To prevent undernutrition in an urban slum in Haiti, a lipid-based nutrient supplement (LNS) was introduced through a randomised control trial. Food supplementation for young child nutrition has a long history in Haiti, but there is little empirical information regarding the effects of supplementation on young child feeding practices. One of the concerns raised by supplementation is that it may disrupt other positive feeding practices such as breastfeeding and use of other complementary foods, with negative consequences for child nutrition. We conducted 29 in-depth interviews with mother-baby pairs from the three comparison groups: control, 3-month LNS supplementation and 6-month LNS supplementation. Findings from those in the LNS groups indicated high acceptance and satisfaction with LNS and perceptions that it positively affects child health and development. LNS was integrated into and enhanced ongoing complementary feeding practices. The effects of LNS use on duration and perceived quantity of breastfeeding were variable, but generally, breastfeeding was maintained during and after the intervention. Interviews generated insights into beliefs regarding infant and young child feeding practices such as introduction and use of complementary foods, and breastfeeding duration, exclusivity and cessation. Implications for the use of LNS in public health nutrition programmes are discussed.

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Objectives Eggs are a rich source of bioavailable nutrients for children, yet have been underutilized in school feeding programs in low- and middle-income countries. The purpose of the Ze Lekòl Project was to identify contextual facilitators, barriers, and resources needed at both the school and food system levels to link local egg value chains to school feeding programs in Cap-Haïtien, Haiti. Methods Key stakeholder interviews (n = 23) were conducted with school principals, representatives from the Ministry of Health and Ministry of Agriculture, domestic egg producers, and egg vendors. Focus groups (n = 4) were conducted with school staff and child caregivers. Interviews and focus groups were transcribed into Haitian Creole or French, and translated into English. Using inductive and deductive coding, interviews were analyzed for factors that facilitate or hinder the potential for incorporating locally produced eggs in school feeding programs. The approach to data collection and analysis was informed by the EPIS Implementation Science framework. Results School administrators and staff described facilitators (i.e., desire for nutritious foods, acceptability of eggs), barriers (i.e., preparation methods, national school feeding program structure) and potential benefits (i.e., improved student focus, reduced caregiver burden) for including eggs in school feeding programs. Local egg producers and vendors expressed facilitators (bulk purchases, customer preference for domestic eggs) and barriers (local availability of supplies, veterinary care, political disruption) to producing and selling locally produced eggs in Cap-Haïtien. Conclusions Locally produced eggs are an acceptable food to include in school feeding programs in Cap-Haïtien, Haiti. However, lack of sufficient infrastructure for domestic egg production prevents the ability to consistently provide the quantity of eggs needed for such programs without additional investments in domestic agriculture and school feeding programs. Findings from this study will inform interventions aimed at linking local agriculture to school feeding programs in low and middle-income countries. Funding Sources The Washington University in St. Louis Institute for Public Health–Center for Dissemination and Implementation funded this study.