Comparison of standardised milk‐based, standardised non‐milk based and hospital‐based formulations on the anthropometric indices of under‐fives with moderate acute malnutrition: A randomised clinical trial.

Background: Moderate acute malnutrition (MAM) causes impaired anthropometry, which can be reversed by supplementary feeding. The present study aimed to compare the effect of a standardised milk‐based formulation (SMBF), standardised non‐milk based formulation (SNMBF) and hospital‐based formulation (HBF) on anthropometric indices of children aged <5 years with MAM. Methods: This was a randomised clinical trial during which eligible children aged 6–59 months with MAM received SMBF, SNMBF or HBF over 4 months. They were followed up on a biweekly basis during which their weight, mid upper arm circumference (MUAC) and length/height were measured. The effect of the formulations was determined at the end of the period by the change in their anthropometric indices using 'per protocol' analysis. p < 0.05 was considered statistically significant. Results: There were 157 evaluable participants of whom 54 received the SMBF, 57 received the SNMBF and 46 received the HBF. The overall result showed a significant improvement in the mean weight and MUAC of the children. Subgroup analysis showed a significant improvement in mean weight and MUAC among children aged 6–23 months (p = 0.013) and improvement in MUAC only among those aged 24–59 months (p = 0.03). Conclusions: The formulations significantly improved the mean weight and MUAC of children with MAM. Key points: Moderate acute malnutrition is a cause of impaired physical growth in children aged <5 years (under‐fives).Ready‐to‐use supplementary foods for managing the condition are usually in short supply in most regions where childhood malnutrition is endemic.WHO recommends the evaluation and use of locally available food stuffs in managing the condition.The use of standardised milk based, standardised nonmilk based and hospital‐based formulations at 50% of the daily caloric requirement along with regular family diet over 4 months in children with moderate acute malnutrition was associated with a significant improvement in the weight and mid upper arm circumference of the children.The improvement in the length/height of the children was not statistically significant.Locally available formulations fortified with micronutrients should be used to manage under‐fives with moderate acute malnutrition in settings where ready‐to‐use supplementary foods are not available. [ABSTRACT FROM AUTHOR]