Milk products in the dietary management of childhood undernutrition – a historical review

Abstract

The present narrative review outlines the use of milk products in infant and young child feeding from early history until today and illustrates how research findings and technical innovations contributed to the evolution of milk-based strategies to combat undernutrition in children below the age of 5 years. From the onset of social welfare initiatives, dairy products were provided by maternal and child health services to improve nutrition. During the last century, a number of aetiological theories on oedematous forms of undernutrition were developed and until the 1970s the dogma of protein deficiency was dominant. Thereafter, a multifactorial concept gained acceptance and protein quality was emphasised. During the last decades, research findings demonstrated that the inclusion of dairy products in the management of severe acute malnutrition is most effective. For children suffering from moderate acute malnutrition the evidence for the superiority of milk-based diets is less clear. There is an unmet need for evaluating locally produced milk-free alternatives at lower cost, especially in countries that rely on imported dairy products. New strategies for the dietary management of childhood undernutrition need to be developed on the basis of research findings, current child feeding practices, socio-cultural conditions and local resources. Exclusive and continued breast-feeding supported by community-based nutrition programmes using optimal combinations of locally available complementary foods should be compared with milk product-based interventions.

Impact of food supplements on early child development in children with moderate acute malnutrition: A randomised 2 x 2 x 3 factorial trial in Burkina Faso

“…In contrast, the effects of milk protein were seen in the tool's fine motor and language domains, which also reflect cognitive functions such as problem-solving, reasoning, and executive functions. Milk products have been used in food supplementation since early programme initiatives [36] and have been studied for their benefits for growth and health, especially in children with poor nutritional status [37]. However, very few studies have assessed the effects of milk on cognitive outcomes.…”

Standard RUTF vs. locally-made RUSF for acutely malnourished children: A quasi-experimental comparison of the impact on growth and compliance in a rural community of Pakistan

“…In this study, families provided with locally-made RUSF demonstrated significantly greater levels of compliance, suggesting that there is greater cultural support for locally-made nutritional supplements. Considering the logistical and financial burden upon health systems to procure imported RUTF, we expect that locally-made RUSF may be used safely in providing nutritional intervention to malnourished children in LMICs [ 28 ]. The chemical composition of the nutritional interventions is summarized in Table 6 .…”

Providing a sound theoretical base and appropriate skills at early ages through nutrition education to improve food consumption patterns in Sri Lanka

“…While the Indian rice diet has a percentage digestibility of 77%, when milk too is consumed the digestibility increases to 87% (WHO, 2002). There is still no scientific evidence about the minimum amount of milk protein required to exert an adequate effect on weight gain and growth among children of different age groups, while the impact of other sources of protein and other beneficial compounds needs to be considered (Sherbaum and Srour, 2018).…”