Locally sourced supplementary feeding programs as a strategic intervention to address weight faltering in children: insights from a primary health center study

Deby Aprilia Haryani*  -  Primary Health Center (Puskesmas) Ajibarang I, Health Office of Banyumas Regency, Central Java, Indonesia
Qorry Amanda  -  Department of Histology, Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, Central Java, Indonesia
Novita Sabjan  -  Health Office of Banyumas Regency, Central Java, Indonesia

(*) Corresponding Author

Pemberian Makanan Tambahan (PMT), a supplementary food program using local ingredients, is a targeted intervention to address toddler malnutrition and weight faltering in Indonesia. Despite its widespread implementation, the long-term efficacy of the 14-day PMT program in sustaining growth recovery remains to be determined. This study aimed to evaluate the impact of a 14-day PMT intervention on weight gain and growth stability in children aged 6–59 months experiencing weight faltering. A prospective cohort study was conducted from May to August 2024 at Primary Health Center (Puskesmas) Ajibarang 1 in Banyumas, Central Java, Indonesia. The intervention consisted of 11 snacks and 3 main meals to meet 30–50% of daily caloric needs. Anthropometric measurements, including body weight (BW) and mid-upper arm circumference (MUAC), were collected pre- and post-intervention. 120 children participated, with baseline averages of 11.2 ± 1.5 kg for BW and 13.4 ± 1.7 cm for MUAC. Significant improvements were observed post-intervention, with averages of 12.9 ± 1.2 kg (BW) and 15.0 ± 1.4 cm (MUAC). A moderate positive correlation was identified between BW gain and MUAC (Spearman analysis). In conclusion, the PMT program effectively improves BW and MUAC in children at risk of growth faltering, highlighting its potential as a scalable intervention. These findings emphasize the importance of tailored nutritional programs during early childhood, a critical period for ensuring long-term health and developmental benefits. Advocacy and policy reforms are essential to support consistent implementation and global accessibility of nutritional interventions.

Keywords: Weight Faltering; Supplementary Food; Strategic Intervention; Primary Health center

  1. Annan R.A., Webb P., B. R. (2014). Management of Moderate Acute Malnutrition (MAM ):
  2. Current Knowledge and Practice. CMAM Forum Technical Brief: September, 2014. Page 1-38. https://foodaidquality.nutrition.tufts.edu/sites/default/files/publications/MAM-management-CMAM-Forum-Technical-Brief-Sept-2014.pdf. Accessed on 1 February 2024.
  3. Binns, P., Dale, N., Hoq, M., Banda, C., & Myatt, M. (2015). Relationship between mid upper arm circumference and weight changes in children aged 6-59 months. Archives of Public Health, 73(1): 1–10. https://doi.org/10.1186/s13690-015-0103-y
  4. Black, R. E. (2023). Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet, 382(9890): 427–451. https://doi.org/10.1016/S0140-6736(13)60937-X
  5. Cooke, R., Goulet, O., Huysentruyt, K., Joosten, K., Khadilkar, A. V., Mao, M., Meyer, R., Prentice, A. M., & Singhal, A. (2023). Catch-Up Growth in Infants and Young Children With Faltering Growth: Expert Opinion to Guide General Clinicians. Journal of Pediatric Gastroenterology and Nutrition, 77(1): 7–15. https://doi.org/10.1097/MPG.0000000000003784
  6. Homan, G. J. (2016). Failure to thrive: A practical guide. American Family Physician, 94(4): 295–299. https://www.aafp.org/pubs/afp/issues/2016/0815/p295.html
  7. Jen, V., Braun, K. V., Karagounis, L. G., Nguyen, A. N., Jaddoe, V. W., Schoufour, J. D., Franco, O. H., & Voortman, T. (2019). Longitudinal association of dietary protein intake in infancy and adiposity throughout childhood. Clinical Nutrition, 38(3): 1296-1302. https://doi.org/10.1016/j.clnu.2018.05.013
  8. Kemenkes-RI. (2023). Peraturan Direktur Jenderal Kesehatan Masyarakat Nomor HK.02.02/B/1622/2023 Tahun 2023 Tentang Petunjuk Teknis Pemberian Makanan Tambahan Berbahan Pangan Lokal Bagi Ibu Hamil Dan Balita.Kementerian Kesehatan Republik Indonesia. Jakarta. https://dinaspmk.benermeriahkab.go.id/media/2024.08/perdirjen_juknis_pmt_lokal_v25_20240130_ed_revisi_20241.pdf
  9. Khatri, et al. (2020). A histological study on the effects of malnutrition on intestinal morphology in children. BMC Gastroenterolog, 20, 75. https://doi.org/10.1186/s12876-020-01224-4
  10. Mertens, A., Benjamin-Chung, J., Colford, J. M., Coyle, J., van der Laan, M. J., Hubbard, A. E., Rosete, S., Malenica, I., Hejazi, N., Sofrygin, O., Cai, W., Li, H., Nguyen, A., Pokpongkiat, N. N., Djajadi, S., Seth, A., Jung, E., Chung, E. O., Jilek, W., … Yori, P. P. (2023). Causes and consequences of child growth faltering in low-resource settings. Nature, 621(7979): 568–576. https://doi.org/10.1038/s41586-023-06501-x
  11. Montoro-Huguet, M. A., Belloc, B., & Domínguez-Cajal, M. (2021). Small and large intestine (I): Malabsorption of nutrients. Nutrients, 13(4): 1–36. https://doi.org/10.3390/nu13041254
  12. Ruel, M. T. (2013). Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? The Lancet, 382(9891): 536–551. https://doi.org/10.1016/S0140-6736(13)60843-0
  13. Shi, H., Ren, Y., & Jia, Y. (2023). Effects of nutritional interventions on the physical development of preschool children: a systematic review and meta-analysis. Translational Pediatrics, 12(5): 991–1003. https://doi.org/10.21037/tp-23-205
  14. Shim, J. O., Kim, S., Choe, B. H., Seo, J. H., & Yang, H. R. (2020). Effect of nutritional supplement formula on catch-up growth in young children with nonorganic faltering growth: A prospective multicenter study. Nutrition Research and Practice, 14(3): 230–241. https://doi.org/10.4162/nrp.2020.14.3.230
  15. Shinsugi, C., Gunasekara, D., & Takimoto, H. (2020). Use of Mid-Upper Arm Circumference ( MUAC ) to Predict Malnutrition among Sri Lankan Schoolchildren. Nutrients, 12(168): 1-8. https://doi.org/10.3390/nu12010168
  16. Trehan, I., Banerjee, S., Murray, E., Ryan, K. N., Thakwalakwa, C., Maleta, K. M., & Manary, M. J. (2015). Extending Supplementary Feeding for Children Younger Than 5 Years With Moderate Acute Malnutrition Leads to Lower Relapse Rates. Journal of Pediatric Gastroenterology and Nutrition, 60(4): 544-549. https://doi.org/10.1097/MPG.0000000000000639
  17. Willacy, H., Tidy, C.(2022). Faltering Growth in Children. https://patient.info/doctor/faltering-growth-in-children. Accessed on 1May 2024.
  18. Zhu, Y., Lin, Q., Zhang, Y., Deng, H., Hu, X., Yang, X., & Yao, B. (2020). Mid-upper arm circumference as a simple tool for identifying central obesity and insulin resistance in type 2 diabetes. PLoS ONE, 15(5): 1–13. https://doi.org/10.1371/journal.pone.0231308

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DOI : 10.30659/sainsmed

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