Research on LNS

This list of published studies is divided into two sections: “LNS for prevention”; and “Acceptability and use of LNS”. The first section includes studies on use of LNS for promotion of healthy growth, development, or micronutrient nutrition, prevention of stunting, or prevention of wasting. Studies assessing breast milk intake are also included. The second section includes acceptability studies, studies on LNS and infant feeding practices, qualitative studies on mothers’ views of LNS, and studies of intra-household distribution/sharing of LNS.

Studies of the use of LNS for treatment of severe or moderate acute malnutrition are not included.

Download the list with links to abstracts, but without annotation, here.

LNS for prevention

• Randomized comparison of 3 types of micronutrient supplements for home fortification of complementary foods in Ghana: effects on growth and motor development. (abstract and free full-text)
  Adu-Afarwuah S, Lartey A, Brown KH, Zlotkin S, Briend A, Dewey KG. Am J Clin Nutr. 2007 Aug;86(2):412-20.
  

  Randomized controlled trial to test the effect of three different approaches for home-fortification of complementary food (multi-micronutrient powder, LNS and a crushable micronutrient tablet) on child growth (between 6 and 12 months of age) and motor development in Ghana.

• Home fortification of complementary foods with micronutrient supplements is well accepted and has positive effects on infant iron status in Ghana. (abstract and free full-text)
  Adu-Afarwuah S, Lartey A, Brown KH, Zlotkin S, Briend A, Dewey KG. Am J Clin Nutr. 2008 Apr;87(4):929-38.
  

  Randomized controlled trial to test the acceptability and effect of three different approaches to home-fortification of complementary food (multi-micronutrient powder, LNS and a crushable micronutrient tablet) on micronutrient status (iron and zinc) and anemia in Ghanaian children between 6 and 12 months of age.

• Randomized controlled trial of the effectiveness of a soybean-maize-sorghum–based ready-to-use complementary food paste on infant growth in South Kivu, Democratic Republic of Congo. (abstract)
  Bisimwa G, Owino VO, Bahwere P, Dramaix M, Donnen P, Dibari F, and Collins S. Am J Clin Nutr. 2012 May;95(5):1157-64. Epub 2012 Apr 4.

  Randomized controlled trial comparing a lipid-rich ready-to-use complementary food with a standard corn-soy blend on the prevalence of underweight and stunting. Infants were enrolled at 6 months of age and received the complementary food for 6 months. Lab measurements included hemoglobin, triglyceride, and cholesterol.
  

• A large-scale distribution of milk-based fortified spreads: Evidence for a new approach in regions with high burden of acute malnutrition. (abstract and free full-text)
  Defourny I, Minetti A, Harczi G, Doyon S, Shepherd S, Tectonidis M, Bradol JH, Golden M. PLoS ONE 4(5): e5455. Doi:10.1371/journal.pone.0005455.
  

  Evaluation of a preventive distribution program implemented during the hungry-season (May-October 2007) in the Maradi region of Niger that provided a monthly ration of Plumpy’doz to children 6-36 months of age. The prevalence and incidence of severe acute malnutrition (SAM) and SAM treatment admission trends were compared to previous years, where no preventive program was in place.

• Lipid-based nutrient supplements: How can they combat child malnutrition? (abstract and free full-text)
  Dewey KG and Arimond M. PLoS Med 2012 Sep;9(9): e1001314.
  

  A perspective article that addresses the variety of lipid-based products, the controversy of providing lipid-based products to infants and children, and reviews some recent research.

• Use of lipid-based nutrient supplements by HIV-infected Malawian women during lactation has no effect on infant growth from 0 to 24 weeks. (abstract)
  Flax VL, Bentley ME, Chasela CS, Kayira D, Hudgens MG, Knight RJ, Soko A, Jamieson DJ, van der Horst CM, Adair LS. J Nutr. 2012 Jul;142(7):1350-6.
  

  This research is part of the Breastfeeding, Antiretroviral, and Nutrition (BAN) study, a randomized controlled trial with a 2 x 3 factorial design (mothers were randomly assigned to receive LNS or no LNS, and mother-infant pairs were randomly assigned to maternal ARV, infant ARV, or no ARV). This paper assesses the effect of BAN study interventions on infant weight, length, and BMI during the period of exclusive breastfeeding, from 0 to 24 wk.

