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

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.