title: Impact of small quantity lipid-based nutrient supplements on infant and young child feeding practices at 18 months of age: results from four randomized controlled trials in Africa.
abstract: Optimal infant and young child feeding (IYCF) practices can help ensure nutrient adequacy and support healthy growth and development. Small-quantity lipid-based nutrient supplements (SQ-LNS) have been proposed to help fill nutrient gaps, but little is known about the impact of provision of SQ-LNS on breastfeeding or complementary feeding practices. In the context of four coordinated randomized controlled nutrient supplementation trials in diverse sites in Africa, we compared IYCF practices at infant age 18 months (after 9-12 months of supplementation) between those receiving and not receiving SQ-LNS. Practices were assessed by caregiver recall. Continued breastfeeding ranged from 74% (Ghana site) to 97% (Burkina Faso site) and did not differ between groups in any site; prevalence of frequent breastfeeding also did not differ. In two sites (Burkina Faso and Malawi), infants receiving SQ-LNS were more likely to meet the World Health Organization recommendations for frequency of feeding (percentage point differences of 12-14%, P < 0.0001 and P = 0.005, respectively; the remaining two sites did not have data for this indicator). Most indicators of infant dietary diversity did not differ between groups in any site, but in the same two sites where frequency of feeding differed, infants receiving SQ-LNS were less likely to have low frequency of consumption of animal-source foods in the previous week (percentage point differences of 9-19% for lowest tertile, P = .02 and P = 0.04, respectively). We conclude that provision of SQ-LNS did not negatively impact self-reported IYCF practices and may have positively impacted frequency of feeding.
authors.affiliation: Department of Nutrition, University of California Davis, Davis, California, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Arimond
authors.affiliation: Department of Nutrition, University of California Davis, Davis, California, USA.
authors.forename: Souheila
authors.initials: S
authors.lastname: Abbeddou
authors.affiliation: Department for International Health, University of Tampere School of Medicine, Tampere, Finland.
authors.forename: Chiza
authors.initials: C
authors.lastname: Kumwenda
authors.affiliation: Department of Nutrition, University of California Davis, Davis, California, USA.
authors.forename: Harriet
authors.initials: H
authors.lastname: Okronipa
authors.affiliation: Nutrition Group, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Jaimie
authors.initials: J
authors.lastname: Hemsworth
authors.affiliation: Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, New Mexico, USA.|Department of Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico, USA.|Center for Education Policy Research, University of New Mexico, Albuquerque, New Mexico, USA.|Pacific Institute for Research and Evaluation, Albuquerque, New Mexico, USA.
authors.forename: Elizabeth Yakes
authors.initials: EY
authors.lastname: Jimenez
authors.affiliation: Department of Nutrition, University of California Davis, Davis, California, USA.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Ocansey
authors.affiliation: Department of Nutrition and Food Science, University of Ghana, Legon, Ghana.
authors.forename: Anna
authors.initials: A
authors.lastname: Lartey
authors.affiliation: Department for International Health, University of Tampere School of Medicine, Tampere, Finland.
authors.forename: Ulla
authors.initials: U
authors.lastname: Ashorn
authors.affiliation: Department of Nutrition and Food Science, University of Ghana, Legon, Ghana.
authors.forename: Seth
authors.initials: S
authors.lastname: Adu-Afarwuah
authors.affiliation: Department of Agricultural and Resource Economics, University of California Davis, Davis, California, USA.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Vosti
authors.affiliation: Department of Nutrition, University of California Davis, Davis, California, USA.
authors.forename: Sonja Y
authors.initials: SY
authors.lastname: Hess
authors.affiliation: Department of Nutrition, University of California Davis, Davis, California, USA.
authors.forename: Kathryn G
authors.initials: KG
authors.lastname: Dewey
mesh_terms: D002050:Burkina Faso; D004032:Diet; D004041:Dietary Fats / Q000008:administration & dosage* / Q000032:analysis; D019587:Dietary Supplements; D005260:Female; D005869:Ghana; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008295:Malawi; D008297:Male; D044342:Malnutrition / Q000453:epidemiology* / Q000517:prevention & control; D018977:Micronutrients / Q000008:administration & dosage; D018673:Nutrition Policy; D009752:Nutritional Status; D012307:Risk Factors; D018401:Sample Size; D015032:Zinc / Q000008:administration & dosage / Q000032:analysis
chemical_list: D004041:Dietary Fats; D018977:Micronutrients; D015032:Zinc
keywords: Africa; breastfeeding; feeding practices; infant; nutrient supplements; young child