Effects of an energy and micronutrient supplement on motor development and motor activity in undernourished children in Indonesia

Objectives: This paper reports the effects of an energy and micronutrient supplement on the motor development, motor milestones and motor activity of nutritionally at risk infants and toddlers in Pangalengan, Indonesia. Design: Two cohorts of children were randomly assigned to three treatments E = 1171 kJ + 12 mg iron; M = 209 kJ + 12 mg iron; S = 104 kJ. Supplementation was given for 12 months. Setting: The sites were six tea plantations in Pangalengan, West Java. Subjects: A 12-month-old (n = 53) and an 18-month-old (n = 83) cohort were recruited from day-care-centers. Twenty children that received S belonged to the 12- and 18-month-old cohorts. Inclusion criteria were: no chronic disease; length-for-age less than or equal to-1 standard deviation (s.d.) and weight-for-length between -1 and -2 s.d. of the median of the reference of the World Health Organization. Methods: Evaluations of intake were made at baseline and every 2 months thereafter. Motor development was assessed with the Bayley Scale and with a custom-made scale to assess gross motor development leading to bipedal locomotion. Motor activity was assessed through 4 h continuous observations of the child's interaction with the social and physical environment. Results: In the 12-month-old cohort, as compared to the M and S groups the children that received the E supplement walked at an earlier age, had higher scores in the Bayley Scale and were motorically more active. Similar intergroup differences were observed in the 18-month-old cohort in the total motor activity score.