Medika Manba - the peanut butter medicine

Here is a link to a story featured on the news show 60-Minutes about Plumpy Nut - the same fortified peanut paste that we will be using here in our intervention. Here in Haiti the peanut paste, called Medika Manba in Haitian Creole, is being produced by an organization called Meds and Foods for Kids using locally grown peanuts. The peanuts are combined with imported oil, sugar, dried milk powder and a mixture of vitamins and minerals to produce an extremely energy dense product that tastes like the inside of a Reese's Pieces candy.

The news story focuses on the use of Medika Manba for rehabilitation of seriously malnourished kids in Niger. This approach requires children to eat up to 3kg of it per week! Our plan is to encourage mothers to feed children a smaller daily dose of 65g (about 5 tablespoons) from 6-12 months in order to prevent the child from becoming malnourished in the first place.

At the clinic where I work, children are particularly vulnerable to becoming malnourished during the 6-12 month window. If the mom had qualified to receive free infant formula for the first 6 months, the free supply ends at 6 months because it's very expensive to buy the imported formula in Haiti and the clinic cannot afford to continue paying for it. If the HIV-infected mom was breastfeeding the infant, they are encouraged to stop at 6 months due to the risk of HIV transmission from mom to baby through the breast milk. (The issue of breastfeeding vs. infant formula feeding by HIV-infected moms is an extremely complicated one on in its own right. I'll try to write more about in a future post)

By 12 months, children have developed teeth and can usually eat the foods the rest of the family is eating but before then, they need foods that will meet both their developmental stage and high nutrient needs. Normally liquids like breastmilk or infant formula provide ~60% of a child's calories and many of their vitamins in the 6-12 month time period. The other common "weaning foods" such as porridges made with corn or rice do not contain enough energy or micronutrients to support the growth of children on their own.

Our hope is that by adding the medika manba to porridges or even feeding a small dose to the child directly, there will be be sufficient energy, vitamins and minerals in their diets to support healthy growth and development without breast milk or infant formula.