Nutritional status and psychomotor development in 12–18-month-old children in a post-intervention study

Abstract

Objectives: A study was undertaken to determine whether benefits gained by providing small-quantity lipid-based nutrient supplements (SQ-LNS) from age 6–12 months were maintained at age 18 months compared with a delayed intervention.
Design: Children who completed a randomised controlled trial were enrolled at age 12 months (n = 392) and followed-up until age 18 months (n = 252; dropout rate 35.7%). Two previously exposed (PE and PE-plus) groups (received SQ-LNS from 6–12 months, but no supplement from 12–18 months) were compared with the delayed intervention (DI) group (received no supplement from 6–12 months, but received SQ-LNS from 12–18 months).
Methods and outcome measures: At age 12 and 18 months, weight, length, haemoglobin (Hb) and psychomotor development were measured.
Setting: The study was carried out in peri-urban Jouberton area, Klerksdorp, South Africa.
Subjects: Children aged 12–18 months.
Results: Compared with DI, negative effects (either a trend or statistically significant) were observed for PE and PE-plus for length-for-age Z-scores (LAZ) (p = 0.091 and p = 0.075, respectively), PE-plus for weight-for-age Z-scores (WAZ) (p = 0.027),
and PE and PE-plus for Hb (p = 0.080 and p = 0.033, respectively); and a positive effect for PE-plus for eye–hand coordination (p = 0.086). The odds for anaemia were higher for PE-plus compared with DI (OR = 1.68; 95% CI 0.91, 3.09). Regardless of group, prevalence of anaemia and stunting increased from age 12 to age 18 months.
Conclusions: Benefits of providing SQ-LNS from age 6–12 months were not sustained at age 18 months, compared with providing SQ-LNS from age 12–18 months. Studies to determine the optimum supplementary period to achieve sustainable
benefits of SQ-LNS on linear growth and iron status are warranted.

Keywords: stunting, cognitive development, haemoglobin, complementary feeding, iron-deficiency anaemia, South Africa