Impact of Small-quantity Lipid-based Nutrient Supplements on Infant and Young Child Feeding Practices
Mary Arimond
Program in International and Community Nutrition, University of California, Davis, CA, USA.
Souheila Abbeddou
Program in International and Community Nutrition, University of California, Davis, CA, USA.
Seth Adu-Afarwuah
University of Ghana, Accra, Ghana.
Ulla Ashorn
University of Tampere School of Medicine, Tampere, Finland.
Kenneth Brown
Program in International and Community Nutrition, University of California, Davis, CA, USA.
Jaimie Hemsworth
London School of Hygiene and Tropical Medicine, London, UK.
Sonja Hess
Program in International and Community Nutrition, University of California, Davis, CA, USA.
Elizabeth Jimenez
University of New Mexico, Albequerque, NM, USA.
Chiza Kumwenda
University of Tampere School of Medicine, Tampere, Finland.
Anna Lartey
University of Ghana, Accra, Ghana.
Harriet Okronipa *
University of Ghana, Accra, Ghana.
Jean-Bosco Ouedraogo
Institut de Recherche en Sciences de la Sante, Bobo-Dioulasso, Burkina Faso.
Stephen Vosti
Program in International and Community Nutrition, University of California, Davis, CA, USA.
Kathryn Dewey
Program in International and Community Nutrition, University of California, Davis, CA, USA.
*Author to whom correspondence should be addressed.
Abstract
Objectives: Lipid-based nutrient supplements (LNS) are energy-dense and could change infant and young child feeding (IYCF) practices by changing caregiver perceptions of needs and/or child appetite and demand for breast milk and local complementary foods. We hypothesized that LNS (10-40g/day) would not have significant impacts on IYCF practices.
Methods: Infants in three randomized controlled trials were assigned to receive either LNS from 9-18 mo (Burkina Faso) or 6-18 mo (Ghana and Malawi) or a delayed intervention (DI). All caregivers were given brief didactic messages promoting continued breastfeeding and diverse diets at first distribution of LNS; messages were repeated periodically in Ghana and Malawi (all groups) and not repeated systematically in Burkina Faso. IYCF practices were assessed at 18 mo by caregiver recall of the preceding day and week.
Results: The reported prevalence of continued breastfeeding did not vary by intervention group in any site, and was 97%, 74%, and 89% in Burkina Faso, Ghana, and Malawi. Reported frequency of breastfeeding yesterday also did not vary. The proportion of infants meeting the WHO recommendation for minimum dietary diversity (4+ food groups) did not differ by intervention group and was 37%, 75%, and 68% in Burkina Faso, Ghana and Malawi. In Burkina Faso, infants in the LNS group were more likely to meet the WHO recommendation for number of meals/snacks yesterday (79%, vs. 66% in DI group).
Conclusions: Provision of LNS did not change most IYCF practices but increased frequency of feeding in one site.