Nutrient supplementation during the first 1000 days and growth of infants born to pregnant adolescents

Dewey, Kathryn G.; Matias, Susana L; Mridha, Malay K

doi:10.1111/nyas.14191

Cited by 13 publications

(16 citation statements)

References 25 publications

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“…The Provision of packaged specialised food supplements are argued to be a rapid and low cost approach to prevent under-nutrition in vulnerable groups such as pregnant-lactating women (PLW) and young children 6-59 months of age [4,5] and more specifically focusing on the critical 1000 day period from conception to 2 years of age [6,7]. These specialized packaged foods comprise of various products which are carefully designed to cater the needs of specific vulnerable groups.…”

Section: Introductionmentioning

confidence: 99%

Food supplements to reduce stunting in Pakistan: a process evaluation of community dynamics shaping uptake

et al. 2020

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Background: There is an increasing interest in use of food supplements to prevent childhood stunting, however the evidence on the process indicators is scarce. We in this study explore the barriers to the effective implementation of food supplementation programs and the possible mitigation strategies which can guide the design of future programs. Methods: We undertook a process evaluation of a stunting prevention food supplementation pilot program in rural Pakistan that distributed Wheat Soy Blend (WSB) to pregnant & lactating women, and Lipid-based Nutrient Supplement (LNS) and micronutrient powder (MNP) to < 5 years children. We used a mixed methods approach through a quantitative survey of 800 households and conducted 18 focused group discussion (FGDs) (with male and female caregivers), 4 FGDs (with Community Health Workers (CHWs)) and 22 key informant interviews (with district stakeholders) to evaluate the community side factors affecting uptake through five parameters: value, acceptability, receipt of supplement, usage and correct dosage. Results: The findings show that proportionately few beneficiaries consumed the full dose of supplements, despite reasonable knowledge amongst caregivers. Sharing of supplements with other household member was common, and the full monthly stock was usually not received. Qualitative findings suggest that caregivers did not associate food supplements with stunting prevention. WSB was well accepted as an extra ration, LNS was popular due its chocolaty taste and texture, whereas MNP sprinkles were perceived to be of little value. The cultural food practices led to common sharing, whereas interaction with CHWs was minimal for nutrition counselling. Qualitative findings also indicate CHWs related programmatic constraints of low motivation, multi-tasking, inadequate counselling skills and weak supervision. Conclusion: We conclude that the community acceptability of food supplements does not translate into optimal consumption. Hence a greater emphasis is needed on context specific demand creation and focusing on the supply side constraints with improved logistical planning, enhanced motivation and supervision of community workers with involvement of multiple stakeholders. While, similar studies are needed in varying contexts to help frame universal guidelines.

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Section: Introductionmentioning

confidence: 99%

Food supplements to reduce stunting in Pakistan: a process evaluation of community dynamics shaping uptake

et al. 2020

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“…Consumption of four servings of dairy products (milk, yogurt and cheese) which equal to 1,200 mg calcium can increase maternal vitamin D and folate serum level and higher newborn weight and bone mineralization (Chan et al, 2006). Supplementation of small-quantity LNS (20 g per day) has important implications on birth outcomes particularly linear growth and head circumference (Dewey et al, 2019). Oral zinc supplementation for 20 mg Zn per day also has a favorable effect on pregnancy outcomes such as lower prematurity rate and proportion of LBW (Castillo-Duran et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

“…There was only one study in each study that provided vitamin D3 supplements (Best et al, 2018), iron and folate supplements (Meier, Olson and Berg, 2003) and zinc and iron supplements (Castillo-Duran et al, 2001). One study compared LNS, Iron-folic acid (IFA) and MNP supplementations (Dewey et al, 2019). One study gave an intervention in the form of a fortified orange juice diet or calcium supplements and dairy products (Chan et al, 2006).…”

Section: Nutritional Supplementationmentioning

confidence: 99%

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Nutrition intervention of pregnant adolescents: a systematic review

