, mild underweight and moderately underweight) using WHO Child Growth Standards weight for age z-scores then assigned to each stratum so that each subgroup have equal number of subjects. Subjects included children ages three to five years old from Cardona, Rizal. Two 50g milk sachets (216 kcal/sachet: 32 g CHO, 7.5 g protein and 7 g fats) was used as a supplement on a daily basis for three months for the intervention group and no additional supplement was given to the control. All eligible subjects had their baseline data taken at the commencement of the study. Anthropometric data include- weight, height, weight for age z scores, mid upper arm circumference; dietary data include a three day 24-hour food recall gathered at baseline, every month for monitoring and at end of study. Psychomotor development test was . gathered at baseline and at end of study. Self report occurrence of cough, fever, flu like symptoms and diarrhea were collected at baseline, every three weeks and at end of study. Analysis of variance, Analysis of covariance, independent t- test, Duncan's test and Pearson's Correlation were all used to analyze the data gathered with level of significance set at 0.05.

Mean age for Experimental group was 4 years old and 4.3 years old for the Control. Sixty three percent of the 120 subjects were female and 33% males. Fifty-eight percent from the experimental group were female while 67% from the control and 42% male from experimental and 33% from the control. Mean weight at baseline for the subjects was 13.8 kg; 13.7 kg for Experimental group and 13.8 kg for the Control. Change in weight after three months among those who took milk supplements is 1.7 kg, those who did not take milk supplements is 0.3 kg, or net gain in weight due to milk supplementation of 1.4 kg. Change in weight after three months is significantly affected by milk supplementation (p<0.0001) and the interaction between milk supplementation and nutritional status (p<0.0001). Change in height after three months among those who took milk supplements is 2. 7 cm, those who did not is 1.3 cm, or net gain in height of 1.4 cm. Change in height after three months is significantly affected by milk supplementation (p<0.0001). Average increase in MUAC for the experimental group was 0.9 cm, and 0.2 cm for the control or net gain in of 0.7 cm for those who took milk supplements. Change in MUAC after three months is significantly affected by milk supplementation (p<0.0001). Mean caloric intake at baseline was 1,094 kcal/day as reported form the subjects' 3-day 24 hour food recall; 1,086 kcal for the experimental group and 1,102 kcal for the Control. Change in caloric intake after three months is significantly affected by milk supplementation (p<0.0001). There was a significant increase for all the three macronutrients: carbohydrates (CHO), protein (CHON) and fat and micronutrients: Vit. A, Vit. C, Thiamin, Riboflavin, Niacin, Calcium, and Iron of the experimental group compared with the control group (p<0.0001). Change in Psychomotor score after three months is significantly affected by milk supplementation (p<0.0001) and anthropometric measures of weight, BMI and MUAC suggest a positive correlation with psychomotor development of children ages three to five.

The study showed that milk supplementation for three months may improve the anthropometric measures of pre-school children specifically weight, height and mid upper arm circumference although may not improve the weight for age classification compared to the control group which did not receive any milk supplements. The present study showed that three month milk supplementation of milk may improve the nutrient intake of pre school children. The study suggests that there is a correlation between nutritional status and psychomotor development of pre school children although further investigation should be done.

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