Introduction: This study aimed to evaluate the effects of micronutrient powders (MNP) containing 15 versus nine nutrients, with or without complementary food blend (BigMo), on the nutritional status of rural young children in the Philippines. Methods: The study was conducted for 6 months among 126 rural children aged 6-17 months in four villages selected by cluster randomisation. Children were randomised into four groups: VitaMix with 15 micronutrients plus Bigas Mongo (BigMo) (n=31); VitaMix without BigMo (n=31); Micronutrient Growth Mix (MGM) with nine micronutrients plus BigMo (n=29); and MGM without BigMo (n=31). Blood samples were collected at baseline and endline to determine haemoglobin, ferritin, retinol, and zinc concentrations. Intervention compliance, weight, length, and dietary intakes were collected every month. One-way ANOVA was used to compare changes in the mean estimates across groups. McNemar and Pearson’s x2 tests were used to compare changes in the proportion estimates within groups and across groups, respectively. Results: Both VitaMix and MGM with or without BigMo improved haemoglobin concentrations and reduced anaemia (Hb<11g/dL). However, only VitaMix and MGM combined with BigMo had effects in reducing moderate anaemia (Hb<10g/dL), compared to groups without BigMo. Only MGM+BigMo group demonstrated significant reduction in the prevalence of moderate non-iron deficiency anaemia (IDA) (Hb<10g/dL and ferritin>12ug/L). A significant increase in the length-for-age z-scores was noted in the MGM with and without BigMo groups. Conclusion: Daily supplementation of MGM with nine micronutrients combined with complementary food blend may have a greater potential than MNP with 15 micronutrients in improving the nutritional status of young children.

Introduction: Stunting persists as a public health problem in the Philippines, affecting 30% of under-five children. This study aimed to identify the drivers of stunting in young Filipino children aged 6-23 months. Methods: Data were extracted from the cross-sectional Updating Survey conducted in 2015 by the Food and Nutrition Research Institute of the Department of Science and Technology (FNRI-DOST). Potential predictors of stunting, which were categorised into childrelated characteristics, feeding practices, maternal socio-demographic status and health practices, and household economic and food security status, were examined using descriptive and regression analyses. Results: Of the 2,275 children aged 6-23 months, 18.7% were stunted and 8.3% were severely stunted. The risk of stunting increased significantly among older children aged 12-23 months (relative risk ratio, RRR 3.04), males within 6-23 months of age (RRR 1.99), and low-birth-weight infants (RRR 2.19). Children born from teenage mothers (RRR 1.90), mothers with short stature (RRR 2.33), and mothers with low education (RRR 1.59) posed higher risks of becoming stunted relative to their counterparts. Mothers with >4 children (RRR 2.44), coming from the poorest households (RRR 4.27), having untimely introduction of complementary foods (RRR 4.44), and not meeting the minimum meal frequency (RRR 2.30) increased the risks of severe stunting. Conclusion: The study illustrated the multi-factorial nature of stunting among Filipino children aged 6-23 months old. Therefore, a multi-sectoral approach is needed to address the underlying factors of stunting among young Filipino children to help achieve the country’s nutrition targets by 2025.

Introduction: Age-appropriate feeding in the first two years of life is essential to a child’s growth and development, with health implications that persist throughout life. This study examined the adherence to age-appropriate feeding practices among children 0-23.9 months old based on a constructed index, its association with anthropometric growth, and factors affecting adherence. Methods: A total of 9,138 children aged 0-23.9 months with complete information on infant and young child feeding practices (IYCF), anthropometric measurements, maternal information, and household characteristics were included in the study. Data were extracted from a nationwide survey conducted in 2018-2019. Results: Among children aged 0-23.9 months, 20.7% adhered to age-appropriate feeding criteria. More than half (57.7%) of children below six months adhered to age-appropriate exclusive breastfeeding practices, while 1.4% of children aged 6-8.9 months old started complementary feeding. Continued breastfeeding at 12 months of age while receiving complementary feeding was uncommon (11%). Significantly higher z-scores for weight-for-age (-0.6±0.04), height-for-age (-0.8±0.05), and weight-for-height (-0.2±0.05) were noted among children who adhered to age-appropriate feeding practices compared to those who did not. Child’s age and birth weight, as well as mother’s age, education, and working status, were found to significantly influence the likelihood of adhering to age-appropriate feeding index. Conclusion: Filipino infants and young children under two years of age have low adherence to age-appropriate feeding practices, putting them at a higher risk of repeated occurrence of infection that could lead to stunting in early life.