• Lipid-based nutrient supplements are feasible as a breastmilk replacement for HIV-exposed infants from 24 to 48 weeks of age. (abstract)
  Flax VL, Bentley ME, Chasela CS, Kayira D, Hudgens MG, Kacheche KZ, Chavula C, Kourtis AP, Jamieson DJ, van der Horst CM, Adair LS. J Nutr. Epub 2013 Mar 6.
  

  This research is part of the Breastfeeding, Antiretroviral, and Nutrition (BAN) study, a randomized controlled trial in Malawi with a 2 x 3 factorial design (mothers were randomly assigned to receive LNS or no LNS, and mother-infant pairs were randomly assigned to maternal ARV, infant ARV, or no ARV).  Assigned interventions were provided from birth to 28 wk.  In addition, all infants were given LNS during (24–28 wk) and following (28–48 wk) weaning. This paper assesses the feasibility of infant LNS as a breastmilk replacement and uses longitudinal random effects models to examine associations of interventions, morbidity, and season with weight-for-age (WAZ), length-for-age (LAZ), and BMI-for-age (BMIZ) Z-scores from 24 to 48 wk.

• Breast milk intake is not reduced more by the introduction of energy dense complementary food than by typical infant porridge. (abstract and free full-text)
  Galpin L, Thakwalakwa C, Phuka J, Ashorn P, Maleta K, Wong WW, Manary MJ. J Nutr. 2007 Jul;137(7):1828-33.
  

  Randomized controlled trial to assess the effect of providing LNS as a complementary food on breast-milk intake in 6-month old infants as compared to a micronutrient-fortified maize-soy flour (likuni phala) used in Malawi for complementary feeding.

• Effect of mass supplementation with ready-to-use supplementary food during an anticipated nutritional emergency. (abstract and free full-text)
  Grellety E, Shepherd S, Roederer T, Manzo ML, Doyon S, Ategbo EA, Grais RF. PLoS One. 2012;7(9):e44549.
  

  Compares the incidence of wasting, stunting, and mortality in Niger among children aged 6-23 mo participating in the distribution (intervention) of RUSF versus children not participating in the distribution (comparison).

• Growth in late infancy among HIV-exposed children in urban Haiti is associated with participation in a clinic-based infant feeding support intervention. (abstract)
  Heidkamp RA, Stoltzfus RJ, Fitzgerald DW, Pape JW. J Nutr. 2012 Apr;142(4):774-80. Epub 2012 Feb 29.
  

  This study implemented and evaluated a new infant feeding support intervention for HIV-exposed, uninfected, non-breast-fed infants enrolled at 6 months of age in Haiti.  The 24-wk intervention examined the effect of an integrated package that included LNS, education, promotion of existing clinical services, and social support on growth outcomes measured at 12 months of age.

• The effect of adding ready-to-use supplementary food to a general food distribution on child nutritional status and morbidity: A cluster-randomized controlled trial. (abstract and free full-text)
  Huybregts L, Houngbe´ F, Salpéteur C, Brown R, Roberfroid D, Ait-Aissa M, Kolsteren P. PLoS Med 2012 Sep;9(9): e1001313.
  

  A two-arm cluster-randomized controlled trial comparing the effect of receiving staple foods vs. staple foods + RUSF for 4 mo on the prevention of wasting in children aged 6-36 mo.  Study was conducted within the framework of a general food distribution program in Chad and anthropometric measurements and morbidity were recorded monthly.

• Prenatal food supplementation fortified with multiple micronutrients increases birth length: a randomized controlled trial in rural Burkina Faso. (abstract and free full-text)
  Huybregts L, Roberfroid D, Lanou H, Menten J, Meda N, Van Camp J, Kosteren P, for the MISAME Study Group. Am J Clin Nutr 2009 Jan; 90: 1593-600.
  

