Author:
Ara Gulshan,Sanin Kazi Istiaque,Khanam Mansura,Sarker Md. Shafiqul Alam,Tofail Fahmida,Nahar Baitun,Chowdhury Imran Ahmed,Boitchi Anika Bushra,Gibson Sarah,Afsana Kaosar,Askari Sufia,Ahmed Tahmeed
Abstract
AbstractApproximately one-third of children under the age of five are stunted in developing countries and many of them are micronutrient-deficient. We designed a comprehensive intervention package including egg/milk-based snacks to improve linear growth and dietary diversity among 6 to 12-month-old children in rural Bangladesh. In this 1-year community-based cluster randomized controlled longitudinal experiment, 412 mother–infant pairs were randomly assigned to receive either monthly food vouchers (for eggs, milk, semolina, sugar, and oil) to prepare egg and milk-based snacks for their children, along with multiple micronutrient powder (MNP), counseling on child feeding and handwashing, or regular government health communication alone (control; n = 206, treatment; n = 206). The trial was conducted in 12 clusters (small administrative units of sub-district). The primary inclusion criteria were ultra-poor households with limited resources and having children under 2-years-old. The primary and secondary outcomes were differences in children's length gain and dietary diversity. The effect of intervention on child growth was examined using a mixed effect linear regression model. Mean weight and length of the children did not significantly differ between groups at baseline. Around 90% of the children in both groups were breastfed. After receiving intervention for 12 months, LAZ score increased by 0.37 (CI 0.24, 0.51,p < 0.001) and risk of stunting reduced by 73% (OR: 0.27, CI 0.13, 0.58,p = 0.001). This comprehensive intervention package improved the growth and dietary diversity of children in extremely poor Bangladeshi households. A scaling-up of this intervention in contexts with limited resources should be taken into consideration.Trial registration:This trial registered retrospectively at ClinicalTrials.gov as NCT03641001, 21/8/2018.
Publisher
Springer Science and Business Media LLC
Reference60 articles.
1. Haddad, L. J. et al. Global Nutrition Report 2015: Actions and Accountability to Advance Nutrition and Sustainable Development (Intl Food Policy Res Inst, 2015).
2. Branca, F. & Ferrari, M. Impact of micronutrient deficiencies on growth: The stunting syndrome. Ann. Nutr. Metab. 46, 8–17 (2002).
3. Black, R. E. et al. Maternal and child undernutrition: Global and regional exposures and health consequences. Lancet 371, 243–260 (2008).
4. Dewey, K. G. & Begum, K. Long-term consequences of stunting in early life. Matern. Child Nutr. 7, 5–18 (2011).
5. Grantham-McGregor, S. et al. Developmental potential in the first 5 years for children in developing countries. Lancet 369, 60–70 (2007).
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