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Lipid-based nutrient supplementation in the first 1000 d improves child growth in Bangladesh: a cluster-randomized

Kathryn G Dewey1, Malay K Mridha2,3, Susana L Matias2

  • 1Departments of Nutrition and kgdewey@ucdavis.edu.

The American Journal of Clinical Nutrition
|March 10, 2017
PubMed

Insights

Home fortification with small-quantity lipid-based nutrient supplements (LNSs) improved child growth during the first 1000 days. This intervention, unlike micronutrient powders, enhanced linear growth and head size in rural Bangladesh.

Area of Science:

  • Maternal and child health
  • Nutritional interventions
  • Growth monitoring

Background:

  • Linear growth stunting primarily occurs during the critical first 1000 days (conception to 24 months).
  • Few interventions have been evaluated for their growth impact across this entire window.
  • Home fortification strategies aim to prevent maternal and child undernutrition.

Purpose of the Study:

  • To evaluate home fortification approaches for preventing maternal and child undernutrition.
  • To assess the impact of small-quantity lipid-based nutrient supplements (LNSs) on child length-for-age z-score (LAZ) at 24 months.
  • To compare LNSs with iron and folic acid (IFA) plus micronutrient powder (MNP) or no supplementation.

Main Methods:

  • A cluster-randomized effectiveness trial with 4 arms was conducted.
  • Intervention arms included LNSs for women and children, IFA for women and LNSs for children, IFA for women and MNP for children, and IFA for women with no supplementation for children.
  • 4011 pregnant women were enrolled at <=20 weeks gestation across 64 community health worker clusters.

Main Results:

  • The LNS-LNS group showed significantly higher LAZ (+0.13 vs. IFA-MNP) and head circumference (+0.15 vs. IFA-Control) at 24 months.
  • Stunting prevalence was lower in the LNS-LNS group at 18 months (OR: 0.70) but this difference diminished by 24 months (OR: 0.81).
  • Micronutrient powder (MNP) did not show significant improvements in growth outcomes compared to control.

Conclusions:

  • Home fortification with small-quantity LNSs effectively improved child linear growth and head size in rural Bangladesh.
  • LNS supplementation during the first 1000 days is a viable strategy for preventing undernutrition.
  • Micronutrient powder (MNP) was not found to be effective in improving child growth in this context.

Keywords:
growth falteringlipid-based nutrient supplementsmalnutritionmicronutrient powderstunting

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