  Randomized controlled trial in Burkina Faso to determine whether a daily prenatal multiple-micronutrient (MMN)-fortified food supplement (composed of peanut butter, soy flour, vegetable oil and sugar) improved anthropometric measures at birth compared with a daily prenatal MMN pill alone.
  

• Effect of preventive supplementation with ready-to-use therapeutic food on the nutritional status, mortality, and morbidity of children aged 6 to 60 months in Niger: a cluster randomized trial. (abstract and free full-text)
  Isanaka S, Nombela N, Djibo A, Poupard M, Van Beckhoven D, Gaboulaud V, Guerin PJ, Grais RF. JAMA. 2009 Jan 21;301(3):277-85.
  

  Cluster-randomized controlled trial that evaluated the effect of providing three months of RUTF to 6-60 month-old children in Niger on the prevention of moderate and severe wasting during an 8-month follow-up period.
  

• Reducing wasting in young children with preventive supplementation: a cohort study in Niger. (abstract)
  Isanaka S, Roederer T, Djibo A, Luquero FJ, Nombela N, Guerin PJ, Grais RF. Pediatrics. 2010 Aug;126(2):e442-50. Epub 2010 Jul 26.

  Cohort study assessing the relative impact on wasting, stunting and mortality of two follow-up interventions. RUSF (6 mo, daily dose of 46 g) or RUTF (4 mo, daily dose of 92 g) were distributed in villages where RUTF was provided the previous year, during the “hunger gap” each year.

• Iterative design, implementation and evaluation of a supplemental feeding program for underweight children ages 6-59 months in Western Uganda. (abstract and free full-text)
  Jilcott SB, Ickes SB, Ammerman AS, Myhre JA. Matern Child Health J. 2010 Mar;14(2):299-306.
  

  This paper describes the development, implementation, and evaluation of a supplemental feeding program for underweight children aged 6-59 months in Western Uganda.  Children received ready-to-use-food (RUF) for five weeks. The program was evaluated by examining RUF nutrient composition, weight gain velocity, and qualitative data from key-informant interviews and home feeding observations.
  

• A lipid-based nutrient supplement mitigates weight loss among HIV-infected women in a factorial randomized trial to prevent mother-to-child transmission during exclusive breastfeeding. (abstract)
  Kayira D, Bentley ME, Wiener J, Mkhomawanthu C, King CC, Chitsulo P, Chigwenembe M, Ellington S, Hosseinipour MC, Kourtis AP, Chasela C, Tembo M, Tohill B, Piwoz EG, Jamieson DJ, van der Horst C, Adair L; for the BAN Study Team. Am J Clin Nutr. 2012 Mar;95(3):759-765. Epub 2012 Jan 18.
  

  Evaluated the efficacy of LNS for prevention of excess weight loss in breastfeeding, HIV-infected women.  Mothers were randomized at delivery according to a 2-arm (with and without LNS) by 3-arm (maternal triple-antiretroviral prophylaxis, infant-nevirapine prophylaxis, or neither) factorial design and received LNS for 28 weeks.
  

• Growth and change in blood haemoglobin concentration among underweight Malawian infants receiving fortified spreads for 12 weeks: a preliminary trial. (abstract)
  Kuusipalo H, Maleta K, Briend A, Manary M, Ashorn P. J Pediatr Gastroenterol Nutr. 2006 Oct;43(4):525-32.
  

  Randomized-controlled trial in Malawian children aged 6-17 months.  Children received for 12 weeks, at home, 1 of 8 food supplementation schemes: nothing, 5, 25, 50, or 75 g/day milk-based LNS or 25, 50, or 75 g/day soy-based LNS. Outcome measures included change in weight, length and blood Hb concentration.
  

• An energy-dense complementary food is associated with a modest increase in weight gain when compared with a fortified porridge in Malawian children aged 6-18 months. (abstract and free full-text)
  Lin CA, Manary MJ, Maleta K, Briend A, Ashorn P. J Nutr. 2008 Mar;138(3):593-8.
  

  Randomized comparison of the effects of a peanut-/soy-based LNS and a corn porridge fortified with fish powder as complementary foods on growth and micronutrient status (zinc and selenium) in rural Malawian children between 6 and 18 months of age.

