Is 'small quantity lipid nutrition supplement' (SQ-LNS) a sustainable and pragmatic strategy to prevent malnutrition?

Young child malnutrition and food insecurity is the result of many factors including social and economic inequities, disempowerment of women, inadequate support for breastfeeding, degraded environments, poor sanitation, unsafe water, violence and conflict. In this complex context, humanitarian agencies have a responsibility to guard against unintended consequences and ensure that the promotion of “quick fix” interventions do no harm. One such intervention is the Small Quantity Lipid Nutrition Supplement (SQ-LNS), that UNICEF is recommending for introduction into national nutrition programs to reduce mortality. The authors believe this recommendation is based on questionable evidence. They point to a fundamental flaw that trials compared “an intervention (SQ-LNS)” with “no comparable food-based intervention.” In effect, a pre-determined outcome. Also present is a conflict of interest, with support and intellectual input coming from interested food companies. Many other concerns are listed: SQ-LNS is an ultra-processed food (UPF), as defined by Nova Classification; daily feeding to children with poor diets will not improve dietary diversity and may undermine confidence in more culturally appropriate and nutritious family foods; the double burden of malnutrition and the emerging pandemic of overnutrition; the environmental impact of packaging and most importantly the clear potential for commercial exploitation. The widespread use of SQ-LNS in the face of food poverty is viewed as an unsustainable, unsafe and nutritionally inappropriate response. UN and humanitarian agencies should use their considerable diplomatic influence to challenge corporate-led food systems and support governments in their efforts to protect, promote and support breastfeeding and the provision of diverse complementary foods.