Complementary Food Supplements After Disasters

  • Caixia Dong
  • Shi-an YinEmail author
Living reference work entry


International experience has proved that even though in previously healthy population living in those areas attacked by natural disaster, elder infants and young children’s morbidity and mortality resulted from acute malnutrition often dramatically increased in very short period since they are the most nutritionally vulnerable group due to poor or limited food choices. Present paper reviews the application of complementary food supplements for elder infants and young children after natural disaster. After a serious destructive event, quickly assessing and monitoring nutritional and health status of infants and young children will be important for providing basic information to the local government to make and implement nutrition intervention to the target vulnerable groups. First, taking methods dependent on the field situation evaluate the risk of nutritional deficiency, establish an effective transportation mechanism in distributing salvage food and guide the usage of complementary food supplements in affected areas. Second, the practical experience of complementary food supplements (CFSs) in application for elder infants and young children includes multi-nutrient powder with food matrix, lipid-based nutrient supplements (LNS), and corn-soy blend (CSB), and micronutrients Sprinkles. Third, it should be particularly paid attention to the issues of safety use and quality control procedures on CFSs for elder infants and young children, implementing CFSs intervention in affected-areas after natural disaster will cover two aspects which involve in hygiene and safety to meet the nutritional requirements. Hygiene is referring to the contamination of traditional microbiology and safety of nutritional needs is related to prevent nutritional deficiencies due to poor compliance and avoid excessive intake due to overuse.


Complementary food supplements Elder infants Young children Natural disaster Nutrition Nutrition deficiencies Lipid-based nutrient supplements Corn-soy blend Sprinkles Micronutrient 