• A Single-Centre, Randomized, Single-Blind, Parallel Group Clinical Trial in Rural Malawi, Testing the Growth Promoting Effect of Long-Term Complementary Feeding of Infants with a High-Energy, Micronutrient Fortified Spread. (abstract and free full-text)
  Mangani C, Ashorn P, Manary M, Alho L.  FANTA-2 Technical Report; Washington, DC: Mar 2012.
  

  A randomized controlled trial in rural Malawi to compare the incidence and prevalence of very severe linear growth failure and symptoms of common childhood illnesses among infants receiving dietary supplementation with milk-LNS, soy-LNS, a corn-soy blend (CSB), or nothing. Healthy infants were tracked for 12 months from the age of 6 to 18 months.
  

• A randomized trial to investigate the effects of pre-natal and infant nutritional supplementation on infant immune development in rural Gambia: the ENID trial: Early Nutrition and Immune Development. (abstract and free full-text)
  Moore SE, Fulford AJ, Darboe MK, Jobarteh ML, Jarjou LM, Prentice AM. BMC Pregnancy Childbirth. 2012 Oct 11;12(1):107.
  

  This paper describes the study design of the ENID (Early Nutrition and Immune Development) trial, a randomized controlled trial in The Gambia with 4 intervention groups: 1) Iron-folate (standard care), 2) multiple micronutrients (MMN), 3) protein-energy (PE), and 4) PE + MMN. Both PE supplements are LNS. Study participants include pregnant women (from < 20 weeks gestation to term) and their infants  (from  6 to 12  months  of  age), with the primary outcome measures of thymic  development  during  infancy  and  antibody  response  to  vaccination.
  

• Breast-milk intake of 9-10-mo-old rural infants given a ready-to-use complementary food in South Kivu, Democratic Republic of Congo. (abstract)
  Owino VO, Bahwere P, Bisimwa G, Mwangi CM, Collins S. Am J Clin Nutr. 2011 Jun;93(6):1300-4. Epub 2011 Mar 30.
  

  Sub-study within a cluster-randomized controlled trial; sub-study compared breast milk intakes of 9 mo old infants who had received, since 6 mo of age, either a lipid-rich ready-to-use complementary food  or a standard corn-soy blend.

• Developmental outcomes among 18-month-old Malawians after a year of complementary feeding with lipid-based nutrient supplements or corn-soy flour. (abstract)
  Phuka JC, Gladstone M, Maleta K, Thakwalakwa C, Cheung YB, Briend A, Manary MJ, Ashorn, P. Matern Child Nutr. Epub ahead of print 2011 Feb 22.
  

  Randomized-controlled trial comparing supplementation for 12 months with LNS (two different doses) or a micronutrient-fortified maize-soy flour (likuni phala). Infant development was assessed at 18 mo; there were no differences between the three micronutrient-supplemented groups.
  

• Complementary feeding with fortified spread and incidence of severe stunting in 6- to 18-month-old rural Malawians. (abstract and free full-text)
  Phuka JC, Maleta K, Thakwalakwa C, Cheung YB, Briend A, Manary MJ, Ashorn P. Arch Pediatr Adolesc Med. 2008 Jul;162(7):619-26. Erratum in: Arch Pediatr Adolesc Med. 2008 Oct;162(10):942.
  

  Randomized-controlled trial that compared supplementation for 12 months with LNS or a micronutrient-fortified maize-soy flour (likuni phala) on child growth and incidence of malnutrition between 6 and 18 months of age.
  

• Postintervention growth of Malawian children who received 12-mo dietary complementation with a lipid-based nutrient supplement or maize-soy flour. (abstract and free full-text)
  Phuka JC, Maleta K, Thakwalakwa C, Cheung YB, Briend A, Manary MJ, Ashorn P. Am J Clin Nutr. 2009 Jan;89(1):382-90.
  

  Follow-up study of Malawian children at 36 months of age to assess the long-term impact on growth and incidence of malnutrition from exposure to 12-months of supplementation with either LNS or a micronutrient-fortified maize-soy flour (likuni phala) between 6 and 18 months of age.

