“Small-Quantity, Lipid-Based Nutrient Supplements Provided to Women during Pregnancy and 6 Mo Postpartum and to Their Infants from 6 Mo of Age Increase the Mean Attained Length of 18-Mo-Old Children in Semi-Urban Ghana: a Randomized Controlled Trial”, 2016 (; backlinks; similar):
Background: Childhood stunting usually begins in utero and continues after birth; therefore, its reduction must involve actions across different stages of early life.
Objective: We evaluated the efficacy of small-quantity, lipid-based nutrient supplements (SQ-LNSs) provided during pregnancy, lactation, and infancy on attained size by 18 mo of age.
Design: In this partially double-blind, individually randomized trial, 1320 women at ≤20 wk of gestation received standard iron and folic acid (IFA group), multiple micronutrients (MMN group), or SQ-LNS (LNS group) daily until delivery, and then placebo, MMNs, or SQ-LNS, respectively, for 6 mo postpartum; infants in the LNS group received SQ-LNS formulated for infants 6–18 mo of age (endline). The primary outcome was child length by 18 mo of age.
Results: At endline, data were available for 85% of 1228 infants enrolled; overall mean length and length-for-age z score (LAZ) were 79.3 cm and −0.83, respectively, and 12% of the children were stunted (LAZ <-2). In analysis based on the intended treatment, mean ± SD length and LAZ for the LNS group (79.7 ± 2.9 cm and −0.69 ± 1.01, respectively) were greater than for the IFA (79.1 ± 2.9 cm and −0.87 ± 0.99) and MMN (79.1 ± 2.9 cm and −0.91 ± 1.01) groups (p = 0.006 and p = 0.009, respectively). Differences were also for weight and weight-for-age z score but not head or midupper arm circumference, and the prevalence of stunting in the LNS group was 8.9%, compared with 13.7% in the IFA group and 12.9% in the MMN group (p = 0.12). In analysis based on actual supplement provided at enrollment, stunting prevalences were 8.9% compared with 15.1% and 11.5%, respectively (p = 0.045).
Conclusion: Provision of SQ-LNSs to women from pregnancy to 6 mo postpartum and to their infants 6–18 mo of age may increase the child’s attained length by age 18 mo in similar settings. This trial was registered at ClinicalTrials.gov as NCT00970866.