Developmental trajectories of poorly nourished toddlers that received a micronutrient supplement with and without energy.

Experimental and quasi-experimental studies on the effects of nutritional supplements on development in young children generally include snapshots of development. Developmental outcomes are better revealed when multiple assessments are made over time. We compared the effects of a micronutrient intervention with and without supplementary energy on the mental and motor growth curves of poorly nourished toddlers in West Java. Subjects (12-mo-old cohort, n = 33; 18-mo-old cohort, n = 42) were randomly assigned to receive energy + micronutrients (E + M) or micronutrients (M) daily for 12 mo. The cohort/treatment groups were then classified as either relatively short or tall. Within the 12-mo cohort, the baseline mean length Z-scores ranged from -2.53 to -1.29 and the baseline mean weight Z-scores ranged from -3.05 to -2.18. The same pretreatment anthropometrics for the older cohort ranged from -3.22 to -1.59 and from -3.42 to -2.26. Mental and motor development scores (Bayley) were obtained at baseline and every 2 mo for 12 mo. There was a Cohort x Length Category x Supplement interaction for mental slopes (P < 0.01). Slopes for tall-E + M (b = 5.35) and tall-M children (b = 5.39) in the 18-mo cohort were equivalent, but slopes for short-E + M (b = 6.13) and short-M (b = 4.67) children differed greatly (P = 0.03). On the basis of this finding and findings previously reported from this study, we concluded that the unfavorable developmental response to the M supplement that was restricted to the shortest children within an already disadvantaged group.

Stunting and delayed motor development in rural West Java.

The association between physical growth and gross motor development, particularly self-produced locomotion, was considered in 557 children 3-18 months of age. Gross motor development was assessed with nine preselected milestones representing the major landmarks in self-produced bipedal locomotion. Motor development is presented by age and by milestone, and is compared to developmental ranges of the Denver Developmental Screening Test. Consistent with other studies of undernutrition and motor development, length-for-age, but not weight-for-length, was a significant predictor of gross motor development (i.e., delayed or not delayed). The effect of weight-for-age on motor development was not statistically significant after accounting for length-for-age. © 1994 Wiley-Liss, Inc.