• Supplementary feeding with fortified spread among moderately underweight 6-18-month-old rural Malawian children. (abstract)
  Phuka J, Thakwalakwa C, Maleta K, Cheung YB, Briend A, Manary M, Ashorn P. Matern Child Nutr. 2009 Apr;5(2):159-70.
  

  Randomized controlled trial comparing LNS vs. fortified maize-soy flour in children aged 6-18 months in Malawi.  Children received the supplement for 12 weeks and the outcomes of underweight, wasting, and stunting were examined.
  

• Prevention of acute malnutrition during the lean season: Comparison of a lipid-based nutrient supplement and an improved dry ration, South Darfur, Sudan. A quasi-experimental study. (abstract and free full-text)
  Talley L, Boyd E, el Sharief F, Blanton C, OmerAli M, Rahman M. J Nutr Disorders Ther 2012;2:117.
  

  This study examined the effect of LNS vs. corn soy blend (CSB) on WHZ in children aged 6-36 months living in two internally displaced persons (IDP) camps in South Darfur.  One camp received LNS and the other camp received CSB during a 4-month blanket supplementary feeding program.
  

• An effectiveness trial showed lipid-based nutrient supplementation but not corn–soya blend offered a modest benefit in weight gain among 6- to 18-month-old underweight children in rural Malawi. (abstract)
  Thakwalakwa CM, Ashorn P, Jawati M, Phuka JC, Cheung YB, Maleta KM. Public Health Nutr. 2012 Jun 13:1-8.
  

  Randomized controlled trial to determine the effect of corn–soya blend vs. LNS vs. no supplementation (control) for 12 weeks on weight gain in moderately underweight children aged 6-15 mo in Malawi.

• 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. (abstract)
  Thakwalakwa C, Ashorn P, Phuka J, Cheung YB, Briend A, Puumalainen T, Maleta K. J Nutr. 2010 Nov;140(11):2008-13. Epub 2010 Sep 22.
  

  Randomized controlled trial testing the growth-promoting effect and other health benefits of daily provision of LNS (daily dose 43 g) or CSB (daily dose 71 g) for 12 wk to infants aged 6-15 mo at baseline. The primary outcome measure was weight change during the follow-up period.
  

   

Acceptability and use of LNS

• Acceptability of lipid-based nutrient supplements (LNS) among Ghanaian infants and pregnant or lactating women. (abstract)
  Adu-Afarwuah S, Lartey A, Zeilani M, Dewey KG. Matern Child Nutr. 2011 Oct;7(4):344-56. Epub 2010 Dec 23.
  

  Study of the acceptability of two LNS (20 g doses) designed for infants and for pregnant/lactating women. Methods included direct observation of consumption of test meals by infants and mothers, maternal sensory reaction to the products (and her perception of infant’s reaction), and maternal reports of experiences and reactions during a 2-week home-feeding trial.

• Intra-household use and acceptability of Ready-to-Use-Supplementary-Foods distributed in Niger between July and December 2010. (abstract)
  Cohuet S, Marquer C, Shepherd S, Captier V, Langendorf C, Ale F, Phelan K, Manzo ML, Grais RF. Appetite. 2012 Aug 4;59(3):698-705. [Epub ahead of print].
  

  A cross-sectional survey, focus groups, and individual interviews were performed in 16 villages in Niger receiving RUSF as part of a preventative distribution program. Caregivers of children 6-35 mo of age were asked about their perceptions, beliefs, social norms and opinion of RUSF, as well as their sharing practices within and outside of the household.
  

• Feeding patterns of underweight children in rural Malawi given supplementary fortified spread at home. (abstract)
  Flax VL, Ashorn U, Phuka J, Maleta K, Manary MJ, Ashorn P. Matern Child Nutr. 2008 Jan;4(1):65-73.
  

  A longitudinal observational study of 16 Malawian children aged 6-17 months examining how caregivers feed LNS to their undernourished children at home, and how LNS use affects other feeding patterns.  LNS was provided for 12 weeks and 12-hour observations were conducted before supplementation and during weeks 1, 4, 8 and 12 of LNS use.
  

