Evidence-Based Nutrition Support in Home Settings: A Follow-Up Study for Optimizing Child Growth Outcomes

Background: Undernutrition remains a persistent challenge , with NFHS-5 data indicating that 32.1% of children under five are underweight. While many undernourished children in outpatient settings meet their daily nutrient requirements, growth faltering persists due to inadequate follow-up and suboptimal implementation of dietary plans. Early, evidence-based nutrition intervention and structured follow-up are essential to promote catch-up growth and sustained health outcomes.

Objective: To evaluate the impact of a structured, evidence-based home nutrition support and follow-up program on improving nutritional status among underweight preschool children.

Methods: This study was conducted from January -November 2025 in the outpatient nutrition clinic of a tertiary care hospital. Children aged 3–5 years without comorbidities, developmental delay, or hypermetabolic conditions were included. The study was executed in three phases:

Phase 1 (P1): Baseline nutritional assessment and individualized diet planning with or without oral nutritional supplements (ONS) to meet catch-up growth needs.

Phase 2 (P2): Implementation of a quality improvement plan with bi-monthly follow-ups over three months for dietary adjustments and compliance monitoring.

Phase 3 (P3): Reassessment of anthropometric parameters using WHO Growth Standards to evaluate outcomes.

Data were analyzed using descriptive statistics and paired t-tests to assess improvement in nutritional status.

Results: A total of 63 children participated (44.43% boys, 55.57% girls). At baseline, 82.7% had wasting, 12.6% had stunting, and 4.7% had both, as per the Waterlow classification. Mean dietary intake was 880 kcal and 8.17 g protein/day, with 36.5% receiving ONS. Follow-up data indicated ONS discontinuation in 28% due to flavor dislike and meal skipping in 7.03% linked to school schedules. At 3-month reassessment, 53.98% achieved normal nutritional status, with undernutrition reduced to 46% (p < 0.05). The prevalence of wasting, stunting, and combined malnutrition decreased to 33.3%, 9.52%, and 3.17%, respectively, while ONS requirement reduced to 18.8%.

Conclusion: Regular follow-up and individualized dietary counseling significantly improve growth outcomes in undernourished children. Integrating home-based nutrition support and appropriate ONS administration can bridge dietary gaps, promote weight gain, and enhance linear growth. Continued engagement of caregivers and paediatric dietitians is key to sustaining nutritional recovery and ensuring a healthy future.

Dr. Sanjana is a graduate of Davao Medical School Foundation, Philippines, where she ranked among the top students in her college. With a strong interest in pediatrics and clinical nutrition research, she has contributed to scientific publications in the field of Pediatric nutrition and is committed to advancing evidence-based medical practice.