This paper uses a prospective randomized trial to assess the impact of two school feeding schemes on health outcomes for pre-school age children from low-income households in northern rural Burkina Faso. The two school feeding programs under consideration are, on the one hand, school meals where students are provided with lunch each school day, and, on the other hand, take home rations which provide girls with 10 kg of cereal flour each month, conditional on 90 percent attendance rate. A unique feature of this program is that data were collected for both children who were enrolled in school and those who were not, hence allowing a direct measure of the spillover effect on children who are too young to be enrolled. After the program ran for one academic year, we found the following impacts on children age 5 and under: take-home rations have increased weight-for-age by .34 standard deviations for boys and girls taken jointly, and by .57 standard deviations for boys taken separately. The school meals intervention has increased weight-for-age by .40 for boys. Neither program had significant impact on girls taken separately. We show that achieving the same gains through increased household expenditures would have required cash transfers much larger than the monetary value of the food transfers. This indicates that most of the gains are realized through intra-household food reallocation.