Ten symptomatic HIV infected children (CDC stage B or C) with a mean age of 76 months (range 22-142 months) and with normal status in all monitored nutritional parameters consumed 1 can daily of a nutrition supplement drink (Peptamen Junior) for 6 months. The mean weight Z score increased from 0.55± 0.51 to 0.89± 0.49 (p=0.059) and the mean height Z score decreased from -0.27± 0.32 to 0.50± 0.39 (p=0.180). Weight gain velocity was significantly greater during the study (13+ 2%) than in an equal time period before the study (5± 2%) (p= 0.047), although there was no improvement in linear growth velocity (4± 1% vs. 2± 0.5%). Supplementation resulted in significantly increased triceps skinfold (TSF) measurements (9± 1mm vs. 12± 1mn; p= 0.021), but no change in mid-arm muscle area (MAMA) (2081± 225mm2 vs. 2394± 227mm2). Anemia is the most common hematological abnormality in HIV infected children. Subjects who consumed the 8 ounce supplement drink daily for more than 65% of the time throughout the study (n=6) increased to or maintained a hematocrit of 35.0% and hemoglobin of 12.0g/dl, while subjects who were less compliant (consumed the drink daily for less than 30% of the time) (n=4) did not; p=0.005. The results of this pilot study are consistent with the original hypothesis that early nutritional intervention is beneficial to the HIV infected child, and provide variance data for outcome parameters to plan larger studies evaluating the effect of early nutritional supplementation.