NEW YORK (AP) -- This "yo-yo" of a year continues for America's nutritional peanut paste manufacturers, nonprofits that have found their lifesaving food packets disrupted by the U.S. State Department's sudden pause in foreign assistance.

Georgia-based MANA Nutrition and Rhode Island-based Edesia Nutrition are two key links in the global supply chain sending nutritional mixtures of ground peanuts, powdered milk, sugar and oil to malnourished children worldwide. American farmers supply ingredients, shipping companies carry paste overseas and NGOs distribute the food throughout countries in need. Any delays complicate the network's delicate logistics, relied upon by millions of children.

Yet the U.S. scrapped all of their upcoming contracts to make peanut butter paste, according to an April 4 email shared with The Associated Press detailing the U.S. Agency for International Development 's anticipated summer demand. Enough boxes to treat more than 450,000 children in Yemen were cancelled and more than 800,000 others "will not move forward at this time."

Complicating matters further, MANA Nutrition CEO Mark Moore said USAID didn't pay $20 million in debts accumulated since December until last week. Neither maker was reimbursed by previous deadlines to expedite debt payments.

Keeping MANA afloat amid the U.S. funding chaos is a longtime partner from across the pond: British billionaire hedge fund manager Chris Hohn.

"The reason I can not be in just complete panic right now," Moore said last month, "is Chris."

But the private support and reopened funding spigot are hardly enough to assure producers they will keep reaching youth in impoverished countries. And they don't expect philanthropy to replace government funding forever.

The ups and downs underscore the pain felt even by the few surviving programs of the Trump administration's USAID purge that recently targeted initiatives keeping millions alive.

Edesia Nutrition is still waiting to be made whole -- and its production lines are running slowly. Production couldn't restart until Edesia CEO Navyn Salem saw "at least some sign of payment."

"It honestly represents an entire life," she said, watching a suspended conveyor belt in March. "Every hour that goes by."

A simple recipe is behind the revolutionary treatment for the estimated 45 million children younger than 5 who suffer from "wasting."

Ten ready-to-eat pouches are filled every second inside MANA's rural factory. Locally sourced peanuts are roasted and cooled. Rollers separate kernels from skin before the peanuts are ground into paste and blended with powdered sugar. Kettles heat the final product to kill bacterial growth.

The sticky paste gets pumped into sachets resembling oversized McDonald's ketchup packets. They don't need refrigeration and have a two-year shelf life. Each contains 500 calories, providing vitamins and nutrients necessary for early brain development. Malnourished children can be rehabilitated in six weeks by eating three of these energy-packed meal replacements a day.

The usual cost? About $40 for a 150-packet box.

This "miracle food" became humanitarians' go-to tool for reducing undernutrition, which contributes to nearly half of deaths among children under age 5. NGOs forecast countries' need months in advance. MANA and Edesia compete for government contracts to make the paste. USAID buys their boxes and ships them overseas. Partners such as UNICEF and the World Food Program deliver them.

Salem compares Plumpy'Nut -- the popular brand name given by French company Nutriset -- to baby formula. When the U.S. experienced a shortage, she said, parents didn't feed cookies to their children instead.

"We don't make a nice-to-have food," she said. "You can't replace it with something else."

All the grinding and mixing was supposed to halt Jan. 29 when MANA and Edesia received stop-work orders from the U.S. State Department.

Secretary of State Marco Rubio said the administration sought a program-by-program review of which USAID projects, criticized as liberal, make "America safer, stronger or more prosperous." He moved to keep strictly life-saving emergency programs going -- but confusion reigned over exemptions.

Moore ignored it nonetheless. "When you have 100,000 pounds of peanut butter surging through a system you can't just really stop," he said.

Welcome news came a week later when the stop orders were rescinded. In late February, however, Moore said USAID contracts totaling $50 million -- enough to treat 300,000 children -- were cancelled. That included requests for countries high on the Famine Early Warning System Network's list of places expected to most need humanitarian food assistance.

Reinstatements arrived late March 2 and MANA began squeezing ready-to-use therapeutic food the following morning after about one week down.

"We're grateful," Moore said. "But there's been a whole lot of uncertainty and craziness injected into our lives."

Thousands of Plumpy'Nut boxes piled up in Edesia's warehouses after the Trump administration paused contracts for their truckers. Salem said some shippers even had contracts terminated while in transit.

Maersk Line, Limited -- a container shipping company that transports ready-to-use therapeutic food, or RUTF -- worked with the U.S. government to comply with the foreign aid pause while "minimizing" supply chain disruptions, according to senior communications and media advisor Patrick Fitzgerald.

Salem halted production on two lines for the first time since her nonprofit's 2010 founding. Edesia finally received $16 million in April for USAID orders shipped last year, she said, but still faces a $20 million hole that opened when the Trump administration froze humanitarian spending abroad. Lacking payments and clarity, she said she was forced to lay off 10% of Edesia's team.

While this period has been difficult, Salem hopes they emerge "more efficient and end up having more impact on children." But switching production on and off is complicated and takes a toll.

"For sure, the ones who have the most costly price (are) children who will lose their lives as a result of these interruptions," Salem said.

Enter Hohn. The London-based investor, who is described as unassuming, has made nutrition a cornerstone of The Children's Investment Fund Foundation.

His charity declined to disclose how much money Hohn has donated to MANA. But neither the nonprofit factory nor Hohn views philanthropy as a sustainable way to fund malnutrition work that already lags behind the immense need.

"Sudden aid cuts have immediate and severe consequences for children, depriving them of life-saving support from products like RUTF," Hohn said in a statement to The Associated Press. "While we are working with partners to minimise the impact, short-term solutions cannot replace stable, long-term government funding."

Hohn -- who had previously given more than $250 million to MANA -- called for "urgent action" to bridge the funding gap and "prevent further suffering." The World Food Program has cut food rations and suspended nutrition assistance in recent years amid donor countries' dwindling support.

A federal judge on March 10 ordered Trump officials to begin paying the roughly $2 billion owed to aid groups and businesses up to mid-February.

Therapeutic food composes such a small fraction of U.S. spending that it amounts to a "rounding error," according to Moore. Nobody thought cuts would meaningfully help balance the federal budget.

"All of a sudden, boom. It's in the crosshairs for the first time ever as a partisan-type conversation," he said. "It does, though, highlight how we are at a unique moment where it could be politicized."

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