Effectiveness of lipid-based nutrient supplementation during the first 1000 days of life for early childhood development: A community-based trial from Pakistan

Abstract

A community-based, cluster non-randomized controlled trial was conducted in Kurram district, Pakistan between January 2018 to December 2020. Age-appropriate lipid-based nutrient supplements and health education (sessions conducted in the households) were given to pregnant women and their born children (6–23 months) in the intervention arm (n = 40 clusters) versus health education only in the control arm (n = 40 clusters) to evaluate its effect on child development. The first and second developmental assessments were completed at ~24 months (n = 689) and ~32 months (n = 608), respectively, using the Caregiver-Reported Early Development Instrument Long form. The overall and domain-specific (motor, language, cognitive and socio-emotional) scores were computed with higher scores indicating better child development. Higher development scores, including overall (β = 0.40, 95% confidence interval [CI]: 0.14, 0.65; p = 0.002), cognitive (β = 0.27, 95% CI: 0.10, 0.45; p = 0.002), motor (β = 0.39, 95% CI: 0.22, 0.56; p < 0.001) and language (β = 0.33, 95% CI: 0.14, 0.51; p = 0.001) were reported for children who received the intervention compared to the control arm at first developmental assessment. However, the effect was not sustained after the discontinuation of the intervention. The LNS received by the mothers (during pregnancy and first 6 months after delivery) and by children during 6–23 months of age was beneficial for the children. The trial is registered in the International Standard Randomised Controlled Trial Number Registry (ID: ISRCTN94319790) on December 11, 2017.