Many factors increase the risks of undernutrition among infants and young children living in urban areas of Haiti:  poor water and sanitation conditions; infectious disease associated with a high population density; and a lack of exclusive breastfeeding. 

Nearly one-third of children under age five in Haiti are stunted, and high proportions suffer from hidden hunger or micronutrient deficiencies. By the age of three months, only 41% of infants are exclusively breastfed, dropping to 24% by five months. 

Brown School researchers are conducting two projects to address this issue.  Both studies are being implemented north of Haiti in the poor and densely populated area of Ft. St. Michel, Cap Haitien.  Researchers are partnering with the Haitian Ministry of Health, which provides women and childen with a package of services that includes: maternal and child health promotion, training on nutrition and breastfeeding practices, family planning and immunizations.

The first project is a randomized clinical trial designed to test the effectiveness of Nutributter, a ready-to-use supplemental food (RUSF), as part of an overall package of services provided by Haiti’s Ministry of Health.

Eligible infants between 6-8 months (n=600) are enrolled and randomly assigned to one of three groups:

• a group that receives Nutributter for three months,
• a group that receives Nutributter for six months, and
• a control group that does not receive the food supplement.

Researchers follow the infants monthly to assess physical size and developmental outcomes. Other aspects of the research will provide insights into the acceptability and feasibility of Nutributter as an intervention; the ability transition to other complementary foods after the supplementation period ends; and the socio-economic and cultural factors influencing young-child feeding practices. 

The second project, Improving Child Nutrition through Cash and Communications (INCC), explores the cultural, financial, and work-related barriers to exclusive breastfeeding.  Researchers will use the findings to design targeted communications and savings interventions. Thirty mothers of children under 24 months of age will be recruited to participate in a 50-question survey. The survey will focus on exclusive breastfeeding beliefs, practices, and work barriers; household economics; and mobile phone ownership and usage. 

Investigators

Lora Iannotti
Assistant Professor, Brown School
liannotti@wustl.edu

Carolyn Lesorogol
Associate Professor, Brown School
clesorogol@wustl.edu

Andrea Spray, Consultant
andrealspray@gmail.com

Funders

World Bank 

Alive & Thrive Small Grants Program, University of California Davis                                                  

World Food Program

Brown School Pilot Research Funding
 

Poster presentation, Institute for Public Health 2011 Annual Conference, Washington University in St. Louis, October, 2011.