20. Supplementary feeding versus no supplementary feeding (control, placebo, standard care, dietary advice), outcome: growth in children, length/height.
| Review | Target group | Intervention | Outcome | Corresponding risk with intervention (95% CI) | Number of participants (studies) | Certainty of evidence (GRADE)a |
| Kristjansson 2007 | School children (aged 5–19 years) | Balanced | Height gain (cm) | MD 0.38 (–0.32 to 1.08)b | 1462 (3) | NR |
| Change in height (cm) | MD 0.28 (–0.01 to 0.57)c | 520 (1) | NR | |||
| Height gain (adjusted ICC = 0.0016) (cm) | MD 1.43 (0.46 to 2.41)d,e | 986 (6) | NR | |||
| MD 0.92 (0.16 to 1.67)f,g | 703 (4) | NR | ||||
| Kristjansson 2015a | Disadvantaged infants and young children (aged 3 months to 5 years) | Supplementary feedingh | Height gain (cm) | MD 0.27 (0.07 to 0.48)i,j | 1463 (9) | Moderate |
| Supplementary feedingk | Height gain (cm) | MD 0.52 (–0.07 to 1.10)l | 1782 (7) | NR | ||
| Supplementary foodm | Height gain (cm) | MD –1.00 (–2.12 to 0.12)n | 45 (1) | NR | ||
| Balanced | Height gain (cm) | MD 0.61 (–0.31 to 1.54)o | 116 (1) | NR | ||
| Lazzerini 2013 | Children with MAM (< 5 years of age) | Balancedp | Height gain (total) (mm) | MD 1.54 (–2.07 to 5.15) | 178 (1) | NR |
| Ota 2015 | Pregnant women | Balanced | Child's birth length (cm) | MD 0.16 (0.01 to 0.31)q | 3370 (5) | NR |
| Child's length at 1 year (cm) | MD 0.00 (–5.69 to 5.69) | 428 (1) | NR | |||
| High protein | Child's height at 11–17 years (cm) | MD –0.39 (–1.73 to 0.94)r | 855 (1) | NR | ||
| Child's length at 1 year (cm) | MD 0.20 (–5.59 to 5.99) | 412 (1) | NR | |||
| Sguassero 2012 | Children < 5 years of age | High energy, protein and balanceds | Length/height at the end of the intervention (cm) | MD 0.28 (–0.11 to 0.67)t | 587 (3) | NR |
| Balanced | Length/height gain during the intervention (cm) | MD 0.19 (0.07 to 0.31)i,u | 795 (2) | NR | ||
| CI: confidence interval; ICC: intracluster correlation coefficient; MAM: moderate acute malnutrition; MD: mean difference; NR: not reported. | ||||||
aAs reported in 'Summary of findings' tables. bLow‐ and middle‐income country (LMIC) randomised controlled trials (RCTs). cHigh‐income country (HIC) RCT. dLMIC controlled before‐and‐after studies (CBAs). eHeight gain significantly increased for children who received school meals (lunch; green gram and sugar; vegetable protein mixture). fHIC CBAs. gHeight gain significantly increased for children who received school meals (milk). hBalanced (five studies); high energy (two studies); high lipid (one study); supplementary food (one study). iAnalyses include the same RCT: Simondon 1996 (multi‐country study). jLMIC RCT. kBalanced (two studies); high energy (one study); high lipid (one study); high protein (one study); supplementary food (two studies). lLMIC CBA. m113 g wet ration fruit cereal, rice cereal with apple sauce, mixed cereal with apple sauce and bananas, and oatmeal with apple sauce and bananas (Gerber Products Company). nHIC RCT oAboriginal children, HIC CBA. pComplementary foods (Pusti Packet). qBirth length significantly increased in newborns of women given balanced energy, protein supplementation (liquid, chocolate‐flavoured supplement; biscuit; milk; supplement with sesame cake, jaggery, oil; fortified food supplement with peanut butter, soy flour, vegetable oil, sugar, micronutrients). rNo significant differences for boys and girls. sComparison group: no food or low‐protein, kcal supplement. tNo subgroup differences based on age, nutritional status (stunted/wasted versus not) of the children and duration of feeding (< 12 months versus > 12 months). uLength gain significantly increased in children given supplementary feeding (porridge and yogurt).
Additional comments:
- Kristjansson 2015a narratively reported two additional RCTs in LMIC. Pollitt 2000 studied effectiveness for two age cohorts, 12 and 18 months old. They found that supplementary feeding had a significant effect on height for the younger (12‐month‐old) cohort only. Obatolu 2003 (60 children) found a significant effect for feeding on length for boys (5.12 cm difference between intervention and control groups; end‐of‐study difference of 5.02; statistically significant) and girls (6.95 cm difference; end‐of‐study difference of 5.92 cm; statistically significant).