List of Abbreviations


Acute respiratory infection


Complementary food


Complementary food supplement


Complementary foods


Complementary food supplements


C-reactive protein


Corn-soy blend


Diarrheal disease


Free erythrocyte proporphyrin




Iron-deficient anemia


Intelligence quotient


Length for age Z score


Lipid-based nutrient supplements


Moderate acute malnutrition


Non-Governmental Organizations


Ready-to-use supplementary food


Ready-to-use therapeutic food


Severe acute malnutrition


Serum ferritin


Serum transferring receptor


Transferring receptor


Weight for age Z score


World Health Organization


Weight for height Z score


Yingyangbao, one kind of complementary food supplements in China


  1. Abbeddou S, Yakes Jimenez E, Some JW, Ouedraogo JB, Brown KH, Hess SY (2017) Small-quantity lipid-based nutrient supplements containing different amounts of zinc along with diarrhea and malaria treatment increase iron and vitamin A status and reduce anemia prevalence, but do not affect zinc status in young Burkinabe children: a cluster-randomized trial. BMC Pediatr 17(1):46. Scholar
  2. Adu-Afarwuah S, Lartey A, Brown KH et al (2007) Randomized comparison of 3 types of micronutrient supplements for home fortification of complementary foods in Ghana: effects on growth and motor development. Am J Clin Nutr 86(2):412–420CrossRefPubMedGoogle Scholar
  3. Adu-Afarwuah S, Lartey A, Brown KH et al (2008) Home fortification of complementary foods with micronutrient supplements is well accepted and has positive effects on infant iron status in Ghana. Am J Clin Nutr 87(4):929–938CrossRefPubMedGoogle Scholar
  4. Adu-Afarwuah S, Lartey A, Okronipa H et al (2016) Small-quantity, lipid-based nutrient supplements provided to women during pregnancy and 6 mo postpartum and to their infants from 6 mo of age increase the mean attained length of 18-mo-old children in semi-urban Ghana: a randomized controlled trial. Am J Clin Nutr 104(3):797–808. Scholar
  5. Arimond M, Zeilani M, Jungjohann S et al (2015) Considerations in developing lipid-based nutrient supplements for prevention of undernutrition: experience from the International Lipid-Based Nutrient Supplements (iLiNS) Project. Matern Child Nutr 11(Suppl 4):31–61. Scholar
  6. Bhutta ZA, Das JK, Rizvi A et al (2013) Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet 382(9890):452–477. Scholar
  7. Briend A, Lacsala R, Prudhon C et al (1999) Ready-to-use therapeutic food for treatment of marasmus. Lancet 353(9166):1767–1768. (Abstract)CrossRefPubMedGoogle Scholar
  8. Campbell RK, Hurley KM, Shamim AA et al (2016) Effect of complementary food supplementation on breastfeeding and home diet in rural Bangladeshi children. Am J Clin Nutr 104(5):1450–1458. Scholar
  9. Chaparro CM, Dewey KG (2010) Use of lipid-based nutrient supplements (LNS) to improve the nutrient adequacy of general food distribution rations for vulnerable sub-groups in emergency settings. Matern Child Nutr 6(Suppl 1):1–69. Scholar
  10. De-Regil LM, Suchdev PS, Vist GE et al (2013) Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age (Review). Evid Based Child Health 8(1):112–201. Scholar
  11. Dewey KG, Adu-Afarwuah S (2008) Systematic review of the efficacy and effectiveness of complementary feeding interventions in developing countries. Matern Child Nutr 4(Suppl 1):24–85. Scholar
  12. Dewey KG, Arimond M (2012) Lipid-based nutrient supplements: how can they combat child malnutrition? PLoS Med 9(9):e1001314. Scholar
  13. Ding X, Zhang F, He Q et al (2016) Nutrition effectiveness of 6–18 months old infants in low-income rural areas in Jiangxi province. Mod Pre Med 43(20):3703–3705. (in Chinese)Google Scholar
  14. Dong C, Ge P, Ren X et al (2013) Prospective study on the effectiveness of complementary food supplements on improving status of elder infants and young children in the areas affected by Wenchuan earthquake. PLoS One 8(9):e72711. Scholar
  15. Dong C, Ge P, Ren X et al (2014) The micronutrient status of children aged 24–60 months living in rural disaster areas one year after the Wenchuan earthquake. PLoS One 9(2):e88444. Scholar
  16. Flax VL, Siega-Riz AM, Reinhart GA et al (2015) Provision of lipid-based nutrient supplements to Honduran children increases their dietary macro- and micronutrient intake without displacing other foods. Matern Child Nutr 11(Suppl 4):203–213. Scholar
  17. Gera T (2010) Efficacy and safety of therapeutic nutrition products for home based therapeutic nutrition for severe acute malnutrition a systematic review. Indian Pediatr 47(8):709–718CrossRefPubMedGoogle Scholar
  18. Hemsworth J, Kumwenda C, Arimond M et al (2016) Lipid-based nutrient supplements increase energy and macronutrient intakes from complementary food among Malawian Infants. J Nutr 146(2):326–334. Scholar
  19. Huo J (2017) Ying Yang Bao: improving complementary feeding for Chinese infants in poor regions. Nestle Nutr Inst Workshop Ser 87:131–138. Scholar
  20. Hyder SM, Haseen F, Rahman M et al (2007) Effect of daily versus once-weekly home fortification with micronutrient Sprinkles on hemoglobin and iron status among young children in rural Bangladesh. Food Nutr Bull 28(2):156–164CrossRefPubMedGoogle Scholar
