Evaluation report
Child Nutrition, Feeding Challenges, and Morbidities: A Retrospective Analysis of Holt’s Child Nutrition Program
Olufemi F, Hayes J, Callo NM, Linh Dan VT, DeLacey E ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This retrospective analysis examined 13,370 vulnerable children aged 0–18 years enrolled in Holt International's Child Nutrition Program across eight low- and middle-income countries. At baseline, nearly half of children were moderately or severely malnourished, and malnutrition and feeding difficulties were independently linked to higher rates of illness. After one year in the program, nutritional status improved in about 29% of children, and morbidity declined, with the greatest gains seen among children with disabilities.
Key points
- 45.5% of enrolled children had moderate or severe malnutrition at baseline, and severe malnutrition was associated with 2.5 times higher odds of hospitalization
- Feeding difficulties were independently associated with 1.86 times higher odds of morbidity, even after accounting for malnutrition status
- After one year, 29.2% of children showed improved nutritional status and both feeding difficulties and morbidity declined
- Children with disabilities experienced the greatest improvements in malnutrition over the one-year period
- 22.3% of children had disabilities at baseline, highlighting the overlap of vulnerability factors in this population
Limitations
This is a retrospective analysis using routine program records without a comparison or control group, so improvements cannot be definitively attributed to the intervention alone. The study does not provide details on the specific components of the nutrition intervention or the timeframe and completeness of follow-up data for the longitudinal subset.
Abstract
Background: /Objectives: Malnutrition, feeding difficulties, and morbidity frequently coexist among vulnerable children and contribute to poor health and developmental outcomes. However, limited evidence has examined how these factors interact across diverse care settings or how structured nutrition interventions influence child health over time. This study examined the relationships among malnutrition, feeding difficulties, disability, and morbidity in children enrolled in Holt International's Child Nutrition Program (CNP) and evaluated changes in nutritional status, feeding difficulties, and morbidity after one year of participation. Methods: We retrospectively analyzed deidentified health and nutrition records from 13,370 children (0–18 years) enrolled in the CNP across eight low- and middle-income countries. Nutritional status was classified using WHO growth standards and references. Logistic regression examined associations between baseline malnutrition, disability, and morbidity, adjusting for age and sex. A longitudinal subset (n = 1,452) was used to assess associations between feeding difficulties and morbidity and changes in nutritional status, feeding difficulties, and morbidity after one year using McNemar tests. Results: At baseline, 45.5% of children were moderately or severely malnourished, 17.6% had at least one morbidity, 12.8% had feeding difficulties, and 22.3% had disabilities. Severe malnutrition was associated with higher odds of morbidity (OR = 1.39, 95% CI: 1.25–1.56), hospitalization (OR = 2.52, 95% CI: 1.92–3.31), cough, and constipation. Feeding difficulties were independently associated with morbidity (OR = 1.86, 95% CI: 1.53–2.25). After one year, nutritional status improved in 29.2% of children, feeding difficulties and morbidity declined, and the greatest improvements in malnutrition were observed among children with disabilities. Conclusions: Malnutrition and feeding difficulties were independently associated with increased morbidity among vulnerable children. Participation in a structured nutrition intervention was accompanied by improved nutritional status and modest reductions in morbidity over one year. These findings support integrating nutrition rehabilitation, feeding assessment, and routine health monitoring into child nutrition programs serving vulnerable populations in low- and middle-income countries.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Holt International's Child Nutrition Program, a structured nutrition intervention with nutrition rehabilitation, feeding assessment, and routine health monitoring
- Population
- 13,370 vulnerable children aged 0–18 years across eight low- and middle-income countries; longitudinal subset of 1,452 children with one-year follow-up
Key finding
29.2% of children in the longitudinal subset showed improved nutritional status after one year
F et al. · Europe PMC · 21 Aug 2026