Conditional and Unconditional Social Transfers, Early-Life Nutrition, and Child Growth: A Randomized Clinical Trial

Area of Science:

• Public Health
• Maternal and Child Health
• Health Economics

Background:

• Declining exclusive breastfeeding rates pose risks to maternal and child well-being.
• Social transfers are a potential intervention to support breastfeeding practices.

Purpose of the Study:

• To evaluate the impact of conditional and unconditional social transfers on exclusive breastfeeding.
• To assess the effects of these transfers on child growth indicators.

Main Methods:

• A 3-arm randomized clinical trial involving 298 mothers in the Lao People's Democratic Republic.
• Interventions included conditional social transfer, unconditional social transfer, and a control group receiving educational materials.
• Primary outcome: exclusive breastfeeding at 6 months postpartum; secondary outcomes: breastfeeding duration and child growth.

Main Results:

• Conditional social transfers increased exclusive breastfeeding odds by 4.60 times (P<.001), and unconditional transfers by 2.51 times (P=.03) compared to controls.
• Both transfer types reduced the risk of early breastfeeding cessation (aHR 0.60-0.68; P<.05).
• No significant differences in child growth (height, weight, head circumference) were observed between groups at 6 months.

Conclusions:

• Social transfers, particularly conditional ones, are effective in improving exclusive breastfeeding rates at 6 months postpartum.
• These findings highlight the potential of social protection programs to enhance infant feeding practices.
• Long-term follow-up is planned to assess sustained effects on child health and development.