  21. Iuel-Brockdorf AS, Draebel TA, Fabiansen C et al (2015) Acceptability of new formulations of corn-soy blends and lipid-based nutrient supplements in Province du Passore, Burkina Faso. Appetite 91:278–286. Scholar
  22. Jack SJ, Ou K, Chea M et al (2012) Effect of micronutrient sprinkles on reducing anemia: a cluster-randomized effectiveness trial. Arch Pediatr Adolesc Med 166(9):842–850. Scholar
  23. Karakochuk C, van den Briel T, Stephens D et al (2012) Treatment of moderate acute malnutrition with ready-to-use supplementary food results in higher overall recovery rates compared with a corn-soya blend in children in southern Ethiopia: an operations research trial. Am J Clin Nutr 96(4):911–916. Scholar
  24. Kounnavong S, Sunahara T, Mascie-Taylor CG et al (2011) Effect of daily versus weekly home fortification with multiple micronutrient powder on haemoglobin concentration of young children in a rural area, Lao People’s Democratic Republic: a randomised trial. Nutr J 10:129. Scholar
  25. Lazzerini M, Rubert L, Pani P (2013) Specially formulated foods for treating children with moderate acute malnutrition in low- and middle-income countries. Cochrane Database Syst Rev 6:CD009584. Scholar
  26. Li S, Zang K, Qiu J et al (2017) Efect evaluation of nutritional intervention of infantile complementary food package in 6–24 month infants. Matern Child Health Care China 32(1):58–61. (in Chinese)Google Scholar
  27. Lopez Boo F, Palloni G, Urzua S (2014) Cost-benefit analysis of a micronutrient supplementation and early childhood stimulation program in Nicaragua. Ann N Y Acad Sci 1308:139–148CrossRefPubMedGoogle Scholar
  28. Lundeen E, Schueth T, Toktobaev N et al (2010) Daily use of sprinkles micronutrient powder for 2 months reduces anemia among children 6 to 36 months of age in the Kyrgyz Republic: a cluster-randomized trial. Food Nutr Bull 31(3):446–460CrossRefPubMedGoogle Scholar
  29. Matsungo TM, Kruger HS, Smuts CM et al (2017) Lipid-based nutrient supplements and linear growth in children under 2 years: a review. Proc Nutr Soc 76:1–9. Scholar
  30. Menon P, Ruel MT, Loechl CU et al (2007) Micronutrient sprinkles reduce anemia among 9- to 24-mo-old children when delivered through an integrated health and nutrition program in rural Haiti. J Nutr 137(4):1023–1030CrossRefPubMedGoogle Scholar
  31. Muslihah N, Khomsan A, Briawan D et al (2016) Complementary food supplementation with a small-quantity of lipid-based nutrient supplements prevents stunting in 6–12-month-old infants in rural West Madura Island, Indonesia. Asia Pac J Clin Nutr 25(Suppl 1):S36–S42. Scholar
  32. Nishikiori N, Abe T, Costa DG et al (2006) Who died as a result of the tsunami? Risk factors of mortality among internally displaced persons in Sri Lanka: a retrospective cohort analysis. BMC Public Health 6:73. Scholar
  33. Phu PV, Hoan NV, Salvignol B et al (2010) Complementary foods fortified with micronutrients prevent iron deficiency and anemia in Vietnamese infants. J Nutr 140(12):2241–2247. Scholar
  34. Phuka JC, Maleta K, Thakwalakwa C et al (2009) Postintervention growth of Malawian children who received 12-mo dietary complementation with a lipid-based nutrient supplement or maize-soy flour. Am J Clin Nutr 89(1):382–390. Scholar
  35. Programme WF (2005) Comprehensive food security and vulnerability assessment thematic guidenlines. World Food Programme, RomeGoogle Scholar
  36. Samadpour K, Long KZ, Hayatbakhsh R et al (2011) Randomised comparison of the effects of Sprinkles and Foodlets with the currently recommended supplement (Drops) on micronutrient status and growth in Iranian children. Eur J Clin Nutr 65(12):1287–1294. Scholar
  37. Sampaio DL, Mattos AP, Ribeiro TC et al (2013) Zinc and other micronutrients supplementation through the use of sprinkles: impact on the occurrence of diarrhea and respiratory infections in institutionalized children. J Pediatr (Rio J) 89(3):286–293. Scholar
  38. Schauer C, Zlotkin S (2003) Home fortification with micronutrient sprinkles – a new approach for the prevention and treatment of nutritional anemias. Paediatr Child Health 8(2):87–90. Scholar
  39. Siega-Riz AM, Estrada Del Campo Y et al (2014) Effect of supplementation with a lipid-based nutrient supplement on the micronutrient status of children aged 6–18 months living in the rural region of Intibuca, Honduras. Paediatr Perinat Epidemiol 28(3):245–254. Scholar
  40. Singh MB, Fotedar R, Lakshminarayana J et al (2006) Studies on the nutritional status of children aged 0–5 years in a drought-affected desert area of western Rajasthan. India Public Health Nutr 9(8):961–967CrossRefPubMedGoogle Scholar
  41. Suchdev PS, Shah A, Jefferds ME et al (2013) Sustainability of market-based community distribution of Sprinkles in western Kenya. Matern Child Nutr 9(Suppl 1):78–88. Scholar
  42. Suchdev PS, Addo OY, Martorell R et al (2016) Effects of community-based sales of micronutrient powders on morbidity episodes in preschool children in western Kenya. Am J Clin Nutr 103(3):934–941. Scholar