Diana

Rachmah

2020

NFS

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Purpose This paper aims to evaluate the effectiveness of nutrition interventions conducted in pregnant adolescents and their implications for future research. Design/methodology/approach The papers in this systematic study were searched through PubMed, PMC, the Cochrane Library (Trial), ScienceDirect and Google Scholar that were published from 2000 to 2019. An experimental study using a randomized controlled trial (RCT) or non-RCT among pregnant adolescents aged 10-19 years were inclusion criteria for this study. While exclusion criteria were studies published before 2000, non-experimental study and non-English-language studies. Findings A total of 14 studies were identified in this review. Six studies provided interventions in the form of nutrition and health education and seven studies provided interventions in the form of nutritional supplementation (calcium, vitamin D, iron-folate, lipid-based nutrient supplements and multi-micronutrient powder. One study provided dietary intervention. The interventions in pregnant adolescents in the form of education and nutritional supplementation effectively increased the knowledge and nutrition of pregnant adolescents and decreased low birth weight (LBW) and premature birth. The impact on birth outcomes was still quite diverse. Some of the studies in this review were conducted without a comparison group, a small sample size and conducted in health-care facilities. Conclusion This systematic review implies a future nutrition intervention for pregnant adolescents is needed to improve nutritional status of pregnant adolescents and birth outcome. Future research using double blind RCT method with bigger sample size and various nutritional outcome are wide open to be developed. Originality/value Interventions in pregnant adolescents effectively increased the knowledge and nutrition of pregnant adolescents and decreased LBW and premature birth. The program implementation in the community needs to be improved so that the effectiveness of the program remains optimal as in healthcare facilities.

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“…Providing packaged specialised food supplements are argued to be a low cost, rapid way to prevent under-nutrition in vulnerable groups such as pregnant-lactating women (PLW) and young children 6-59 months of age (1,2). The premise of use lies in providing a quick window of action during the critical 1000 day period from conception to two years of age to prevent stunting (3,4) as opposed to sustainable food based approaches that require longer term efforts. Specialized packaged foods comprise of different products carefully manufactured for needs of specific vulnerable groups.…”

Section: Introductionmentioning

confidence: 99%

Food supplements to reduce stunting in Pakistan: a process evaluation of community dynamics shaping uptake

Zaidi¹,

Das²,

Khan³

et al. 2019

Preprint

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Abstract BackgroundThere is an increasing interest in use of food supplements to prevent stunting, however evidence from trials remains inconclusive meriting qualitative examination of barriers and synergies for supplement use by targeted groups. We contribute evidence on factors influencing community uptake of food supplements to feed into the design of future food supplementation programs for countering stunting.MethodsA process evaluation was undertaken of a stunting prevention food supplementation pilot in rural Pakistan that distributed wheat soy blend (WSB) to pregnant & lactating women, and lipid-based nutrient supplement (LNS) and micronutrient powder (MNP) to <5 years children. We investigated community uptake applying five parameters: value, acceptability, receipt of supplement, usage by target group, correct dosage used. Mixed methods were used: survey of 800 households, 18 FGDs with male and female caregivers, 4 FGDs with community health workers (CHWs), 22 key informant interviews with district stakeholders.ResultsSurvey findings showed that proportionately few beneficiaries consumed the full dose of supplements –, despite reasonable knowledge levels amongst caregivers. Sharing of supplements with other household member was common, and full monthly stock was not received by several beneficiaries. Qualitative findings revealed caregivers did not associate food supplements with stunting reduction. WSB was well accepted as an extra ration, LNS was popular due its chocolaty taste and texture, whereas MNP sprinkles were perceived to be of little value and also mistrusted. Cultural food practices led to common sharing, whereas interaction with CHWs was minimal for nutrition counselling. Qualitative findings also indicated CHW related programmatic constraints of low motivation, multi-tasking, inadequate counselling skills and weak supervision.ConclusionWe conclude that community acceptability of food supplements does not translate into optimal consumption. Instead a greater emphasis is needed on demand creation amongst caregivers and moving from sole reliance on CHWs to a broadening of food delivery and behavioural change options.

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Nutrient supplementation during the first 1000 days and growth of infants born to pregnant adolescents

Cited by 13 publications

References 25 publications

Food supplements to reduce stunting in Pakistan: a process evaluation of community dynamics shaping uptake

Food supplements to reduce stunting in Pakistan: a process evaluation of community dynamics shaping uptake

Nutrition intervention of pregnant adolescents: a systematic review

Food supplements to reduce stunting in Pakistan: a process evaluation of community dynamics shaping uptake

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