• Responsive feeding and child interest in food vary when rural Malawian children are fed lipid-based nutrient supplements or local complementary food. (abstract)
  Flax VL, Mäkinen S, Ashorn U, Cheung YB, Maleta K, Ashorn P, Bentley ME. Matern Child Nutr. 2011 Nov 24. [Epub ahead of print]
  

  Study of maternal feeding behavior and infant acceptance of bites when comparing LNS with local complementary food.  Behaviors examined during videotaped feeding sessions of infants 6-17 months old in Malawi.
  

• Intake of lipid-based nutrient supplements during illness and convalescence among moderately-underweight Malawian children. (abstract and free full-text)
  Flax VL, Maleta K, Ashorn U, Manary MJ, Briend A, Ashorn P. J Health Popul Nutr. 2008 Dec;26(4):468-70.
  

  A letter-to-the-editor summarizing a study of 16 Malawian children aged 6-17 months, participating in a 12-week LNS supplementation trial.  The study examined LNS intake during illness and convalescence.
  

• Feeding patterns and behaviors during home supplementation of underweight Malawian children with lipid-based nutrient supplements or corn-soy blend. (abstract)
  Flax VL, Phuka J, Cheung YB, Ashorn U, Maleta K, Ashorn P. Appetite. 2010 Jun; 54(3):504-11. Epub 2010 Feb 11.
  

  Based on in-home direct observations, detailed comparison of feeding and hygiene practices of caregivers of underweight infants aged 6-17 months; infants were supplemented with either LNS or corn-soy blend.
  

• Malawian mother's attitudes towards the use of two supplementary foods for moderately malnourished children. (abstract)
  Flax VL, Thakwalakwa C, Phuka J, Ashorn U, Cheung YB, Maleta K, Ashorn P. Appetite. 2009 Oct;53(2):195-202. Epub 2009 Jun 21.
  

  Evaluation of maternal attitudes towards LNS and corn-soy-blend for feeding moderately malnourished children in Malawi, including acceptability, use during illness, and willingness to pay.

• Acceptability of zinc-fortified, lipid-based nutrient supplements (LNS) prepared for young children in Burkina Faso. (abstract)
  Hess SY, Bado L, Aaron GJ, Ouédraogo JB, Zeilani M, Brown KH. Matern Child Nutr. 2011 Oct; 7(4): 357-67. Epub 2010 Dec 15.
  

  Study of the acceptability of LNS containing either 0 or 10 mg of zinc per daily 20 g LNS dose, among 9-15 month-old infants and their mothers in Burkina Faso. Included direct observation of consumption by infants, maternal sensory reaction to the products (and her perception of infant’s reaction), and maternal reports of infant-feeding experiences during a 2-week home-feeding trial.

• Examination of facilitators and barriers to home-based supplemental feeding with ready-to-use food for underweight children in western Uganda. (abstract)
  Ickes SB, Jilcott SB, Myhre JA, Adair LS, Thirumurthy H, Handa S, Bentley ME, Ammerman AS. Matern Child Nutr. 2012 Jan;8(1):115-29. Epub 2010 Jul 19.
  

  During a supplemental feeding program, caregivers, RUF producers, and program staff were interviewed regarding facilitators and barriers to appropriate use of RUF. Locally produced RUF was well received by caregivers and children, and was perceived to be a healthy supplemental food for malnourished children. Child feeding practices, including sharing of RUF, compromised the nutrient delivery to the intended child.

• Acceptability of a Lipid-Based Nutrient Supplement among Guatemalan Infants and Young Children. (free full-text)
  Matias SL, Chaparro CM, Perez-Exposito AB, Peerson JM, Dewey KG. FANTA-2 Technical Report; Washington, DC: Aug 2011.
  

  Study of acceptability of LNS, testing both the “regular” peanut flavor and a new cinnamon flavor, among infants 6-18 months of age in Guatemala.  A 2-day test-feeding trial was carried out, followed by a 2-week home-use trial.  Measurements included amount consumed by infant, caregiver’s sensory preferences, and caregiver’s perception of infant’s preferences.
  

