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Lipid-Based Nutrient Supplements Plus Malaria and Diarrhea Treatment Increase Infant Development Scores in a
Elizabeth L Prado1, Souheila Abbeddou1, Elizabeth Yakes Jimenez2,3
1Department of Nutrition, University of California Davis, Davis, CA.
Insights
Small-quantity, lipid-based nutrient supplements (SQ-LNSs) improved infant development in Burkina Faso. Combined with malaria and diarrhea treatment, SQ-LNSs enhanced motor, language, and social skills by 18 months, irrespective of added zinc.
Area of Science:
- Global Health
- Nutritional Science
- Developmental Pediatrics
Background:
- Infant brain development critically depends on adequate nutrition.
- Malaria and diarrhea are significant health challenges in infancy, potentially impacting cognitive and developmental trajectories.
- Small-quantity, lipid-based nutrient supplements (SQ-LNSs) are a potential strategy to deliver essential nutrients during the vulnerable period of infancy.
Purpose of the Study:
- To evaluate the impact of SQ-LNSs, combined with malaria and diarrhea treatment, on infant development.
- To assess the effect of varying zinc dosages within SQ-LNSs on infant developmental outcomes.
- To investigate the influence of nutritional interventions on motor, language, and personal-social development in infants.
Main Methods:
- A partially masked, cluster-randomized controlled trial was conducted in rural Burkina Faso.
- Infants were assigned to either an intervention cohort receiving SQ-LNSs and medical treatment or a non-intervention cohort.
- Developmental milestones (motor, language, personal-social) were assessed at 18 months using the Developmental Milestones Checklist II.
Main Results:
- Infants receiving SQ-LNSs plus treatment showed significantly higher scores in motor, language, and personal-social development compared to the non-intervention group (P < 0.001).
- The amount of added zinc in the SQ-LNSs did not yield significant differences in developmental outcomes.
- No significant effect was observed on caregiver-child interaction.
Conclusions:
- Provision of SQ-LNSs alongside malaria and diarrhea treatment positively influences infant development in rural Burkina Faso.
- The benefits on motor, language, and personal-social development were observed by 18 months of age, irrespective of supplemental zinc content.
- This study supports the use of SQ-LNSs as a public health intervention to improve early childhood development in resource-limited settings.
Background:
Adequate nutrition is necessary for the rapid brain development that occurs during infancy.
Objectives:
We tested the hypothesis that the provision of small-quantity, lipid-based nutrient supplements (SQ-LNSs) plus malaria and diarrhea treatment positively affects infant development. We also tested the effect of various doses of zinc provided in SQ-LNSs or in a tablet.
Methods:
In a partially masked, cluster-randomized controlled trial, communities in rural Burkina Faso were stratified by selected characteristics and then randomly assigned within strata to the intervention (IC; 25 communities, 2435 children) or the nonintervention (NIC; 9 communities, 785 children) cohorts. IC children were randomly assigned to 4 groups. As secondary outcomes, a subsample of 3 of these 4 groups (n = 747) and of the NIC (n = 376) were assessed for motor, language, and personal-social development at age 18 mo by using the Developmental Milestones Checklist II. The 3 IC groups received 20 g SQ-LNSs/d containing 0 or 10 mg added zinc with a placebo tablet or 20 g SQ-LNSs/d containing 0 mg added zinc with a tablet containing 5 mg Zn. All IC groups received treatment of malaria and diarrhea from age 9 to 18 mo. Data collectors and participants were aware of allocation to the IC or NIC but did not know the particular IC subgroup.
Results:
Children in the IC scored 0.34 (95% CI: 0.21, 0.46), 0.30 (95% CI: 0.15, 0.44), and 0.32 (95% CI: 0.16, 0.48) SDs higher in motor, language, and personal-social development, respectively, than did children in the NIC (All P < 0.001). Children who received different amounts of zinc did not differ significantly in any of the scores. No effect on caregiver-child interaction was found.
Conclusion:
In rural Burkina Faso, the provision of SQ-LNSs to infants from age 9 to 18 mo, regardless of added zinc content, plus malaria and diarrhea treatment positively affected motor, language, and personal-social development at age 18 mo. This trial was registered at clinicaltrials.gov as NCT00944281.
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