Objectives
To assess the effects of provision of small-quantity lipid-based nutrient supplements (SQ-LNS) containing 22 vitamins and minerals to pregnant women and/or infants on neurobehavioral development.
Methods
We conducted four randomized trials: iLiNS-ZINC in Burkina Faso, iLiNS-DOSE and iLiNS-DYAD-M in Malawi, and iLiNS-DYAD-G in Ghana, enrolling 3220 and 1932 infants, 869 and 1320 pregnant women, respectively. Participants were assigned to receive various doses and formulations of SQ-LNS or to control groups. We monitored the acquisition of developmental milestones. At 18 months, we assessed language, motor, socio-emotional, and executive function development. In Burkina Faso, personal-social development was assessed, rather than the latter two domains.
Results
In both trials that began in pregnancy, a greater percentage of children whose mothers received SQ-LNS and who received SQ-LNS from age 6-18 months were observed to be able to walk at age 12 months (53% in Ghana, 58% in Malawi), compared to a group who only received maternal iron/folic acid supplements (43% and 49%). At age 18 months, no differences were found between groups. Likewise, in iLiNS-DOSE, no differences were found between groups who received 20-40g LNS/d from age 6-18 months and the control group. In iLiNS-ZINC, children who received SQ-LNS containing varying amounts of zinc plus malaria and diarrhea treatment from age 9-18 months scored 0.34 (95% CI 0.21,0.46), 0.30 (0.15,0.44), and 0.32 (0.16,0.48) SD higher in motor, language, and personal-social development, respectively, than the control group (Ps<0.001).
Conclusions
SQ-LNS positively affects neurobehavioral development in certain contexts and perhaps in combination with illness treatment.
