Suboptimal complementary feeding practices contribute to a rapid increase in the prevalence of stunting in young children from age 6 months. The design of effective programmes to improve infant and young child feeding requires a sound understanding of the local situation and a systematic process for prioritizing interventions, integrating them into existing delivery platforms and monitoring their implementation and impact. The identification of adequate food-based feeding recommendations that respect locally available foods and address gaps in nutrient availability is particularly challenging.We describe two tools that are now available to strengthen infant and young child-feeding programming at national and subnational levels. ProPAN is a set of research tools that guide users through a step-by-step process for identifying problems related to young child nutrition; defining the context in which these problems occur; formulating, testing, and selecting behaviour-change recommendations and nutritional recipes; developing the interventions to promote them; and designing a monitoring and evaluation system to measure progress towards intervention goals. Optifood is a computer-based platform based on linear programming analysis to develop nutrient-adequate feeding recommendations at lowest cost, based on locally available foods with the addition of fortified products or supplements when needed, or best recommendations when the latter are not available. The tools complement each other and a case study from Peru illustrates how they have been used. The readiness of both instruments will enable partners to invest in capacity development for their use in countries and strengthen programmes to address infant and young child feeding and prevent malnutrition.

This is the largest formal pharmacokinetic evaluation of 2 dosage combinations of IDV/RTV in HIV-infected individuals. Pharmacokinetic parameters were consistent with previous results in patients but lower than in seronegative controls. Both regimens exhibited similar tolerability and response rates. High toxicity with a low response suggests that the optimum IDV/RTV combination would include an RTV dose <400 mg and an IDV dose <800 mg in this population.

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Many children in developing countries survive on a nutritionally inadequate diet. Dietary inadequacies during the complementary feeding period can be prevented by using complementary food supplements (CFSs) such as water dispersible or crushable micronutrient tablets, micronutrient sprinkles added to food just before feeding, or fortified spreads added to food just before feeding or fed as a snacks. A meeting was convened to discuss technical and operational issues related to the development of these new approaches and to identify knowledge gaps. The technical issues covered: what micronutrients to include, tolerable upper intake limits, bioavailability, micronutrient and macronutrient stability, package systems and amounts, encapsulation technologies, methods to limit or eliminate allergens, bacterial and chemical contamination, interactions between CFSs and complementary foods, and flavoring agents. Operational issues included: identifying the market positioning of CFSs, cost positioning of CFSs, regulatory requirements, CFS production and technology transfer, quality assurance, and public-private sector partnership and coordination. Intervention trials are needed to determine the efficacy of CFSs in preventing micronutrient deficiencies. Other important knowledge gaps relate to technical and operational issues. Sprinkles and tablets are produced using well-known technologies, but further research is needed to modify them for use as CFSs. Spread development is not as advanced as sprinkle and tablet development, and further research is needed to improve the technology. Although none of the products is ready for widespread use, enough information is available to set research priorities and accelerate product development and implementation.

Background: Malnutrition, including undernutrition and micronutrient deficiencies is a chronic problem in most developing countries. Animal-source foods (ASFs) provide essential sources of proteins and micronutrients, yet little is known about ASF consumption patterns or household preferences towards animal-source products among low-income populations. This is particularly critical for malnourished children for whom even small increases in consumption could help improve nutrition and health outcomes. This study analysed both the demand as well as the drivers and barriers for ASF consumption among households in two low-income areas in Nairobi, Kenya. Methods: Data on ASF expenditures and quantities purchased in the previous week, and reasons for consuming or not consuming ASFs were collected in a cross-sectional study from 205 randomly selected households in Korogocho and Dagoretti settlements. Self-reported reasons for consuming or not-consuming ASFs were described. Demand for ASFs was estimated using the Almost Ideal Demand System to provide measures of demand elasticity for changes in food prices and expenditures. Results: On average households purchased 48 grams of ASFs, including fresh milk, per week per household member. Expenditure on ASFs counted for 38% (520 Kenyan Schillings) of the overall food expenditure of which, on average, 48% was spent on fresh milk. Price was the most commonly self-reported barrier for consumption, while taste was reported as the main driver for consumption. The perceived nutritional value was an important driver for consuming more commonly purchased ASFs (beef, eggs, fish and milk). For less commonly purchased ASFs (pork, sausages, sheep and goat meat, offal) taste, access and tradition were given as main reasons for not consuming. Estimated demand elasticities indicated that increases in total food expenditure would lead to greatest increase in the demand for beef meat. Price reductions would increase the demand relatively more for fish, other meats and dairy. Conclusions: For most ASFs better affordability would be a clear driver to increase the consumption. However, to increase the variety and quantity of ASFs eaten, other policies targeting improvements in physical access, food safety and consumer education on nutritional values and cooking methods should be considered.