Thiamine supplementation holds neurocognitive benefits for breastfed infants during the first year of life

Abstract

Women reliant on mostly rice-based diets can have inadequate thiamine intake, placing breastfed infants at risk of thiamine deficiency and, in turn, physical and cognitive impairments. We investigated the impact of maternal thiamine supplementation doses on infants' cognitive, motor, and language development across the first year. In this double-blind, four-parallel-arm, randomized controlled trial, healthy mothers of exclusively breastfed newborn infants were recruited in Kampong Thom, Cambodia. At 2 weeks postnatal, women (n = 335) were randomized to one of four treatment groups to consume one capsule/day with varying amounts of thiamine for 22 weeks: 0, 1.2, 2.4, and 10 mg. At 2, 12, 24, and 52 weeks of age, infants were assessed with the Mullen Scales of Early Learning (MSEL) and the Caregiver Reported Early Development Instrument (CREDI). Multiple regression and mixed effects modeling suggest that by 6 months of age, the highest maternal thiamine dose (10 mg/day) held significant benefits for infants' language development, but generally not for motor or visual reception development. Despite having achieved standardized scores on the MSEL that approximated U.S. norms by 6 months, infants showed a significant drop relative to these norms in both language domains following trial completion, indicating that nutritional interventions beyond 6 months may be necessary.

Thiamine deficiency in Gambian women of reproductive age

“…In this study, the thiamine breastmilk content at 2 weeks of age was highly predictive of the infant's cognitive development up to 1 year of age, when the study concluded. 51 While none of these exclusively breastfed infants showed clinical symptoms of thiamine deficiency, the breastmilk status was generally very low, as was the mother's blood thiamine status, and the study adds to the growing evidence that thiamine plays an important role in cognitive development. It also highlights the need to correct thiamine deficiency early, perhaps even preconception in WRA because of the sequestration of thiamine to the fetus, leading to higher thiamine requirements during pregnancy, and the role that thiamine plays in fetal development.…”

A fresh look at thiamine deficiency—new analyses by the global thiamine alliance

“…18 To further understand the role of thiamine in cognitive development, researchers leading a placebo-controlled, dose-response supplementation trial of lactating women in Cambodia followed the cognitive development of their breastfed infants. As described in the paper by Measelle et al, 19 infants whose mothers received the highest supplementation dose (10 mg/day) performed the highest on some cognitive assessment tests, but this advantage disappeared after supplementation ended. Interestingly, breastmilk thiamine content at 2 weeks of age, prior to the supplementation of the mothers, was highly predictive of infants' cognitive scores up to 12 months of age.…”

The associations between stunting and wasting at 12 months of age and developmental milestones delays in a cohort of Cambodian children

“…In contrast, > 50% of infants aged 6–12 months had urinary iodine concentrations regarded as deficient (< 100 µg/L), and at least 38% of infants had thiamine deficiency, using the most strict cut-off 50 , 51 . Recently, we showed a positive impact of thiamine supplementation of lactating Cambodian mothers on expressive and receptive language development of their infants at 6 months of age 52 . In children with stunting, the prevalence of iodine and thiamine deficiencies are likely to be higher, and have certainly contributed to delays in achieving motor and cognitive milestones.…”