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J Nutr. 2015 Jun;145(6):1345-53. doi: 10.3945/jn.114.207225. Epub 2015 Apr 29.

Supplementation of Maternal Diets during Pregnancy and for 6 Months Postpartum and Infant Diets Thereafter with Small-Quantity Lipid-Based Nutrient Supplements Does Not Promote Child Growth by 18 Months of Age in Rural Malawi: A Randomized Controlled Trial.

Author information

1
Department for International Health, University of Tampere School of Medicine, Tampere, Finland; Department of Paediatrics, Tampere University Hospital, Tampere, Finland; per.ashorn@uta.fi.
2
Department for International Health, University of Tampere School of Medicine, Tampere, Finland;
3
Department for International Health, University of Tampere School of Medicine, Tampere, Finland; Centre for Quantitative Medicine, Duke-National University of Singapore Graduate Medical School, Singapore;
4
Departments of Nutrition and.
5
Department of Community Health, University of Malawi College of Medicine, Blantyre, Malawi;
6
Department of Nutrition & Food Science, University of Ghana, Accra, Ghana; and.
7
Agricultural and Resource Economics, University of California, Davis, Davis, CA;
8
Department for External Research and Nutrition Strategies Nutriset S.A.S., Malaunay, France.

Abstract

BACKGROUND:

Intrauterine growth restriction may be reduced by supplementing maternal diets during pregnancy, but few studies have assessed the impact of combined prenatal and postnatal interventions on child growth.

OBJECTIVE:

We tested a hypothesis that provision of small-quantity lipid-based nutrient supplements (SQ-LNSs) to mothers in pregnancy and 6 mo postpartum and to their infants from 6 to 18 mo of age would promote infant and child growth in the study area in rural Malawi.

METHODS:

We enrolled 869 pregnant women in a randomized trial in Malawi. During pregnancy and 6 mo thereafter, the women received daily 1 capsule of iron-folic acid (IFA), 1 capsule containing 18 micronutrients (MMN), or one 20-g sachet of SQ-LNS [lipid-based nutrient supplements (LNS), containing 21 MMN, protein, carbohydrates, essential fatty acids, and 118 kcal]. Children in the IFA and MMN groups received no supplementation; children in the LNS group received SQ-LNSs from 6 to 18 mo. Primary outcome was child length at 18 mo.

RESULTS:

At 18 mo, the mean length in the IFA, MMN, and LNS groups was 77.0, 76.9, and 76.8 cm (P = 0.90), respectively, and the prevalence of stunting was 32.7%, 35.6%, and 37.9% (P = 0.54), respectively. No intergroup differences were found in the mean weight, head circumference, or midupper arm circumference or the proportions with low z scores for these variables (P > 0.05). Covariate adjustment did not change the analysis results, and the associations between the intervention and child length were not modified by maternal parity, age, or nutritional status (P > 0.10).

CONCLUSIONS:

The findings do not support a hypothesis that provision of SQ-LNSs to women in pregnancy and postpartum and to children from 6 to 18 mo of age would promote child growth in this Malawian study area. This trial was registered at clinicaltrials.gov as NCT01239693.

KEYWORDS:

LNS; Sub-Saharan Africa; dietary supplementation; infant; linear growth failure; postnatal intervention; prenatal intervention; stunting

PMID:
25926413
DOI:
10.3945/jn.114.207225
[Indexed for MEDLINE]

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