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Per Ashorn, MD; John C. Phuka, MBBS; Kenneth Maleta, PhD; Chrissie Thakwalakwa, MPH; Yin Bun Cheung, PhD; André Briend, PhD; Mark J. Manary, MD

Arch Pediatr Adolesc Med. 2009;163(2):186.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We commend Dr Humphrey¹ on an insightful and well-written editorial on infant underweight malnutrition and thank her for her interest in our study on this topic.² In our trial, provision of fortified spread, a novel lipid-based nutrient supplement, to Malawian infants was associated with a markedly reduced incidence of severe stunting between 6 and 18 months of age. Yet, there was a large decrease in mean height-for-age, indicating that even the infants given supplementation often failed to maintain normal growth during this critical age. Dr Humphrey proposes 2 explanations for how this might be linked to insufficient dietary intakes: breast-milk displacement and increased energy and nutrient needs due to high rates of disease. Whereas the former has been documented in other settings, we found little evidence . . . [Full Text of this Article]

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