Background: As the SARS-CoV-2 virus (COVID-19) continues to affect the capacity of the health system to deliver essential nutrition and health services, many countries, especially the low- and middle-income countries, including the Philippines, are beset with addressing undernutrition and micronutrient deficiencies among children. Objective: The rapid nutrition assessment survey (RNAS) was conducted in selected areas in the Philippines to provide evidence of the effect of the COVID-19 pandemic on children's participation in the nutrition services and their mothers' knowledge level on nutrition. Methodology: The RNAS was a cross-sectional survey conducted through phone interviews in nine (9) selected areas in the Philippines. A total of 7,092 children aged 0 to 12 years were included in the survey, of which 5,239 mothers and caregivers were interviewed regarding nutrition program participation of their children, and their knowledge on nutrition. Results: A significant decline in children's participation in the Operation Timbang (OPT) Plus (83.0% vs. 51.1%), Vitamin A supplementation (65.4% vs. 54.9%), supplementary feeding (21.6% vs. 11.9%), and deworming (60.4% vs. 11.9%) was recorded during the COVID-19 pandemic based on RNAS as compared to the pre-pandemic period using the 2019 Expanded National Nutrition Survey (ENNS). The most commonly cited reasons for health service disruptions include: child did not visit health centers due to fear of infection, community health workers did not visit the child at home, and no available health workers in the facility. Stunting among children was more likely to be perceived by food insecure (19.7% vs 14.4%; p <0.001) and poor (22.1% vs 16.6%; p<0.000) mothers or caregivers than their counterpart mothers from food secure and rich households. Conclusion With prolonged limited access to health and nutrition services, children, particularly those from poor households, are at risk of hunger, malnutrition, and consequently, of not developing their full potential. Findings can guide efforts to ensure the continuity of essential health and nutrition services towards improving maternal knowledge and promotion of child health and nutrition during the COVID-19 outbreak and crisis recovery period.
COVID-19 ; Infant Nutritional Physiological Phenomena ; Community Health Workers

Introduction: With the new set of 2021 infant and young child feeding (IYCF) indicators released by WHO and UNICEF, there is a need for its validation in the Philippine setting. The study evaluated the validity of cut-off points used for minimum dietary diversity and minimum feeding frequency in terms of micronutrient and energy intake adequacy, respectively, and minimum acceptable diet (MAD) in relation to anthropometric status. Methods: The study covered 8360 infants and young children aged 6-23.9 months with complete information on IYCF, anthropometric measurements, maternal information, and household characteristics from the 2018-2019 Expanded National Nutrition Survey (ENNS). Bivariate and correlation analyses using STATA version 15 (Corp LLC, Texas, USA 2017) were performed to determine the association of specific IYCF indicators: dietary diversity and feeding frequency with nutrient and energy intake adequacy, and MAD with anthropometric status. Sensitivity and specificity analyses were performed to evaluate the accuracy of dietary diversity score (DDS) and feeding frequency in identifying children with adequate nutrient and energy intakes, respectively. Results: Significant associations were found between DDS and micronutrient adequacy, and between feeding frequency and energy intake adequacy, regardless of breastfeeding status. A DDS of 5 and 6 and feeding frequency of 4-5 and 8 maximised sensitivity and specificity in identifying breastfed and non-breastfed children meeting 100% nutrient and energy adequacy, respectively. Conclusion: The selected 2021 complementary feeding indicators are practical guidelines to reflect dietary adequacy, but may not capture the entire process related to nutritional outcomes, especially stunting.