• Heat Treatment of Expressed Breast Milk Is a Feasible Option for Feeding HIV-Exposed, Uninfected Children after 6 Months of Age in Rural Zimbabwe. (abstract)
  Mbuya MN, Humphrey JH, Majo F, Chasekwa B, Jenkins A, Israel-Ballard K, Muti M, Paul KH, Madzima RC, Moulton LH, Stoltzfus RJ. J Nutr. 2010 Aug;140(8):1481-8. Epub 2010 Jun 23.
  

  Evaluation of the feasibility of expressing and heat treating all breast milk fed to HIV-exposed, uninfected infants in rural Zimbabwe, following 6 months of exclusive breastfeeding. LNS (Nutributter®) was provided along with instruction on EHT and counseling on complementary feeding using local foods.

• Acceptability of Lipid-Based Nutrient Supplements and Micronutrient Powders among Pregnant and Lactating Women and Infants and Young Children in Bangladesh and Their Perceptions about Malnutrition and Nutrient Supplements. (free full text)
  Mridha MK, Chaparro CM, Matias SL, Hussain S, Munira S, Saha S, Day LT, Dewey KG. FANTA-2 Bridge Technical Report; Washington, DC: Feb 2012.
  

  Study of the acceptability of several flavors of LNS for pregnant and lactating women (PLW) and for infants and young children (IYC), using test feeding, home use trials and focus group discussions. During the test-feeding phase a randomized cross-over design was used for peanut and cumin flavors (PLW) and for peanut and cardamom flavors (IYC).

• Complementary feeding messages that target cultural barriers enhance both the use of lipid-based nutrient supplements and underlying feeding practices to improve infant diets in rural Zimbabwe. (abstract)
  Paul KH, Muti M, Chasekwa B, Mbuya MN, Madzima RC, Humphrey JH, Stoltzfus RJ. Matern Child Nutr. 2012 Apr;8(2):225-38. Epub 2010 Aug 4.
  

  Formative research was conducted in rural Zimbabwe to develop feeding messages to improve complementary feeding with and without LNS. Common feeding problems were poor dietary diversity and low energy density. While provision of LNS was crucial to ensure adequate intakes of iron and zinc for infants 6-11 mo, educational messages that were barrier-specific and delivered directly to mothers were crucial to improving the underlying diet.

• The Acceptance and Feasibility of Replacement Feeding at 6 Months as an HIV Prevention Method in Lilongwe, Malawi: Results From the BAN Study. (abstract)
  Parker ME, Bentley ME, Chasela C, Adair L, Piwoz EG, Jamieson DJ, Ellington S, Kayira D, Soko A, Mkhomawanthu C, Tembo M, Martinson F, Van der Horst CM. AIDS Educ Prev. 2011 Jun;23(3):281-95.
  

  This study investigated the use and acceptability of a lipid-based nutrient supplement (LNS) as a breast milk substitute when provided to infants (6-12mo) of HIV-positive mothers, as part of the Breast-feeding, Antiretroviral, and Nutrition (BAN) Study. At the time the study was implemented, WHO recommended exclusive breastfeeding for 6 months with rapid weaning thereafter.

• Acceptability of three novel lipid-based nutrient supplements among Malawian infants and their caregivers. (abstract)
  Phuka J, Ashorn U, Ashorn P, Zeilani M, Cheung YB, Dewey KG, Manary M, Maleta K. Matern Child Nutr. 2011 Oct;7(4):368-77. Epub 2011 Apr 21.
  

  Study of the acceptability of three new lipid-based nutrient supplements (LNS) designed for preventing undernutrition among infants 6-18 mo of age. Included direct observation of consumption by infants, maternal sensory reaction to the products (and her perception of infant’s reaction), and maternal reports of infant-feeding experiences during a 2-week home-feeding trial.

• Formative research for the development of a market-based home fortification programme for young children in Niger. (abstract and free full-text)
  Tripp K, Perrine CG, de Campos P, Knieriemen M, Hartz R, Ali F, Jefferds ME, Kupka R.  Matern Child Nutr. 2011 Oct;7(Suppl 3):82-95.
  

  Qualitative results from focus group discussions among mothers, fathers and grandmothers of children 6-23 months, assessing the acceptability and willingness to pay for LNS and a micronutrient powder.