  43. Sun J, Dai Y, Zhang S et al (2011) Implementation of a programme to market a complementary food supplement (Ying Yang Bao) and impacts on anaemia and feeding practices in Shanxi, China. Matern Child Nutr 7(Suppl 3):96–111. Scholar
  44. Sun J, Huo J, Zhao L et al (2013) The nutritional status of young children and feeding practices two years after the Wenchuan Earthquake in the worst-affected areas in China. Asia Pac J Clin Nutr 22(1):100–108. Scholar
  45. Thakwalakwa C, Ashorn P, Phuka J et al (2010) A lipid-based nutrient supplement but not corn-soy blend modestly increases weight gain among 6- to 18-month-old moderately underweight children in rural Malawi. J Nutr 140(11):2008–2013. Scholar
  46. Thakwalakwa CM, Ashorn P, Phuka JC et al (2014) Impact of lipid-based nutrient supplements and corn-soy blend on energy and nutrient intake among moderately underweight 8–18-month-old children participating in a clinical trial. Matern Child Nutr 11(Suppl 4):144–150. Scholar
  47. Walker CL, Rudan I, Liu L et al (2013) Global burden of childhood pneumonia and diarrhoea. Lancet 381(9875):1405–1416. Scholar
  48. Wang Y, Chen C, Jia M et al (2004) Effect of complementary food supplements on anemia in infant and young children. Wei Sheng Yan Jiu 33(3):334–336. (in Chinese)PubMedGoogle Scholar
  49. Wang Y, Chen C, Wang F et al (2007) Effects of nutrient fortified complementary food supplements on growth of infants and young children in poor rural area in Gansu Province. Wei Sheng Yan Jiu 36(1):78–81. (in Chinese)PubMedGoogle Scholar
  50. Wang YY, Chen CM, Wang FZ et al (2009) Effects of nutrient fortified complementary food supplements on anemia of infants and young children in poor rural of Gansu. Biomed Environ Sci 22(3):194–200CrossRefPubMedGoogle Scholar
  51. Wang LJ, Huo JS, Sun J et al (2010) The nutrition status of children aged 6–23 months after three months of Wenchuan Earthquake in Beichuan and Lixian, Sichuan Province. Zhonghua Yu Fang Yi Xue Za Zhi 44(8):696–700 (in Chinese). Scholar
  52. Wang L, Huo J, Sun J et al (2011) Nutrition effectiveness of infants and yound children aged 6 to 23 months by Yingyangbao in Lixin county affected by Wenchuan earthquake in Sichuan Province. J Hyg Res 40(1):61–64. (in Chinese)Google Scholar
  53. Wang J, Wang H, Chang S et al (2015) The influence of malnutrition and micronutrient status on anemic risk in children under 3 years old in poor areas in China. PLoS One 10(10):e0140840. Scholar
  54. Wang J, Chang S, Zhao L et al (2017) Effectiveness of community-based complementary food supplement (Yingyangbao) distribution in children aged 6–23 months in poor areas in China. PLoS One 12(3):e0174302. Scholar
  55. World Health Organization. Comunity based management of severe acute malnutrition [online]. Available: accessed 2010Google Scholar
  56. Yang Q, Yin S, Zhao X et al (2004) Effect of daily or once weekly iron supplementation on growth and iron status of preschool children. Wei Sheng Yan Jiu 33(2):205–207. (in Chniese)PubMedGoogle Scholar
  57. Yang Q, Zhao X, Yin S et al (2005) Effect of multi-micronutrients supplementation on iron and cognitive ability in preschool children. Chinese Gen Pract 8(11):891–895Google Scholar
  58. Yang Y, Van den Broeck J, Wein LM (2013) Ready-to-use food-allocation policy to reduce the effects of childhood undernutrition in developing countries. Proc Natl Acad Sci USA 110(12):4545–4550. Scholar
  59. Yin S, Dong C (2015) The usage of complementary food supplements for young children during natural disasters. In: Public health in natural disasters. Wageningen Academic Publishers, Wageningen, pp 236–250Google Scholar
  60. Young H, Borrel A, Holland D et al (2004) Public nutrition in complex emergencies. Lancet 364(9448):1899–1909. Scholar
  61. Yu D, Wang Y, Wang F (2007) Effects of complementary food supplements on respiratory infections and diarrhea of infants and young children in poor rural. Wei Sheng Yan Jiu 36(3):355–357. (in Chinese)PubMedGoogle Scholar
  62. Zhang Y, Wu Q, Wang W et al (2016) Effectiveness of complementary food supplements and dietary counselling on anaemia and stunting in children aged 6–23 months in poor areas of Qinghai Province, China: a controlled interventional study. BMJ Open 6(10):e011234. Scholar
  63. Zhao LY, Yu DM, Huang J et al (2010a) The nutrition status of special population living in the areas affected by Wenchuan Earthquake after 3 months. Zhonghua Yu Fang Yi Xue Za Zhi 44(8):701–705 (in Chinese). Scholar
  64. Zhao XF, Yin SA, Zhao L et al (2010b) The nutritional status among children under 60 months year-old after one year of the Earthquake in Wenchuan. Zhonghua Yu Fang Yi Xue Za Zhi 44(8):691–695 (in Chinese). Scholar
  65. Zlotkin SH, Schauer C, Christofides A et al (2005) Micronutrient sprinkles to control childhood anaemia. PLoS Med 2(1):e1. Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Chronic DiseasesGansu Center for Disease Control and PreventionLanzhou CityChina
  2. 2.Department of Maternal and Child NutritionNational Institute for Nutrition and Health, Chinese Center for Disease Control and PreventionBeijingChina

Personalised recommendations